1
|
Hoare S, Thomas GPA, Powell A, Armstrong N, Mant J, Burt J. Why do people choose not to take part in screening? Qualitative interview study of atrial fibrillation screening nonparticipation. Health Expect 2023; 26:2216-2227. [PMID: 37452480 PMCID: PMC10632648 DOI: 10.1111/hex.13819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/30/2023] [Accepted: 07/01/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION While screening uptake is variable, many individuals feel they 'ought' to participate in screening programmes to aid the detection of conditions amenable to early treatment. Those not taking part in screening are often presented as either hindered by practical or social barriers or personally at fault. Why some people choose not to participate receives less consideration. METHODS We explored screening nonparticipation by examining the accounts of participants who chose not to participate in screening offered by a national research trial of atrial fibrillation (AF) screening in England (SAFER: Screening for Atrial Fibrillation with ECG to Reduce stroke). AF is a heart arrhythmia that increases in prevalence with age and increases the risk of stroke. Systematic screening for AF is not a nationally adopted programme within the United Kingdom; it provides a unique opportunity to explore screening nonparticipation outside of the norms and values attached to existing population-based screening programmes. We interviewed people aged over 65 (n = 50) who declined an invitation from SAFER and analysed their accounts thematically. RESULTS Beyond practical reasons for nonparticipation, interviewees challenged the utility of identifying and managing AF earlier. Many questioned the benefits of screening at their age. The trial's presentation of the screening as research made it feel voluntary-something they could legitimately decline. CONCLUSION Nonparticipants were not resistant to engaging in health-promoting behaviours, uninformed about screening or unsupportive of its potential benefits. Instead, their consideration of the perceived necessity, legitimacy and utility of this screening shaped their decision not to take part. PATIENT OR PUBLIC CONTRIBUTION The SAFER programme is guided by four patient and carer representatives. The representatives are embedded within the team (e.g., one is a co-applicant, another sits on the programme steering committee) and by participating in regular meetings advise on all aspects of the design, management and delivery of the programme, including engaging with interpreting and disseminating the findings. For the qualitative workstream, we established a supplementary patient and public involvement group with whom we regularly consult about research design questions.
Collapse
Affiliation(s)
- Sarah Hoare
- The Healthcare Improvement Studies Institute (THIS Institute), Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - Gwilym P. A. Thomas
- The Guildhall and Barrow SurgeryBury St EdmundsUK
- Primary Care Unit, Department of Public Health and Primary CareStrangeways Research Laboratory, University of Cambridge School of Clinical MedicineUniversity of CambridgeCambridgeUK
| | - Alison Powell
- The Healthcare Improvement Studies Institute (THIS Institute), Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - Natalie Armstrong
- SAPPHIRE Research Group, Department of Population Health SciencesUniversity of LeicesterLeicesterUK
| | - Jonathan Mant
- Primary Care Unit, Department of Public Health and Primary CareStrangeways Research Laboratory, University of Cambridge School of Clinical MedicineUniversity of CambridgeCambridgeUK
| | - Jenni Burt
- The Healthcare Improvement Studies Institute (THIS Institute), Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| |
Collapse
|
2
|
Hicks A. Risky (information) business: an informational risk research agenda. JOURNAL OF DOCUMENTATION 2023. [DOI: 10.1108/jd-09-2022-0198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
PurposeThe purpose of this conceptual paper is to suggest that the growing sociocultural theorisation of risk calls for a more robust research focus on the role that information and in particular, information literacy, plays in mediating hazards and danger.Design/methodology/approachStarting by tracing how information has been conceptualised in relation to risk through technoscientific, cognitive and sociocultural lenses, the paper then focuses on emerging sociocultural understandings of risk to present a research agenda for a renewed sociocultural exploration of how risk is shaped through the enactment of information literacy.FindingsThe paper identifies and examines how information literacy shapes four key aspects of risk, including risk perception, risk management, risk-taking and “at-risk” populations. These four aspects are further connected through broader themes of learning, identity, work and power, which form the basis of the sociocultural risk research agenda.Originality/valueThis paper is the first study bringing together the many understandings related to how risk is informed and establishes risk as a key area of interest within information literacy research.
