Factors that influence mammography screening behaviour: A qualitative study of Greek women's experiences

https://doi.org/10.1016/j.ejon.2012.08.001Get rights and content

Abstract

Aim

To identify the factors that influence mammography screening behaviour in a sample of Greek women.

Methods/Sample

Data were collected in Athens-Greece, from individuals who were members of six women's associations. A subset of 33 women were interviewed about their screening behaviour and experiences out of the 186 women who completed an initial questionnaire. This paper focuses on the findings revealed from the interviews. Women's associations were approached for the recruitment of the interviewees.

Results

Influences arising from women's immediate networks, such as family and close friends, appeared to be of essential importance in relation to their screening behaviour, while influences from their broader networks were of moderate impact. Fear acted as a motivator but also as a barrier in relation to mammography screening participation. Experiences that arose from engagement with the mammography screening processes were mostly characterized by having to overcome a variety of obstacles, such as long bureaucratic procedures and distrust in doctors.

Conclusions

The interpersonal relationships between women and their social networks appeared to have an important and influential role in relation to breast screening behaviour. The quality of these relationships appeared to determine women's participation in mammography screening. It would appear that future practice needs to focus on these relationships in order to utilize them in a positive way. Future research is needed to explore this further.

Section snippets

Background

Breast cancer is the third largest cause of cancer deaths in Europe (Ferlay et al., 2007). It accounts for 29% of all cancer incidences (Linos, 2005; Ioannidou-Mousaka, 2006).

Early detection of breast cancer can decrease mortality rates. Indeed mortality resulting from breast cancer has decreased by an average of 1.7% per year in the European Union during the period 1995 to 2000, mainly due to early diagnosis and effective treatment (Levi et al., 2007). However, despite the general decrease of

Design

The study was conducted in Athens (Greece), using questionnaires and interviews as data collection tools. Prior to the interviews a survey was conducted in order to recruit the sample for the interviews and to provide descriptive information about the sample. For the analysis of the interviews, a qualitative, interpretative approach was adopted.

The TTM was utilized to guide and influence the formation of the interviews. Questions on women's breast screening behaviour stage were used, influenced

Results

In this paper, the findings revealed from the interviews are presented. Findings from the analysis of the questionnaires have been presented elsewhere (Kaltsa et al., 2012).

Table 1 presents the demographic characteristics of the interviewees. The majority of the interviewees belonged to the age groups 40–49 and 50–59. Most of them were married, having an advanced level of education. Six women out of the total 33 had a history of breast cancer in their family, while one of them had been treated

Discussion

The nature of interaction that occurs in women's lives was identified as very influential in relation to subsequent breast screening behaviour; possibly more influential than anticipated. The interaction women had with their immediate social networks, such as family, close friends and school, appeared to have more influence on their screening behaviour, compared to the influence arising from their interaction with their broader networks. Such influences impacted on women's beliefs, perceptions,

Conclusions

Influences arising from the interviewees' interactions with their social networks appeared to be of essential importance in relation to their mammography screening behaviour. This study provides insight on the direction and level of such influences. The influence arising from women's broader networks ranged from moderate to low, while influences that arose from their immediate networks seemed to be of fundamental importance. It was the quality of interactions between women and their social

Conflict of interest

No Conflict of Interest.

References (77)

  • F. Levi et al.

    Continuing declines in cancer mortality in the European Union

    Annals of Oncology

    (2007)
  • L. Suarez et al.

    Social networks and cancer screening in four U.S. Hispanic groups

    American Journal of Preventive Medicine

    (2000)
  • A. Surbone et al.

    Evolution of truth-telling attitudes and practices in Italy

    Critical Reviews in Oncology/Hematology

    (2004)
  • S. Tejeda et al.

    Barriers and facilitators related to mammography use among lower educated Mexican women in the USA

    Social Science and Medicine

    (2009)
  • M.D. Alicke et al.

    Personal contact, individuation, and the better-than-average effect

    Journal of Personality and Social Psychology

    (1995)
  • J.D. Allen et al.

    Intention to have a mammogram in the future among women who have underused mammography in the past

    Health Education and Behavior

    (1998)
  • P. Autier et al.

    Disparities in breast cancer mortality trends between 30 European countries: retrospective trend analysis of WHO mortality database

    British Medicine Journal

    (2010)
  • G. Borgias et al.

    Breast cancer stage 1 in Southwestern Greece: ten-year results, concerns and prospects

    Journal of Greek Medicine

    (1998)
  • J.M. Borras et al.

