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Experiences and perceptions about undergoing mammographic screening: a qualitative study involving women from a county in Sweden
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. (LIVSSTIL)ORCID iD: 0000-0002-4629-7781
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Natl Board Hlth & Welf, Evaluat & Anal Unit, Stockholm, Sweden..ORCID iD: 0000-0001-9059-599X
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. (SAMPRODUKTION)ORCID iD: 0000-0002-3787-1040
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. (CAREH)ORCID iD: 0000-0002-3307-6779
2018 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 13, no 1, article id 1521256Article in journal (Refereed) Published
Abstract [en]

Purpose:An organized population-based mammographic screening programme aims for an early detection of potential breast abnormalities so that treatment can commence. Continuous participation and a high attendance rate are vital for an effective programme. It is important to understand the underlying reasons for participation in mammographic screening, should there be factors that are amendable within reason and could be adjusted. Therefore, the invited women are valuable sources of information. This study aimed at describing the experiences and perceptions about mammographic screening of women from three municipalities in a Swedish county.Method:Six semi-structured focus-group discussions, each with four to five participants, were held. Content analysis was then conducted.Results:The screening procedure, such as staff professionalism, was covered. Other people's opinions and the woman's own understanding affected the women's decisions on whether or not to undergo the procedure. Structural conditions, such as travel time and financial issues, were sources of concern. However, the offer to perform mammographic screening was perceived with gratitude.Conclusions:Structural conditions, risk and time perceptions, the screening procedure, attitudes towards undergoing it and appreciation of its benefit may influence the women's continuous willingness to be screened, which in turn may affect public and individual health.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD , 2018. Vol. 13, no 1, article id 1521256
Keywords [en]
Experiences, focus groups, mammographic screening, participation, perceptions, public health, qualitative study
National Category
Health Sciences Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:mdh:diva-41008DOI: 10.1080/17482631.2018.1521256ISI: 000444566400001PubMedID: 30215571Scopus ID: 2-s2.0-85053259288OAI: oai:DiVA.org:mdh-41008DiVA, id: diva2:1251398
Available from: 2018-09-27 Created: 2018-09-27 Last updated: 2020-11-12Bibliographically approved
In thesis
1. Access to and participation in mammographic screening within a region in Sweden
Open this publication in new window or tab >>Access to and participation in mammographic screening within a region in Sweden
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The population-based mammographic screening programme offers every woman in Sweden between 40 and 74 years of age a mammogram with the purpose of early detection of potential breast cancer. The programme is seemingly equal in its setup; however, approximately 20 percent of the women do not participate in the screening. The overall aim of Sweden’s public health policy is to create prerequisites for good and equal health, and health care, a health determinant, falls under the responsibility of the self-governed Regions. Therefore, it is important to analyse regional participation in mammographic screening to develop strategies to reach those who refrain from screening.

The aim of the doctoral dissertation was to describe, explore and understand access to and participation in health care using mammographic screening as an example. Study I was a quantitative cross-sectional study based on individual and aggregated data. The analysis consisted of frequencies of data, multivariate logistic regressions, and pairwise chi-square tests. Study II used group discussions with women participating in mammographic screening for data collection. In Study III, women who had not participated in mammographic screening for at least the last two invitational rounds were interviewed. In Study IV, interviews with regional politicians were conducted. The method of analysis for Studies II and III was qualitative content analysis, and in Study IV a reflexive thematic analysis was performed.

The results show that access to and participation in mammographic screening involve both structural and individual conditions. Municipality of residency as a potential proxy for distance to the mammographic facility is indicated to impact participation, as is age. Getting to and from the facility and taking time off from work are examples of structural conditions. Facilitators for and barriers to participation in mammographic screening are similar for women who participate and women who lately have not. The phases of the screening process are addressed. Psychological preparation before the visit, encounters with the staff, and managing the wait for the results reflect individual determinants. Caring for health is perceived as a shared commitment between politicians and individuals. This responsibility requires information and understanding of the impact social determinants have on the decision to participate in the screening. It also requires resources for the lowering of thresholds for participation.

Encounters with the health care system and the health care systems responsiveness are important for continuous participation in mammographic screening, whereas information and knowledge are pivotal to making well-informed decisions.

Place, publisher, year, edition, pages
Västerås: Mälardalen University, 2020
Series
Mälardalen University Press Dissertations, ISSN 1651-4238 ; 323
Keywords
Access, experiences, mammographic screening, participation, perceptions, public health, qualitative content analysis
National Category
Health Sciences
Research subject
Public Health Sciences
Identifiers
urn:nbn:se:mdh:diva-51561 (URN)978-91-7485-486-2 (ISBN)
Public defence
2020-12-18, Delta +(Online Zoom), Mälardalens högskola, Västerås, 09:00 (English)
Opponent
Supervisors
Available from: 2020-10-19 Created: 2020-10-19 Last updated: 2020-12-17Bibliographically approved

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Norfjord van Zyl, MariaAkhavan, ShararehTillgren, PerAsp, Margareta

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