RESUMO
This study aims to describe the medical itineraries followed by breast cancer women affiliated to the People's Health Insurance in San Luis Potosí, central Mexico. We used an ethnographic approach based on oral histories of 12 women diagnosed with breast cancer in the year prior to the first meeting. Two face-to-face sessions per participant lasting 60 minutes each were conducted followed by a telephone interview. Content and diachronic analyses were used. Three main itineraries were identified: (1) diagnostic process, (2) final diagnosis to treatment, and (3) cancer control and relapse. Findings suggested that infrastructure and human resources to adequately screen and timely diagnose breast cancer were scant and insufficiently trained, respectively. Deferral of medical assessment was related with lack of information about breast cancer consequences, with women being afraid of a positive result, and with economic constraints. The current screening program needs to be redesigned to prevent diagnostic delays, as these seem to explain the high frequency of advanced stages reported at the time of diagnosis.
Assuntos
Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Acessibilidade aos Serviços de Saúde , Seguro Saúde , Pesquisa Qualitativa , Adulto , Neoplasias da Mama/prevenção & controle , Feminino , Humanos , México , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Recidiva Local de Neoplasia , Adulto JovemRESUMO
This study aims to describe the medical itineraries followed by breast cancer women affiliated to the People's Health Insurance in San Luis Potosí, central Mexico. We used an ethnographic approach based on oral histories of 12 women diagnosed with breast cancer in the year prior to the first meeting. Two face-to-face sessions per participant lasting 60 minutes each were conducted followed by a telephone interview. Content and diachronic analyses were used. Three main itineraries were identified: (1) diagnostic process, (2) final diagnosis to treatment, and (3) cancer control and relapse. Findings suggested that infrastructure and human resources to adequately screen and timely diagnose breast cancer were scant and insufficiently trained, respectively. Deferral of medical assessment was related with lack of information about breast cancer consequences, with women being afraid of a positive result, and with economic constraints. The current screening program needs to be redesigned to prevent diagnostic delays, as these seem to explain the high frequency of advanced stages reported at the time of diagnosis.
Describir los itinerarios de atención medicalizada seguidos por mujeres con cáncer de mama, afiliadas al Seguro Popular de Salud en San Luis Potosí, México. Se realizó un estudio cualitativo con enfoque etnográfico en el que participaron 12 mujeres. Se recolectaron historias orales, dos entrevistas cara a cara y una telefónica por participante. Se efectuó análisis de contenido y diacrónico. Tres itinerarios fueron identificados en la búsqueda de atención: (1) el proceso de diagnóstico, (2) del diagnóstico al tratamiento, y (3) el control del cáncer y la recaída. Los hallazgos sugieren que la infraestructura y los recursos humanos son escasos para obtener una detección adecuada y un diagnóstico oportuno. El aplazamiento de la valoración médica también se relaciona con la falta de información sobre las consecuencias del cáncer y el temor de las mujeres al resultado. El programa de cribado actual necesita ser rediseñado para evitar retrasos de diagnóstico, los cuales parecen explicar la alta frecuencia de estadios avanzados reportados.
Descrever as rotas seguidas para os cuidados de mulheres com câncer de mama filiadas ao Seguro Popular de Saúde em San Luís Potosí, no México. Pesquisa qualitativa realizada com abordagem etnográfica, envolvendo 12 mulheres que foram diagnosticadas. Foram conduzidas histórias narradas por duas participantes, seguidas de uma entrevista por telefone. As análises do conteúdo e diacrônica foram realizadas. Três opções foram identificadas em busca de atenção: (1) o processo de diagnóstico, (2) a partir do diagnóstico até o tratamento, e (3) controle e reincidência do câncer. Os resultados sugerem que os recursos de infraestrutura e humanos são escassos para a detecção adequada e diagnóstico oportuno. O adiamento da avaliação médica também está relacionado com a falta de informação sobre as consequências do câncer e o medo das mulheres em saber o resultado. O programa de rastreio atual precisa ser redesenhado para evitar atrasos no diagnóstico, que parecem explicar a alta frequência de estágios avançados relatados.
