https://www.mdu.se/

mdu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Non-participation in mammographic screening – experiences of women from a region 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.ORCID iD: 0000-0001-9059-599X
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. (LIVSSTIL)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
2020 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 20, no 1, article id 219Article in journal (Refereed) Published
Abstract [en]

Understanding women’s life conditions regarding their non-participation in different health-promoting and disease-preventing activities is important as it may draw attention to potential areas for improvement in the healthcare sector. Mammographic screening, a disease-preventing service, facilitates early detection of any potential malignancies and consequently prompts initiation of treatment. The reasons for non-participation in mammographic screening can be understood from different perspectives, such as socioeconomic and lifestyle-related determinants of health. This study aims to gain a deeper understanding of women’s experiences and perceptions about non-participation in mammographic screening in a Swedish region with a single mammographic facility.

Methods

Data from individual semi-structured interviews, conducted in 2018 with eleven women between the ages of 48 and 73, were analysed by a qualitative content analysis.

Results

The findings reveal three main categories: 1) doubts regarding mammographic screening and its organisation, 2) sense and sensibility in the decision to refrain from mammographic screening, and 3) dependency and options. These three categories indicate aspects, such as the individual’s life situation, accessibility to the offered service, and the flexibility of the healthcare system, that need to be considered to improve the organisation of mammographic screening.

Conclusion

Listening to the women’s voices regarding their experiences and perceptions about mammographic screening is important as individual characteristics and social circumstances interact with healthcare and affect the degree of participation.

Place, publisher, year, edition, pages
London: BMC , 2020. Vol. 20, no 1, article id 219
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-47047DOI: 10.1186/s12889-020-8306-8ISI: 000514661700005PubMedID: 32050943Scopus ID: 2-s2.0-85079334677OAI: oai:DiVA.org:mdh-47047DiVA, id: diva2:1393634
Available from: 2020-02-17 Created: 2020-02-17 Last updated: 2023-08-28Bibliographically 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

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMedScopus

Authority records

Norfjord van Zyl, MariaAkhavan, ShararehTillgren, PerAsp, Margareta

Search in DiVA

By author/editor
Norfjord van Zyl, MariaAkhavan, ShararehTillgren, PerAsp, Margareta
By organisation
Health and Welfare
In the same journal
BMC Public Health
Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 127 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf