Open Access Research article

Care-seeking behavior of Japanese gynecological cancer survivors suffering from adverse effects

Sumiko Oshima1,2*, Kengo Kisa1, Takayoshi Terashita3, Hidenobu Kawabata1 and Masaji Maezawa1

Author Affiliations

1 Department of Healthcare Systems Research, Graduate School of Medicine, Hokkaido University, Sapporo, Japan

2 Department of Psychology and Communication, School of Humanities, Hokusei Gakuen University, 2-3-1 Oyachi-nishi, Atsubetsu-ku, Sapporo, 004-8631, Japan

3 Faculty of Health Sciences, Hokkaido University, Sapporo, Japan

For all author emails, please log on.

BMC Women's Health 2013, 13:1 doi:10.1186/1472-6874-13-1

Published: 8 January 2013

Abstract

Background

Post-treatment follow-up visits for gynecological cancer survivors should provide opportunities for management of adverse physical/psychological effects of therapy and early recurrence detection. However, the adequacy of such visits in Japan is poorly documented. We qualitatively explored care-seeking experiences of Japanese gynecological cancer survivors and deduced factors influencing care-seeking behaviors and treatment access.

Methods

We conducted 4 semi-structured focus groups comprising altogether 28 Japanese gynecological cancer survivors to collect a variety of participants’ post-treatment care-seeking behaviors through active interaction with participants. Factors influencing access to treatment for adverse effects were analyzed qualitatively.

Results

Survivors sought care through specialty clinic visits when regular post-treatment gynecological follow-ups were inadequate or when symptoms seemed to be non-treatment related. Information provided by hospital staff during initial treatment influenced patients’ understanding and response to adverse effects. Lack of knowledge and inaccurate symptom interpretation delayed help-seeking, exacerbating symptoms. Gynecologists’ attitudes during follow-ups frequently led survivors to cope with symptoms on their own. Information from mass media, Internet, and support groups helped patients understand symptoms and facilitated care seeking.

Conclusions

Post-treatment adverse effects are often untreated during follow-up visits. Awareness of possible post-treatment adverse effects is important for gynecological cancer survivors in order to obtain appropriate care if the need arises. Consultation during the follow-up visit is essential for continuity in care.

Keywords:
Health behavior; Adverse effects; Gynecological cancer; Quality of health care; Post-treatment follow-up