Collapse
|
3
|
Hicks A. The missing link: Towards an integrated health and information literacy research agenda. Soc Sci Med 2021; 292:114592. [PMID: 34839085 DOI: 10.1016/j.socscimed.2021.114592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/24/2021] [Accepted: 11/18/2021] [Indexed: 11/18/2022]
Abstract
Information forms one of the main commonalities shared between definitions of health literacy. However, information literacy research, which centres how people become informed within a specific setting, has been almost completely sidelined from health literacy scholarship. This oversight risks limiting understanding of how health literacy is practised as well as narrowing research discourses. It also forms a missed opportunity as the recent sociocultural turn creates a valuable point of synergy between each field. This paper carries out a narrative literature review to identify key areas where information literacy research could help to extend understanding about how people interact with information within health contexts. Centred on exploring theoretical and empirical work, the paper uses examples from literature to suggest that assumptions related to how information, models of information use, social dynamics of information environments, the outcomes of information activity and critical approaches to information practice are understood impact the scope and the reach of health literacy research and practice. The goal of this paper is to establish an initial, shared research agenda that places health and information literacy in dialogue rather than in isolation from each other.
Collapse
Affiliation(s)
- Alison Hicks
- Department of Information Studies, University College, London (UCL), Foster Court, Gower Street, London, WC1E 6BT, UK.
| |
Collapse
|
4
|
Asymmetric Power Relations in Gynaecological Consultations for Cervical Cancer Prevention: Biomedical and Gender Issues. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157850. [PMID: 34360140 PMCID: PMC8345629 DOI: 10.3390/ijerph18157850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 11/17/2022]
Abstract
A generic qualitative research, using a poststructuralist feminist perspective, was conducted in a Spanish gynaecology unit with the following aims: (a) to analyse how asymmetric power relations in relation to biomedical knowledge and gender shape the medical encounters between gynaecologists and women diagnosed with cervical intraepithelial neoplasia and (b) to explore the cognitive, moral, and emotional responses expressed by patients. A total of 21 women diagnosed with cervical intraepithelial neoplasia were recruited through purposive sampling. Semi-structured interviews were recorded and transcribed, and a thematic analysis was carried out. Two major themes were identified: (a) gendered relations in cervical intraepithelial neoplasia medical encounters are based on hidden, judgmental moral assumptions, making women feel irresponsible and blamed for contracting the human papillomavirus infection; (b) biomedical power is based on the positivist assumption of a single truth (scientific knowledge), creating asymmetric relations rendering women ignorant and infantilised. Women reacted vehemently during the interviews, revealing a nexus of cognitive, moral, and emotional reactions. In medical encounters for management of cervical intraepithelial neoplasia, patients feel they are being morally judged and given limited information, generating emotional distress. Healthcare professionals should question whether their practices are based on stereotypical gender assumptions which lead to power asymmetries during encounters.
