Colon Cancer in Palestine: Associated risks, Perceived Causes, Patterns of Distress, and Help Seeking Behaviors

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Date
2018-07-17
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An-Najah National University
Abstract
Background: With cancer being the second leading cause of death in West Bank and colon cancer being the second common cancer, attention should be drawn to it in order to better understand all the aspects of this diseases in the Palestinian settings. Among what attention should be drawn to are colon cancer risk factors and how the illness affects the patients’ lives. Objectives: To identify the risks associated with colon cancer among Palestinian patients. To better understand the illness experience of the colon cancer patients in terms of perceived causes, patterns of distress, and help seeking behaviors. Methods and Materials: A mixed method was used to achieve the purpose of this study, in the first phase, a total of 103 cases and 116 control were conveniently selected to participate in the case control study were they were asked to fill a questionnaire consisting of 3 sections: the socio-demographics, the colon cancer section, and the food frequency section. In the second phase, a qualitative study was conducted on 20 colon cancer patients who participated in the first phase of the study; data was collected via face-to-face Explanatory Model Interview Catalogue (EMIC) interview consisting of 3 sections: perceived causes, patterns of distress, and help seeking behavior. Results of the Case-Control Phase: Analysis showed that family history of colon cancer, regular screening, personal history of cancer, diabetes, constipation, constipation duration, cooked cereals, fruits, vegetables, legumes, red meat, cold meats, fats, type of fats, and fast foods were found to be different between cases and controls but following logistic regression, family history (OR=3.543), constipation (OR=29.989), hot cereals (OR=0.557), fats (OR=1.615), and fast food (OR=1.501) were the only factors found be significantly associated with colon cancer with only hot cereals as a protective factor. Results of the Qualitative Phase: Colon cancer patients went through a variety of challenges and hardships but chemotherapy and psychological distress was the most common among the sample. Few had an answer to what was the cause of their illness and the majority reported their low level of knowledge regarding that matter. Each patient had his/her own unique journey through the illness, but all agreed that surgery was the most effective step as it alleviated their physical symptoms and gave them back their movement abilities which is what defines the general health according to those patients. Conclusion: Study had found that having a family history of colon cancer, suffering from constipation, consuming fats and fast food increase the risk of developing colon cancer while consuming hot cereals such as oatmeal works as a protective factor against colon cancer. When looking at colon cancer as an illness, patients were unaware of the possible causes for their cancer, physical and psychological pain is considered a source of distress with chemotherapy being the hardest distress of all. Contradiction was noticed when patients used fatalistic phrases while showing high level of psychological distress. As for seeking help, patients’ surgery, faith, and family support had positive impact on their wellbeing.
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