Family Practice Advance Access published online on November 6, 2009
Family Practice, doi:10.1093/fampra/cmp080
‘If I feel something wrong, then I will get a mammogram’: understanding barriers and facilitators for mammography screening among Chilean women
a Department of Family and Community Medicine, Chile School of Medicine, P.Universidad Católica de Chile, Lira 44 1° Piso, Santiago, Chile
b Cancer Prevention Program, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North M3-B232, PO Box 19024, Seattle, Washington 98109-1024, USA
c School of Nursing, P.Universidad Católica de Chile, Vicuña McKenna 8489, Santiago, Chile
Correspondence to Klaus Püschel, Department of Family and Community Medicine, School of Medicine, P.Universidad Católica de Chile, Santiago, Chile; E-mail: kpuschel{at}med.puc.cl
Received 9 April 2009; Revised 1 October 2009; Accepted 7 October 2009.
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Abstract |
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Background. Breast cancer is the leading cause of cancer among women in Chile and in many Latin American countries. Breast cancer screening is an effective strategy to reduce mortality, but it has a very low compliance among Chilean women.
Objective. To understand barriers and facilitators for breast cancer screening in a group of Chilean women aged 50–70.
Methods. Following the Predisposing, Enabling and Reinforcing (PRECEDE) framework, seven focus groups (N = 48 women) were conducted with women that have had diverse experiences with breast cancer and screening practices. Information was collected using field notes and audio and video recording. Following the grounded theory model, a sequential process of open, axial and selective coding was used for the information analysis. Atlas ti 5.5 software was used for coding and segmenting the data obtained from the interviews.
Results. The presence of symptoms and/or the finding of lumps through breast self-examination (BSE) were the main predisposing factors for getting a mammogram. Secrecy, embarrassment and fatalism about breast cancer were significant cultural factors that influenced the decision to seek mammogram screening. Confidence in medical staff and dignity in the treatment at the clinic were important enabling factors. The main reinforcing factors for getting the test were a sense of fulfilment by doing something good for themselves and getting timely information about the results.
Conclusions. Primary health care providers should use culturally appropriate strategies to better inform women about the importance of mammography screening and the limitations of BSE for preventing advanced breast cancer.
Keywords. Breast cancer, Chile, qualitative evaluation, screening.
Püschel K, Thompson B, Coronado G, Gonzalez K, Rain C and Rivera S. ‘If I feel something wrong, then I will get a mammogram’: understanding barriers and facilitators for mammography screening among Chilean women. Family Practice 2009; Pages 1–8 of 8.