Collapse
|
5
|
Freijomil-Vázquez C, Gastaldo D, Coronado C, Movilla-Fernández MJ. When risk becomes illness: The personal and social consequences of cervical intraepithelial neoplasia medical surveillance. PLoS One 2019; 14:e0226261. [PMID: 31841543 PMCID: PMC6913976 DOI: 10.1371/journal.pone.0226261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 11/23/2019] [Indexed: 11/19/2022] Open
Abstract
Background After the early detection of cervical intraepithelial neoplasia (CIN), medical surveillance of the precancerous lesions is carried out to control risk factors to avoid the development of cervical cancer. Objective To explore the effects of medical surveillance on the personal and social lives of women undergoing CIN follow-up and treatment. Methodology A generic qualitative study using a poststructuralist perspective of risk management was carried out in a gynecology clinic in a public hospital of the Galician Health Care System (Spain). Participants were selected through purposive sampling. The sample consisted of 21 women with a confirmed diagnosis of CIN. Semistructured interviews were recorded and transcribed, and a thematic analysis was carried out, including researcher triangulation to verify the results of the analysis. Findings Two main themes emerged from the participants’ experiences: CIN medical surveillance encounters and risk management strategies are shaped by the biomedical discourse, and the effects of “risk treatment” for patients include (a) profound changes expected of patients, (b) increased patient risk management, and (c) resistance to risk management. While doctors’ surveillance aimed to prevent the development of cervical cancer, women felt they were sick because they had to follow strict recommendations over an unspecified period of time and live with the possibility of a life-threatening disease. Clinical risk management resulted in the medicalization of women’s personal and social lives and produced great uncertainty. Conclusions This study is the first to conceptualize CIN medical surveillance as an illness experience for patients. It also problematizes the effects of preventative practices in women’s lives. Patients deal with great uncertainty, as CIN medical surveillance performed by gynecologists simultaneously trivializes the changes expected of patients and underestimates the effects of medical recommendations on patients’ personal wellbeing and social relations.
Collapse
Affiliation(s)
- Carla Freijomil-Vázquez
- Facultade de Enfermaría e Podoloxía, Universidade da Coruña, Ferrol, Spain
- Laboratorio de Investigación Cualitativa en Ciencias da Saúde (CCSS), Grupo de Investigación Cardiovascular (GRINCAR), Universidade da Coruña, Ferrol, Spain
- * E-mail:
| | - Denise Gastaldo
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
- Centre for Critical Qualitative Health Research, University of Toronto, Toronto, Canada
| | - Carmen Coronado
- Facultade de Enfermaría e Podoloxía, Universidade da Coruña, Ferrol, Spain
- Laboratorio de Investigación Cualitativa en Ciencias da Saúde (CCSS), Grupo de Investigación Cardiovascular (GRINCAR), Universidade da Coruña, Ferrol, Spain
| | - María-Jesús Movilla-Fernández
- Facultade de Enfermaría e Podoloxía, Universidade da Coruña, Ferrol, Spain
- Laboratorio de Investigación Cualitativa en Ciencias da Saúde (CCSS), Grupo de Investigación Cardiovascular (GRINCAR), Universidade da Coruña, Ferrol, Spain
| |
Collapse
|
6
|
Gaspar M, Rosenes R, Burchell AN, Grennan T, Salit I, Grace D. Diagnosing uncertainty: The challenges of implementing medical screening programs for minority sub-populations in Canada. Soc Sci Med 2019; 244:112643. [PMID: 31698281 DOI: 10.1016/j.socscimed.2019.112643] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 10/22/2019] [Accepted: 10/25/2019] [Indexed: 12/29/2022]
Abstract
The social science literature on medical screening has documented a notable disjuncture between the promises of population-based screening programs and the complex realities of their rollout in everyday practice. We contribute to this scholarship by examining how healthcare providers confront numerous uncertainties associated with the implementation of anal cancer screening programs in Canada given the absence of standardized national evidence-based guidelines. The data was derived from in-depth interviews conducted with 13 physicians and 2 clinical researchers about anal cancer screening for gay, bisexual and other men who have sex with men living with HIV, the minority sub-population at the highest risk for HPV-associated anal cancer. Despite having unknown utility and low specificity, an initial anal Pap test was used to triage patients into anal dysplasia clinics for high-resolution anoscopy. This process led to technological scepticism toward the Pap's accuracy, diagnostic ambiguity related to the interpretation of the cytology results and increased patient anxiety regarding abnormal results. Physicians navigated a tension between wanting to avoid exposing their patients to additional uncertainties caused by screening and pre-cancer treatment and wanting to ensure that their patients did not develop anal cancer under their care. A high number of abnormal anal Pap results paradoxically reintroduced some of the capacity issues that the Pap was meant to resolve, as the existing dysplasia clinics were incapable of seeing all patients with abnormal results. We define this sequence as the epistemic-capacity paradox, a dynamic whereby seeking evidence to improve healthcare capacity simultaneously produces evidence that introduces capacity challenges and generates additional uncertainty. The epistemic-capacity paradox demonstrates the limitations of evidence-based medicine frameworks at determining best practices in the context of rarer health conditions affecting minority sub-populations, where smaller population numbers and limited institutional support pose systemic challenges to the acquisition of sufficient evidence.
