The Importance of Culturally Relevant Breast Clinic Navigation in Improving Breast Cancer Care in Africa.

Carol-Ann Benn, Cassandra P T Mbanje, Dominic Van Loggerenberg, Julie Makani
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Abstract

Objective: Cultural norms, community-specific cultural or religious beliefs, and resultant patient health-belief models are known to pose a significant but imperceptible barrier to breast cancer care. However, there is a paucity of data addressing the need for culturally relevant breast clinic navigation in the context of culturally diverse regions. Thus, this study aimed to assess the benefit of culturally similar breast clinic navigators in facilitating treatment adherence and improving overall care in patients.

Materials and methods: This study was a retrospective qualitative study. It included breast cancer patients who attended our clinic from January, 2017 to December, 2017 and whose management plan included neoadjuvant chemotherapy. These patients were assigned culturally similar breast clinic navigators who counselled them from diagnosis, to treatment, to survivorship. Additionally, navigation concerns were grouped into the following: Navigating the neighbourhood, navigating hostile hospital environments, and navigating medical consultations.

Results: Through counselling sessions and regular telephone follow-up, breast clinic navigators were able to address navigation concerns, provide support for the patient as well as inform the multidisciplinary team (MDT) on the patient's thought process and potential barriers for care. Thus, treatment plans were personalised, resulting in improved, holistic care.

Conclusion: The role of culturally relevant patient navigators within the MDT is not well-described in the current literature. However, this role is useful where a gap exists between medical professionals and patients from varied backgrounds. Thus, navigators from the same/similar backgrounds help improve the healthcare worker's understanding of the patient's thought process, ensuring good quality and holistic breast cancer care.

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文化相关的乳腺诊所导航在改善非洲乳腺癌护理中的重要性。
目的:众所周知,文化规范、社区特定的文化或宗教信仰以及由此产生的患者健康信念模式对乳腺癌护理构成了重大但不易察觉的障碍。然而,在文化多样化地区的背景下,缺乏解决与文化相关的乳腺诊所导航需求的数据。因此,本研究旨在评估文化相似的乳腺诊所导航员在促进治疗依从性和改善患者整体护理方面的益处。材料与方法:本研究为回顾性定性研究。纳入2017年1月至2017年12月在我诊所就诊,治疗方案包括新辅助化疗的乳腺癌患者。这些患者被分配到文化上相似的乳腺诊所导游员,从诊断到治疗,再到生存。此外,导航问题被分为以下几类:在邻居中导航,在敌对的医院环境中导航,以及在医疗咨询中导航。结果:通过咨询会议和定期电话随访,乳腺诊所导航员能够解决导航员关注的问题,为患者提供支持,并告知多学科团队(MDT)患者的思维过程和潜在的护理障碍。因此,治疗计划是个性化的,从而改善了整体护理。结论:在MDT中,文化相关患者导航员的作用在目前的文献中没有得到很好的描述。但是,在医疗专业人员和来自不同背景的患者之间存在差距的情况下,这一作用是有用的。因此,具有相同/相似背景的导航员有助于提高医护人员对患者思维过程的理解,从而确保高质量和全面的乳腺癌护理。
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