Academic Journal
Refusal of Hospital-Based Oral Cancer Treatment Driven by Health Beliefs in Pakistan: A Qualitative Study.
| Τίτλος: | Refusal of Hospital-Based Oral Cancer Treatment Driven by Health Beliefs in Pakistan: A Qualitative Study. |
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| Συγγραφείς: | Amanat MU; Department of Oral Diagnostic Sciences, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, Thailand., Sriplung H; Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand., Wichaidit W; Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand., Naorungroj S; Department of Conservative Dentistry and Research Center of Excellence for Oral Health, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, Thailand. Electronic address: supawadee.n@psu.ac.th., Kerdpon D; Department of Oral Diagnostic Sciences, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, Thailand. Electronic address: duangporn.ke@gmail.com. |
| Πηγή: | International dental journal [Int Dent J] 2026 Oct; Vol. 76 (5), pp. 109701. Date of Electronic Publication: 2026 Jun 27. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: England NLM ID: 0374714 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1875-595X (Electronic) Linking ISSN: 00206539 NLM ISO Abbreviation: Int Dent J Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2021- : London : Elsevier Original Publication: London : FDI World Dental |
| Ιατρικοί όροι (MeSH): | Treatment Refusal*/psychology , Mouth Neoplasms*/therapy , Mouth Neoplasms*/psychology , Health Knowledge, Attitudes, Practice* , Attitude to Health*, Humans ; Pakistan ; Female ; Qualitative Research ; Male ; Middle Aged ; Adult ; Interviews as Topic ; Decision Making |
| Περίληψη: | Objectives: Hospital-based treatment refusal among oral cancer (OC) patients remains poorly understood. No qualitative studies have examined this phenomenon specifically in OC. This study aimed to explore the beliefs and attitudes underlying treatment refusal among OC patients in Pakistan. Methods: We conducted a theory-informed qualitative case study guided by the Health Belief Model (HBM) using purposive criterion sampling. Semistructured interviews were conducted with eight OC patients who refused hospital-based treatment, eight family members involved in decision-making, and three oral surgeons. Interviews were audio-recorded, transcribed verbatim, translated into English, and analysed using inductive thematic analysis. Emergent themes were subsequently interpreted in relation to HBM constructs using abductive, theory-informed pattern matching. Methodological rigour was enhanced through data source triangulation and member checking. Results: From the 19 in-depth interviews, we identified seven interconnected themes underlying treatment refusal: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, cues to action, and religious beliefs. Treatment refusal was shaped by fatalistic perceptions of cancer incurability, intense fears of treatment-related harm, and substantial financial, access, and role-related constraints. Strong family influence and trust in traditional and complementary medicine further reinforced these decisions. Religious interpretations functioned bidirectionally, reinforcing acceptance of divine destiny and legitimizing nonbiomedical healing pathways, while in some cases also supporting treatment-seeking through religious doctrine. Conclusion: Refusal of hospital-based OC treatment reflects a culturally embedded decision-making process shaped by interacting sociocultural, religious, and structural factors. The findings support the applicability of the HBM in this context and inform the development of culturally responsive, communication-focused interventions in oral oncology. Clinical Relevance: Recognition of belief-driven treatment refusal can help clinicians tailor communication, address fears of treatment harm, and engage family and religious influences to improve acceptance of hospital-based OC care. (Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved.) |
| Competing Interests: | Conflict of interest The authors have no conflicts of interest relevant to this article. |
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| Contributed Indexing: | Keywords: Case study; Health Belief Model; Oral cancer; Pakistan; Treatment refusal |
| Entry Date(s): | Date Created: 20260628 Date Completed: 20260916 Latest Revision: 20260926 |
| Update Code: | 20260926 |
| PubMed Central ID: | PMC13329492 |
| DOI: | 10.1016/j.identj.2026.109701 |
| PMID: | 42365791 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1875-595X |
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| DOI: | 10.1016/j.identj.2026.109701 |