Thursday, 31 August 2017

FACTORS INFLUENCING PROSTATE CANCER SCREENING AND TREATMENT DECISION AMONG NIGERIAN MALES

Abstract
Introduction
            Cancer of the prostate is a major contributor to morbidity, mortality on men of African descent. Multiplicities of factors are influence men’s decision to present themselves for screening and treatment services. Inequities in the utilization of prostate cancer screening and treatment aligns with such variables as income, age, language, cost, knowledge, transport, fear, embarrassment, worry, pain, and social factors such as lack of trust of personnel, unfriendly staff, and time. The purpose of this study was to understand the factors that influence decision by males to undergo prostate cancer screening and by extension treatment in Nigerian men.
Method
            The study involved the use of qualitative data administered as interviewer guided survey questionnaire to one hundred and thirty-one (131) men attending the Out-patient Clinic of UNTH, Ituku/Ozalla, Enugu. Descriptive statistics were used to analyze the demographic variables, and independent t-test to determine the level of significance of the personal, social, economic and health-facility related factors on men’s decision to undergo prostate cancer screening and treatment services. Analysis was done using SPSS 16 stats transfer, to ascertain frequencies, mean, standard deviation, and p-values.
Results
            The study revealed that a good percentage of men attending the clinic, 35% were aged 65-69, married (92.9%), attained primary education (39.4%), engaged in various forms of trade (36.2%) and are Christians (100%). Personal factors that influence their prostate cancer screening and treatment decision were: Afraid that I might be told I have prostate cancer, I feel embarrassed to expose my private parts to other persons for examination, prostate cancer is not common in African men, I don’t have the heart to withstand prostate cancer screening, Going for prostate cancer screening will lower my image as a man, not of prostate cancer screening, whether one screens or not, one will surely die, belief that it is better not to know ones prostate cancer status. The health-facility related factors include facility being very far from their homes, difficulty accessing healthcare service in the hospitals, not having enough strength to move around the hospital because the places of care are far away from each other, poor attitude of healthcare providers and favouritism. For the social factors, the following were found to be significant inability to get permission from their place of work, prostate cancer screening takes time, the National Health Insurance Scheme (NHIS) not covering prostate cancer screening, and prostate cancer screening taking much time. The economic factors include inability to afford cost of screening and screening taking time that would have been used to fend for family.
Conclusion
            This study found that personal, social, economic and health-facility-related factors combine to influence men’s decision to access prostate cancer screening and treatment services. An understanding of these roles played by these factors in men’s decision to avail themselves of  prostate cancer screening and treatment services may provide healthcare professionals with the information they need to develop and implement interventions/strategies to address these factors with intent to increase prostate cancer screening and early treatment which will lead to decrease in morbidity and mortality and increase in survivorship.
Recommendations
Based on the findings, the researcher recommended among other things that healthcare providers especially general practitioners need to do their part in promoting prostate cancer screening by disseminate information that focus on educating men about prostate cancer risks, prevention and early detection to enhance uptake of screening practices.


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