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Pourquoi les femmes diffèrent-elles leur recours aux soins relativement à un cancer du sein localement avancé

Judy Gould, Barbara Fitzgerald, Karen Fergus, Mark Clemons, Fauzia Baig
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Abstract


Le cancer du sein localement avancé (CSLA) est impliqué dans 10–30 % de tous les nouveaux diagnostics de cancer du sein primaire. Pour des raisons encore mal comprises, 20–30 % des femmes atteintes du cancer du sein (quelque que soit le stade) attendent huit semaines ou plus entre le moment où elles remarquent un ou plusieurs symptôme(s) mammaire(s) et celui où elles consultent un prestataire de soins de santé. Il est essentiel de bien comprendre les mécanismes sous-tendant les comportements liés à l’autoévaluation de la santé et au recours aux soins de santé, particulièrement chez les femmes atteintes d’un CSLA. Cette étude avait pour but de mener une exploration qualitative de l’expérience cognitive, émotionnelle et contextuelle des femmes atteintes du cancer du sein localement avancé durant la période située entre la découverte d’un symptôme et le recours à des soins de santé. Des entrevues qualitatives détaillées, une analyse du contenu et une analyse globale ont révélé que les participantes retardaient leur recours aux soins parce qu’elles ne se considéraient pas à risque de développer un cancer du sein, avaient un symptôme autre qu’une masse ce qui les amenait à minimiser la gravité du symptôme ou à l’attribuer, à tort, à une autre cause parce qu’elles avaient déjà eu une tumeur bénigne et/ou parce qu’elles éprouvaient durant ce même temps des événements de la vie stressants. Ces participantes en venaient à consulter si elles avaient déjà pris rendez-vous avec un professionnel de la santé pour une autre raison, si elles jugeaient que le symptôme empirait avec le temps ou si un être cher les avait encouragées à consulter. On discute des implications de l’étude pour la promotion de la santé et l’éducation à la santé auprès des femmes ayant des antécédents de maladie bénigne du sein et auprès du grand public.


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