Collapse
Affiliation(s)
- Mark Gaspar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Ron Rosenes
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
| | - Ann N Burchell
- Department of Family and Community Medicine and MAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
| | - Troy Grennan
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Irving Salit
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| |
Collapse
|
7
|
Gaspar M, Grennan T, Salit I, Grace D. Confronting comorbidity risks within HIV biographies: gay men’s integration of HPV-associated anal cancer risk into their narratives of living with HIV. HEALTH RISK & SOCIETY 2018. [DOI: 10.1080/13698575.2018.1519114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Mark Gaspar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Troy Grennan
- Provincial HIV/STI Program, British Columbia Centre for Disease Control, Vancouver, Canada
- Division of Infectious Diseases, University of British Columbia, Vancouver, Canada
| | - Irving Salit
- Department of Medicine, University of Toronto, Toronto, Canada
- University Health Network, Toronto, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| |
Collapse
|
8
|
|
9
|
Young B, Bedford L, Kendrick D, Vedhara K, Robertson JFR, das Nair R. Factors influencing the decision to attend screening for cancer in the UK: a meta-ethnography of qualitative research. J Public Health (Oxf) 2017; 40:315-339. [DOI: 10.1093/pubmed/fdx026] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 02/24/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- B Young
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - L Bedford
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - D Kendrick
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - K Vedhara
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - J F R Robertson
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, UK
| | - R das Nair
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
| |
Collapse
|
10
|
Ward JK, Crépin L, Bauquier C, Vergelys C, Bocquier A, Verger P, Peretti-Watel P. ‘I don’t know if I’m making the right decision’: French mothers and HPV vaccination in a context of controversy. HEALTH RISK & SOCIETY 2017. [DOI: 10.1080/13698575.2017.1299856] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Jeremy K. Ward
- Aix Marseille University-INSERM-IRD, SESSTIM (Economy and Social Sciences, Health Care Systems and Societies), Marseille, France
- LIED, Paris Diderot University, Paris, France
| | - Laure Crépin
- Aix Marseille University-INSERM-IRD, SESSTIM (Economy and Social Sciences, Health Care Systems and Societies), Marseille, France
- Department of Social Sciences, Ecole Normale Supérieure de Cachan, Cachan, France
| | - Charlotte Bauquier
- Aix Marseille University-INSERM-IRD, SESSTIM (Economy and Social Sciences, Health Care Systems and Societies), Marseille, France
- GRePS, Lumière Lyon 2 University, Lyon, France
| | - Chantal Vergelys
- Aix Marseille University-INSERM-IRD, SESSTIM (Economy and Social Sciences, Health Care Systems and Societies), Marseille, France
| | - Aurélie Bocquier
- Aix Marseille University-INSERM-IRD, SESSTIM (Economy and Social Sciences, Health Care Systems and Societies), Marseille, France
- ORS PACA (Southeastern Health Regional Observatory), Marseille, France
| | - Pierre Verger
- Aix Marseille University-INSERM-IRD, SESSTIM (Economy and Social Sciences, Health Care Systems and Societies), Marseille, France
- ORS PACA (Southeastern Health Regional Observatory), Marseille, France
| | - Patrick Peretti-Watel
- Aix Marseille University-INSERM-IRD, SESSTIM (Economy and Social Sciences, Health Care Systems and Societies), Marseille, France
- ORS PACA (Southeastern Health Regional Observatory), Marseille, France
| |
Collapse
|
11
|