    Educational level, voluntary private health insurance and opportunistic cancer screening among women in Catalonia (Spain)

    European Journal of Cancer Prevention

    (1999)
  • P.R. Brown

    Trusting in the New NHS: instrumental versus communicative action

    Sociology of Health & Illness

    (2008)
  • E. Chamot et al.

    Misconceptions about efficacy of mammography screening: a public health dilemma

    Journal of Epidemiology and Community Health

    (2001)
  • V.A. Clarke et al.

    Unrealistic optimism and the Health Belief Model

    Journal of Behavioral Medicine

    (2000)
  • S. Cohen et al.

    Social Support and Health

    (1985)
  • M. Conner

    Health Behaviours

    (2002)
  • J.W. Creswell et al.

    Designing and Conducting Mixed Methods Research

    (2011)
  • J.A. Dacey et al.

    The relationship between social network characteristics and breast cancer screening practices among employed women

    Annals of Behavioral Medicine

    (1999)
  • C. Dimitrakaki et al.

    Use of cancer screening services in Greece and associated social factors: results from the nation-wide Hellas Health I survey

    European Journal of Cancer Prevention

    (2009)
  • G. Domenighetti et al.

    Women's perception of the benefits of mammography screening population- based survey in four countries

    International Journal of Epidemiology

    (2003)
  • Giakimoba, B., Roussos, G., Bombas, A., Batalis, K., Abakian, I., Rapti, S., et al., 2003. Analysis of Epidemiological...
  • C. Gilligan

    In a Different Voice: Psychological Theory and Women's Development

    (1982)
  • B.G. Glaser et al.

    The Discovery of Grounded Theory

    (1967)
  • P.C. Gotzsche et al.

    Breast screening:the facts or may be not

    British Medicine Journal

    (2009)
  • I. Heath

    Life and Death. It is not wrong to say no

    British Medical Journal

    (2009)
  • K. Hoffken

    The European experience

    Journal of Clinical Oncology

    (2001)
  • I. Holloway

    Qualitative Research in Health Care

    (2005)
  • B.A. Husaini et al.

    Predictors of breast cancer screening in a panel study of African American women

    Women's Health

    (2001)
  • L. Ioannidou-Mousaka

    Introduction

    Journal of the Hellinic Mastological Society

    (2005)
  • L. Ioannidou-Mousaka

    Introduction

    Journal of the Hellinic Mastological Society

    (2006)
  • Cited by (17)

    • Practice theoretical approach on the reasons why target group women refrain from taking breast cancer screening

      2021, Patient Education and Counseling
      Citation Excerpt :

      A Swedish study claimed there are two categories of reasons why women may refrain from BCS – i.e. individual needs, which do not adapt to the mammography screening process, and the absence of active promotion [11]. Women’s immediate networks (e.g. family and close friends) are important and influential in determining whether a woman participates in BCS or not [12]. Although the reasons women refrain from BCS have been widely investigated globally, the issue needs re-examination due to changing environments and technical opportunities.

    • Why do women refrain from mammography screening?

      2018, Radiography
      Citation Excerpt :

      Perceived benefits of mammography14 and knowledge about breast cancer15 have been found to be factors with a positive effect on attendance. Previous experience16,18 or immediate networks, consisting of women's family, school, and close friends,19–21 appeared to have strong influence on breast screening behaviour. The use of patient reminders and navigators has led to a higher participation rate.22,23

    • Determinants of participation in a cardiometabolic health check among underserved groups

      2016, Preventive Medicine Reports
      Citation Excerpt :

      This barrier may, thus, have been a potential barrier imagined to be applicable to others in the same situation. On the other hand, these participants may have participated despite of their anxiety so that in case of a high-risk test result, they would at least know that they would experience the benefits of early diagnosis (Kaltsa et al., 2013; Hennelly et al., 2014). Indeed, a large majority of these HRA completers expressed their most important facilitator to be obtaining insight into risks.

    • Client-practitioner interactions within breast care services

      2022, Digital Mammography: A Holistic Approach
    View all citing articles on Scopus
    1

    Current Address: Ag. Sofia Children's University Hospital, Thivon & Papadiamantopoulou, 115 27 Goudi, Athens, Greece.

    2

    Current address: Centre for Integrated Healthcare Research, School of Nursing, Midwifery, and Social Care, Edinburgh Napier University, EH11 4BN Edinburgh, Scotland, UK.

    3

    Current address: Cancer and Palliative Care, University of Nottingham, NG7 2RD Nottingham, UK.

    View full text