Emotional Barriers to Bowel Screening in Italy: Scale psychometric properties and effects on screening attendance

OBJECTIVE

To assess a three-factor version of the Emotional Barriers to Bowel Screening (EBBS) scale; analyze the scale's psychometric properties; and investigate the associations of fecal disgust, embarrassment, and fear with colorectal cancer (CRC) screening avoidance.

METHODS

Retrospective design: We asked participants to rate negative emotions associated with CRC screenings as well as whether they had ever attended a fecal occult blood test.

SAMPLE

268 Italian adults aged 45-74 years.

MEASURES

negative emotions, screening knowledge, CRC risk perception, demographic and background data, and hypothetical medical help-seeking.

ANALYSES

Confirmatory factor analyses, correlations, logistic regressions.

RESULTS

The EBBS scale is a multidimensional instrument and, at least where fecal tests are of interest, can be used without the insertion disgust subscale. The analyzed negative emotions were negatively correlated with screening attendance and positively correlated with intention to delay seeking medical help. However, logistic regression models showed that, of the three analyzed emotions, fear about outcome was the only significant predictor of screening behavior and delaying medical care.

CONCLUSIONS

Further studies can adopt the version of the EBBS scale that is most suitable for their research contexts. Interventions must be designed to reassure patients.