Chorley AJ, Marlow LAV, Forster AS, Haddrell JB, Waller J. Experiences of cervical screening and barriers to participation in the context of an organised programme: a systematic review and thematic synthesis. Psychooncology 2017; 26:161-172. [PMID: 27072589 PMCID: PMC5324630 DOI: 10.1002/pon.4126] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 02/04/2016] [Accepted: 03/07/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE As uptake of cervical screening continues to decline, this systematic review synthesises the qualitative literature on women's perceptions and experiences of cervical screening in the context of an organised call-recall programme, in order to understand the barriers to informed uptake. METHODS We searched nine databases for English language peer-reviewed publications reporting on qualitative data from screening-eligible women, exploring barriers to cervical screening in countries that offer a nationally organised call-recall programme. Evidence was integrated using thematic synthesis. RESULTS Thirty-nine papers from the UK, Australia, Sweden and Korea were included. The majority of participants had attended screening at least once. Two broad themes were identified: (a) should I go for screening? and (b) screening is a big deal. In considering whether to attend, women discussed the personal relevance and value of screening. Women who had previously attended described how it was a big deal, physically and emotionally, and the varied threats that screening presents. Practical barriers affected whether women translated screening intentions into action. CONCLUSIONS The variation in women's understanding and perceptions of cervical screening suggests that interventions tailored to decisional stage may be of value in increasing engagement with the invitation and uptake of screening in those who wish to take part. There is also a need for further research with women who have never attended screening, especially those who remain unaware or unengaged, as their perspectives are lacking in the existing literature. © 2016 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.
Collapse
Affiliation(s)
- Amanda J. Chorley
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public HealthUCLLondonUK
| | - Laura A. V. Marlow
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public HealthUCLLondonUK
| | - Alice S. Forster
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public HealthUCLLondonUK
| | - Jessica B. Haddrell
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public HealthUCLLondonUK
| | - Jo Waller
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public HealthUCLLondonUK
| |
Collapse
|
12
|
Holland K, McCallum K, Walton A. ‘I’m not clear on what the risk is’: women’s reflexive negotiations of uncertainty about alcohol during pregnancy. HEALTH RISK & SOCIETY 2016. [DOI: 10.1080/13698575.2016.1166186] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
13
|
Hami MY, Ehlers VJ, Van der Wal DM. Women’s perceived susceptibility to and utilisation of cervical cancer screening services in Malawi. Health SA 2014. [DOI: 10.4102/hsag.v19i1.787] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Malawi provides cervical cancer screening services free of charge at some public health facilities. Few women make use of these cancer screening services in Malawi and many women continue to be diagnosed with cervical cancer only during the late inoperable stages of the condition. Objectives: The purpose of this study was to discover whether the perceived susceptibility to cervical cancer, amongst Malawian women aged 42 and older, influenced their intentions to utilise the available free cervical cancer screening services.Method: A quantitative, cross-sectional descriptive study design was adopted. Structured interviews were conducted with 381 women who visited 3 health centres in the Blantyre District of Malawi.Results: A statistically-significant association existed between women’s intentions to be screened for cervical cancer and their knowledge about cervical cancer (X² = 8.9; df = 1; p = 0.003) and with having heard about HPV infection (X² = 4.2; df = 1; p = 0.041) at the 5% significance level. Cervical cancer screening services are provided free of charge in government health institutions in Malawi. Nevertheless, low perceived susceptibility to cervical cancer amongst women, aged 42 and older, might contribute to limited utilisation of cervical screening services, explaining why 80% of cervical cancer patients in Malawi were diagnosed during the late inoperable stages.Conclusion: Malawian women lacked awareness regarding their susceptibility to cervical cancer and required information about the available cervical cancer screening services. Malawi’s women, aged 42 and