Symptomatic Care Issues

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symptomatic care, self-management support for treatment side effects and supportive care (i.e. providing women with a telephone number to contact health professionals in case of concerns outside the clinic). It is worth noting that women with breast cancer may also receive care from more local health facilities if they experience any treatment side effects.
Breast cancer care at oncology clinics in Ghana is provided by a team of healthcare professionals (Aziato and Clegg-Lamptey, 2015). This team (usually comprised by a surgeon, pathologist, oncologist and nurses) works together and undertakes case discussions, shares perspectives on clinical issues facing patients and contributes to treatment decision-making. At Komfo Anokye Teaching Hospital
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On the other hand, the limited number of oncological services in the whole of the country means these healthcare professionals have a heavy workload, which may limit their ability to explore the concerns and values of patients sufficiently. Furthermore, due to the limited numbers of specialist oncological staff in Ghana, including surgeons, oncologists and other allied health professionals with specialist oncology training (Center et al., 2011), healthcare professionals with only generalist training take on roles within oncology. Generalist healthcare professionals may not have adequate knowledge and skills in oncology, which may impact on the quality of care and support patients receive for effective treatment decision-making.
Overall, the contextual factors described above indicate that uptake of breast cancer treatment may be influenced by many issues in Ghana. As healthcare providers involved in the care continuum, there is a need to understand these factors.
2. Literature review on factors influencing breast cancer treatment uptake in women diagnosed with the disease in
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Primary research papers concerning factors that influence decisions by women in Africa diagnosed with breast cancer on whether to start or continue treatment were considered. A narrative review is a narrative summary of primary studies, which critically analyses, explains and draws conclusions on a particular topic or question (Chronin et al., 2008). While this approach has been criticised for being less comprehensive than systematic reviews, it is nonetheless flexible, allowing for different types of evidence to be reviewed (Mays, 2005). As such, a narrative review tends to be suitable for providing a comprehensive background and understanding of current knowledge on an area of research (Chronin et al., 2008). Furthermore, a narrative approach is also suitable for highlighting the significance of new research (Chronin et al., 2008).
2.1.1 Search strategy
This review sought to identify, critically appraise and summarise primary studies on factors influencing breast cancer treatment uptake to address the review’s question:
1. What are the factors influencing breast cancer treatment uptake (decision to start or continue treatment) among women diagnosed with the disease (all stages) in

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