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Understanding Perceptions of Breast Reconstruction in a Rural Population: A Qualitative Study
Cody L. Mullens; J. Andres Hernandez; Mary Ellen Conn; Stephenie Kennedy-Rea; Cristiane Ueno
West Virginia University School of Medicine
2019-01-28
Presenter: Cody L. Mullens
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting.
Director Name: Aaron C. Mason
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Introduction:
Despite the Women's Health and Cancer Rights Act (WHCRA), breast reconstruction awareness varies. Limitations in understanding of breast reconstruction is associated with age, ethnicity, socioeconomic status, education level and access to care, all of which are challenging issues in rural populations. Qualitative analysis using focus groups is an underutilized tool for obtaining patient perspectives regarding health-related issues. Our aim is to better understand patient perceptions using qualitative analysis.
Methods:
Focus groups were held in rural West Virginia aiming understand patient's perceptions, knowledge, beliefs regarding breast health and access to breast reconstruction including how to disseminate information regarding breast reconstruction. Major themes analyses were performed on the focus group transcripts, and intercoder reliability data were analyzed using NVivo software to ensure consistency in the interpretation of the findings.
Results:
Major themes analyses revealed perceived barriers related to lacking care coordination, insurance coverage and other resources, including access to care. Participants consistently discussed avoiding breast screening due to fear and denial. Few patients were aware of the WHCRA, many were concerned about lack of provider understanding of WHCRA, follow-up burden, complications and ability to care for their family after a breast cancer diagnosis. Themes related to dissemination of information included social media, referring physician education and coordination of care among providers.
Conclusion:
Rural women have unique viewpoints regarding access and perceived barriers to breast reconstruction. This study demonstrates need of improvement on education, to providers and patients, and in care coordination to increase breast reconstruction access among rural breast cancer patients.