older, must be informed about the advantages of cervical cancer screening and about the importance of effective treatment if an early diagnosis has been made. Women aged 42 and older rarely attend antenatal, post-natal, well baby or family-planning clinics, where health education about cervical cancer screening is often provided. Consequently, these women aged 42 and older should be informed about cervical screening tests when they utilise any health services.Vroue se vermeende vatbaarheid en benutting van servikale kanker dienste in Malawi Agtergrond: Malawi verskaf gratis servikale kanker siftings dienste by sommige openbare gesondheids instansies. Min vrouens maak gebruik van die kanker siftings dienste in Malawi en baie vrouens word steeds gediagnoseer met servikale kanker tydens die laat onopereerbare fases van die toestand.Doelwitte: Die doel van die studie was was om te bepaal of Malawiese vrouens wat 42 en ouer is se waargenome vatbaarheid vir servikale kanker hulle beïnvleod om beskikbare gratis servikale siftingsdienste te gebruik. ’n Kwantitatiwe, deursnee beskrywende navorsingsontwerp was gekies.Metode: Gestruktureerde onderhoude is met 381 vrouens gevoer wat drie gesondheidsdiensentrums in die Blantyre Distrik van Malawi besoek het.Resultate: ’n Statistiese beduidende verhouding het bestaan tussen vrouens se voornemens om vir servikale kanker getoets te word en hulle kennis oor servikale kanker (X² = 8.9; df = 1; p = 0.003) en dat hulle al gehoor het van MPV infeksies (X² = 4.2; df = 1; p = 0.041) op die 5% vlak van beduidenis. Servikale kanker siftingsdienste is gratis beskikbaar in openbare gesondheidsdiensinrigtings in Malawi. Desnieteenstaande was daar ’n lae waargenome risiko van servikale kanker onder vrouens wat 42 jaar oud en ouer was en dit het bygedra tot die beperkte benutting van siftingsdienste, wat verduidelik waarom 80% van servikale kankergevalle in Malawi gedurende die laat onopereerbare fases gediagnoseer is.Gevolgtrekkings: Malawiese vrouens was onbewus van hulle vatbaarheid vir servikale kanker en het inligting benodig oor servikale kanker siftingsdienste. Malawi se vrouens wat 42 jaar oud en ouer is, moet ingelig word aangaande die voordele van servikale sifting en die belangrikheid van effektiewe behandeling indien ’n vroë diagnose gemaak is. Vrouens van 42 of ouer benut selde voorgeboorte, nageboorte gesonde baba, of gesinsbeplanningsklinieke waar voorliging aangaande servickale kanker verskaf word. Gevolglik behoort die vrouens ingelig te word oor servikale siftingstoetse wanneer hulle enige gesondheidsdienste benut.
Collapse
|
14
|
|
15
|
Lindberg LG, Svendsen M, Dømgaard M, Brodersen J. Better safe than sorry: a long-term perspective on experiences with a false-positive screening mammography in Denmark. HEALTH RISK & SOCIETY 2013. [DOI: 10.1080/13698575.2013.848845] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
16
|
“Subutex is safe”: Perceptions of risk in using illicit drugs during pregnancy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2012; 23:365-73. [DOI: 10.1016/j.drugpo.2012.01.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Revised: 11/23/2011] [Accepted: 01/18/2012] [Indexed: 01/06/2023]
|
17
|
Armstrong N, Eborall H. The sociology of medical screening: past, present and future. SOCIOLOGY OF HEALTH & ILLNESS 2012; 34:161-176. [PMID: 22369578 DOI: 10.1111/j.1467-9566.2011.01441.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Medical screening raises fundamental issues for sociological inquiry, but at present a well-developed sociology of medical screening is lacking. This special issue on the sociology of screening brings together an exciting collection of new work that tackles medical screening from a variety of theoretical and methodological approaches. In this opening paper, we begin by explaining what we mean by screening, and why we believe screening merits sociological attention. Secondly, we reflect on the sociology of screening to date and provide an introduction for those new to this area. We then provide an overview of the papers in this collection, highlighting links and contrasts between papers. We conclude by reflecting on sociology's potential contribution to wider debates about screening, and propose future research directions.
