title: Care-seeking behavior of Japanese gynecological cancer survivors suffering from adverse effects.
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.
authors.affiliation: Department of Healthcare Systems Research, Graduate School of Medicine, Hokkaido University, Sapporo, Japan. oshima@hokusei.ac.jp
authors.forename: Sumiko
authors.initials: S
authors.lastname: Oshima
authors.forename: Kengo
authors.initials: K
authors.lastname: Kisa
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Terashita
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Kawabata
authors.forename: Masaji
authors.initials: M
authors.lastname: Maezawa
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D017144:Focus Groups; D005500:Follow-Up Studies; D005833:Genital Neoplasms, Female / Q000523:psychology* / Q000628:therapy*; D015438:Health Behavior; D006801:Humans; D057226:Information Seeking Behavior; D007564:Japan; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D016387:Women's Health