title: Psychosocial and cultural reasons for delay in seeking help and nonadherence to treatment in Indonesian women with breast cancer: a qualitative study.
abstract: OBJECTIVE
  The aim of this study was to explore reasons for delay in seeking medical help and nonadherence to treatment in Indonesian women with breast cancer.
  
  
  METHODS
  Semistructured interviews were conducted by purposive sampling, using a consecutive sample of 50 breast cancer patients who were treated at the Outpatient Surgical Oncology Clinic of Hasan Sadikin Hospital in Bandung, Indonesia. Interviews were recorded, transcribed verbatim, and coded using qualitative software. Codes were merged into main themes that were subsequently mapped onto the study's aim.
  
  
  RESULTS
  Eight main themes concerning reasons for delay in seeking medical help and treatment nonadherence emerged, namely: lack of awareness and knowledge, cancer beliefs, treatment beliefs, financial problems, emotional burden, severe side effects, paternalistic style of communication, and unmet information needs.
  
  
  CONCLUSIONS
  This study has identified several modifiable psychosocial and cultural factors related to delay in seeking help and nonadherence to treatment in breast cancer patients. We suggest that the provision of extensive information through media campaigns, treatment decision aids, and caregiver and patient education are needed to change the illness behaviors of Indonesian breast cancer patients.
authors: Department of Medical Psychology and Psychotherapy, Erasmus MC University Medical Centre.
authors: Aulia
authors: A
authors: Iskandarsyah
authors: Department of Medical Psychology and Psychotherapy, Erasmus MC University Medical Centre.
authors: Cora
authors: C
authors: de Klerk
authors: Department of Surgical Oncology, Hasan Sadikin Hospital.
authors: Dradjat R
authors: DR
authors: Suardi
authors: Department of Surgical Oncology, Hasan Sadikin Hospital.
authors: Monty P
authors: MP
authors: Soemitro
authors: Department of Clinical Psychology, Padjadjaran University.
authors: Sawitri S
authors: SS
authors: Sadarjoen
authors: Department of Medical Psychology and Psychotherapy, Erasmus MC University Medical Centre.
authors: Jan
authors: J
authors: Passchier
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology / Q000628:therapy*; D003142:Communication; D054626:Consumer Health Information; D003466:Cultural Characteristics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D007214:Indonesia; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology*; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012959:Socioeconomic Factors; D061665:Time-to-Treatment / Q000706:statistics & numerical data*