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Oncological Disease » Articles » Cervical cancer: a qualitative study on subjectivity, family, gender and health services
Thursday, 04 December, 2008



Cervical cancer: a qualitative study on subjectivity, family, gender and health services


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In the meantime, anxiety levels rise and women find relief in religion. Facing confirmed diagnosis, the most frequent response is denial, a stage that has been identified in studies regarding grief [24], and, in this case, it could be refered to an "anticipated pain", associated with the idea of inevitable death. Again, the role of religion is important, and within the context of socialization, provides consolation in despair. Both science and religion represent possibilities of a cure for these women.

Family

The lack of intra-family communication is clearly a problem in these families and it translates into a limited number of support networks to face situations where positive diagnosis is either suspected and/or confirmed.

The belief that cancer is exclusively the woman's responsibility probably originates in the lack of knowledge about the disease process. Women tend to believe that cervical cancer stems from their own body (not an effect of an external agent). As a result, women tend to blame themselves for the disease. These elements create psychological barriers for early detection and timely treatment.

Gender

Gender is a category on which ideas regarding masculinity and femininity are constructed. These ideas are the basis upon which women define their lives and their view of themselves, derive their obligations and develop feelings such as guilt.

In the Mexican culture, masculinity is built around ideas of toughness and aggression and is associated with work [25]. Femininity is socially defined by motherhood – as is observed with the cessation of fertility and the process of menopause, which represents a tragic event for women who have assumed maternity to be basis of their identity [26]. In the present study, this emphasis on motherhood is what justifies the abandonment by the partners of women diagnosed with cancer (see Figure 3). The map reveals men's feelings and behavior (shown with double lines) in relation to women with cervical cancer. The symptoms developed by some women do worry their male partners, who see surgery as the only possible solution. Support is sometimes expressed by accompanying women to their medical appointments. However, not all men react in the same way. For some men, a woman with cervical cancer has lost the possibility of fulfilling the social role of bearing children and this constitutes a reason strong enough to leave her. In the end, abandonment confirms the lonely existence of a woman with cervical cancer.

Another conspicuous aspect revealed in this study is the concept of the body. The body is considered to be private, yet these women are the last to govern their own body, and this lack of control prevents women from going to the doctor to be examined. In the case et hand, our subjects reported that the daughters were who advised their mothers to seek a PAP smear.

Also, the lack of ownership of her own body justifies the woman's submission when faced with the extramarital behavior of her husband or partner. Hence, to confront this behavior bears a pricetag that women are not willing to pay. Such large cultural emphasis on sexuality often forces women to assume responsibility for the couple's failure.

These beliefs, which negatively affect women's health, are not easy to overcome or transform. A common effort would be needed involving the society as a whole, given that the social context provides "...the narratives we use to talk and think about ourselves" [27]. Nevertheless, it is important to become more familiar with a health-related event such as cancer. If beliefs that surround and justify certain behaviors are recognized, preventive actions can be more effective.

Health services

From the users' point of view, public health services in Mexico are deficient because of the long waiting periods and brief consultations. This perception was confirmed in the present study. Women delay visits to the doctor because of the long waiting periods, and when they finally decide to go it is may be too late. Hence, the social, psychological and economical costs of disease rise just as Becker refers in the Health Belief Model [28].

These findings should be taken into account when planning the content of health programs which aim to modify behavior significantly.

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