Collapse
Affiliation(s)
- Natalie Armstrong
- Department of Health Sciences, University of Leicester, Leicester, LE1 7RH, UK.
| | | |
Collapse
|
18
|
Blomberg K, Forss A, Ternestedt BM, Tishelman C. From 'silent' to 'heard': professional mediation, manipulation and women's experiences of their body after an abnormal Pap smear. Soc Sci Med 2008; 68:479-86. [PMID: 19081661 DOI: 10.1016/j.socscimed.2008.11.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2008] [Indexed: 11/25/2022]
Abstract
While there is a large body of research on cervical cancer screening, fewer studies address the experiences of women receiving abnormal Pap smear results after routine screening. Those studies highlighting such experiences tend to concentrate on resulting psychosocial distress, with an absence in the literature about women's experiences of their bodies during medical follow-up for dysplasia, and no studies were found that explore such experiences over time. In this article, we focus on bodily experiences over time during medical follow-up of an abnormal Pap smear among a group of women in Sweden. This qualitative analysis is based on interview data from a total of 30 women, and with in-depth analysis of the content of 34 transcribed interviews with nine women who were followed longitudinally. We found that medical follow-up involved an experience of both "having" and "being" a body, which changed over time. Women described a process that ranged from having a cervix that was neither felt, 'heard', nor seen, to having a body that became known to them first indirectly through professional mediation and later through direct experience after professional manipulation. The conceptualization of bodily boundaries appeared to change, e.g. through visualization of the previously unfamiliar cervix, pain, vaginal discharge, and bleeding, as well as linkages to the bodies of women in their extended families through the generations. Thus, bodily experiences appear to be an intrinsic part of medical follow-up of an abnormal Pap smear through which health, disease, and risks in the past, present, and future were reconceptualised.
Collapse
Affiliation(s)
- Karin Blomberg
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
| | | | | | | |
Collapse
|
19
|
Carolan MC. Towards understanding the concept of risk for pregnant women: some nursing and midwifery implications. J Clin Nurs 2008; 18:652-8. [PMID: 18705630 DOI: 10.1111/j.1365-2702.2008.02480.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES This paper aims to explore the concept of risk in pregnancy. BACKGROUND Notions of risk and 'not knowing' have always surrounded pregnant women, although in the last two decades trends of increased consumer confidence and midwifery activism have together promoted a greater appreciation of pregnancy as a normal life event. At the same time, advances in pregnancy-related technologies have contributed new levels of concern related to an increasing ability to detect minor abnormalities by ultrasound. This, in turn, causes a concordant rise in the number of women referred to high-risk pregnancy care to monitor suspect findings. Overall, it seems likely that this increasing emphasis on abnormality detection and risk may have serious implications for women. DESIGN Concept analysis. METHOD In this paper, I undertake an exploration of the concept of risk as understood by health professionals and pregnant women. Then, using Deborah Lupton's understanding of a 'discourse of risk', I discuss the ways pregnant women both contribute to and are enmeshed in, this discourse. In the final section, I consider how nurses act informally to shield vulnerable women. CONCLUSIONS Health professionals and pregnant women understand risk differently. Women employ a subjective appraisal of risk, measuring it against their personal values and prior experience, while health professionals evaluate risk in an objective manner. RELEVANCE TO CLINICAL PRACTICE As increasing numbers of women are referred to 'at risk' care, it is important that health professionals understand and respond to maternal understandings of risk. Nurses and midwives particularly, have a role to play in assisting women to make sense of risk calculations. In this way, they can act to ameliorate the growing concept of risk for pregnant women.
Collapse
Affiliation(s)
- Mary C Carolan
- School of Nursing and Midwifery, Victoria Institute of Health and Diversity, Victoria University, Melbourne, Australia.
| |
Collapse
|