Behavioural Sciences and Ethics

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    Facilitators and barriers to decision-making for hospital treatment among patients diagnosed with breast cancer in Dar es Salaam, Tanzania: a qualitative urban-based study
    (PLOS, 2024-11-07) Dominic, Pascal M.
    Background Breast cancer is a major public health problem in both developed and developing countries and has become the second leading cause of death among women worldwide. The mortality may be related to delayed or inappropriate treatment decision-making among the diagnosed patients. Decision-making is an important determinant for successful treatment for patients diagnosed with breast cancer. In Tanzania, there is a lack of information in the context of facilitators and barriers to treatment decision-making after a breast cancer diagnosis. This study aimed to explore facilitators and barriers to treatment decision-making among cancer patients in Tanzania. Material and methods A descriptive qualitative design was employed to explore the facilitators and barriers to treatment decision-making at Ocean Road Cancer Institute in Dar es Salaam. A purposive sampling technique was used to recruit fourteen female patients diagnosed with breast cancer. Data were collected through in-depth, semi-structured interviews, which were audio-recorded. A thematic approach was used to analyze the data. Findings Two major themes emerged from the study findings, namely; facilitators to treatment decision-making such as patient understanding of treatment information, and healthcare providers’ support. Barriers to treatment decision-making include the cost of treatment, uncertainty about cancer treatment, and religious healing. Conclusion This study found that practising decision‐making for hospital treatment remains a challenge for patients diagnosed with breast cancer. Patients’ understanding of treatment information and healthcare providers’ support are the main tools that can facilitate decision-making. Sensitization activities on breast cancer treatment in the community and coverage of insurance should be advocated to promote decision-making for hospital treatment.
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    Prevalence and factors associated with mental distress among caregivers of children with mental illness attending child and adolescent clinic at Muhimbili National Hospital, Dar Es Salaam
    (East African Scholars Journal of Psychology and Behavioural Sciences, 2023-03-09) Ahmed, Nadia A.
    Background: Caregivers play an exceptionally important role in the lives of those they provide care for as well as to the healthcare system. The burden of caring for children with mental illness (CWMI) often falls on their caregivers, especially the mothers. Caregivers of CWMI experience significant challenges and are at an increased risk of experiencing mental distress than the general population. Resilience, emotion regulation, and social support are identified as protective factors against mental distress among caregivers. Objective: To determine the prevalence and factors associated with mental distress among caregivers of CWMI attending the child and adolescent mental health clinic at Muhimbili National Hospital (MNH) in Tanzania. Methodology: Hospital-based descriptive cross-sectional study was conducted at MNH Dar es Salaam, Tanzania. A purposive and convenient sample of 120 caregivers of CWMI attending the child and adolescent mental health clinic at MNH were recruited in the study. Interviewer-administered paperless questionnaire consisting of a socio- demographic questionnaire, self-reporting questionnaire (SRQ), 10-item Connor- Davidson Resilience Scale (CD-RISC), Emotion Regulation Questionnaire (ERQ), and Multidimensional Scale of Perceived Social Support (MSPSS) were used to collect data. Data were analyzed using SPSS version 28.0.1.1, where descriptive, bivariate and multivariate analyses were conducted. Results: Among the 120 caregivers studied, 97 (80.8%) were female, and 43 (35.8%) were aged between 35 – 44 years. Among the 120 participants 27 (22.5%) had mental distress, 35 (29.2%) had low resilience, 22 (81.7%) had low cognitive reappraisal, 27 (47.5%) had high expressive suppression, and 5% (6) had low perceived social support. All variables with a p-value of < 0.20 in the bivariate analysis were entered into the multivariate analysis model, where the independent risk of mental distress was four times higher amongst those living out of Dar es Salaam (AOR = 4.41; 95% CI 1.05-18.48; p=0.04); and four times higher amongst those with low resilience (AOR = 3.5, CI = 1.02 – 10.77; p=0.05). Conclusion: This study observed a less than twenty five percent prevalence of mental distress among caregivers of CWMI attending the child and adolescent mental health clinic at MNH, which was lower than that of other studies. Area of residence was significantly associated with mental distress while resilience was found to have a borderline association. Recommendation: Screening and early evidence- based psychosocial interventions directed towards caregivers of CWMI is required. Research to explore the effectiveness of evidenced- based interventions and further cross-sectional and longitudinal studies exploring psychosocial factors associated with mental distress among caregivers should is necessary. Keywords: Caregiver, Mental Distress, Children, Mental Illness, Resilience, Emotion Regulation, Perceived Social Support