Abstract

Background
Breast cancer is a global health problem affecting people worldwide. Breast cancer is a treatable disease, yet, it has taken many lives in countries like Nigeria. Nigeria has rated the country with the highest breast cancer mortality in Africa, calling for great attention. To effectively address and make a health care decision, the treatment experiences of breast cancer patients and the knowledge of the social and cultural context are essential as factors like sociocultural influence treatment and healing practices.
Aim
This study explored breast cancer patients' treatment experiences and investigated the impact of sociocultural factors as mediators of effects of breast cancer treatment outcomes in Oyo (Ibadan) and Lagos state (both in Nigeria).
Methods
A mixed-method design involving a systematic review, qualitative and quantitative research approach was adopted in this study. Data for the systematic review was obtained through a systematic literature search on CINAHL, PubMed Central and Discover databases. Articles that met the inclusion criteria were included in the study. The qualitative data was collected using face to face interviews, while the quantitative data was collected via questionnaire. Participants in the study were breast cancer patients from selected hospitals in the study areas. The systematic review was conducted to create a holistic picture of the already known. Sociocultural factors that impact breast cancer management in West Africa and identify the current gap in the literature that needs to be filled. The qualitative study was conducted, and its findings iteratively inform the quantitative data collection instrument. Data analysis for the systematic review was done using narrative synthesis. The qualitative and quantitative data were analysed using thematic and statistical analysis. A mediation analysis was conducted using a multiple regression model to investigate the impact of sociocultural factors as mediators of treatment outcome,
Results
The findings of this study provided evidence of the treatment experiences of breast cancer patients in Nigeria. In addition, the study identified sociocultural factors (cultural and religious beliefs, alternative treatment, family and societal support, body image and gender role) that impact breast cancer treatment. In the bivariate regression model, religion and family support showed a statistically significant association with the health-seeking behaviours of participants. Also, culture, alternative treatment and breast cancer stages were statically significant when regressed on quality of life. In the multivariate regression model, religion remained statistically significant in the health-seeking behaviour while alternative treatment and breast cancer stage at diagnosis remained statistically significant on quality of life. The findings also establish evidence on the effects of religion, stage of breast cancer at diagnosis, and alternative factors that mediate treatment outcomes of breast cancer in Ibadan and Lagos State, Nigeria.
Conclusion
There is a need to replicate this study in other parts of Nigeria to effectively address the impact of sociocultural factors on breast cancer treatment and outcomes in Nigeria. Nevertheless, the findings will build on this evidence and support the Nigerian Health Ministry in establishing a national policy for positive breast cancer treatment outcomes in Nigeria.