Psychological Distress And Health-seeking Behaviour Among Patients With Orofacial Tumour: Examining The Roles Of Spirituality, Health Belief And Stigmatization.

The level of psychological distress and health-seeking behaviour (HSB) among patients with orofacial tumours (OFT) were assessed using explanatory sequential mixed methods designed in a two-component study. A sample of 272 comprising 143 patients with OFT and 129 patients with general periodontal diseases who served as a comparison group aged between 18 and 83 years were purposively selected from the Oral and Maxillofacial Units of the Korle-Bu Teaching hospital, 37 Military hospital and the Ridge hospital in Accra. Study one was a cross-sectional quantitative study with data collected via self-administered structured questionnaires. Study two was a qualitative study using a sample of 20 patients drawn from the original sample used in study one, with data collected through in-depth interviews to further explore HSB among patients. The results of Study one using regression analyses indicated that the type of condition, patients‘ perceptions of body image and stigmatization significantly predicted psychological distress among patients. The result also showed that the level of psychological distress among patients with OFT was significantly higher than that of the patients with periodontal diseases. Additionally, spirituality and perception of stigmatization were found to be the most significant predictors of HSB. The results showed a significant positive relationship between perception of stigmatization and health-seeking behaviour. Mediation analyses were done with the process procedures for SPSS (2.12.3) by Hayes (2013) and the result indicated that spirituality mediated the effect of the condition and health-seeking behaviour. Results from moderation analyses also indicated that spirituality and stigmatization moderated the type of condition and levels of psychological distress among patients. The findings from study 2 revealed five themes including conceptualization of cause of the condition, physical trauma, self-stigmatization and spiritual coping. In sum, spirituality emerged as one of the key determinants of health-seeking behaviour and also a major coping tool for the patients. This study provides knowledge about the role of spirituality as an additional factor to what has been provided in the health belief model as predictor of HSB. The study proffers a number of recommendations for the improvement of healthcare for patients with OFT in Ghana.