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Family Practice Vol. 21, No. 1, 28-32
© Oxford University Press 2004, all rights reserved.

Article

"You can't prevent everything anyway"

A qualitative study of beliefs and attitudes about refusing health screening in general practice

Karen-Dorthe Bach Nielsena,, Lise Dyhrb, Torsten Lauritzena,c and Kirsti Malterudb,d

a The Ebeltoft Health Promotion Project, Ebeltoft, b Department of General Practice and Research Unit, Institute of Public Health, University of Copenhagen, c The Department of General Practice, University of Aarhus, Denmark and d Section for General Practice-Department of Public Health and Primary Health Care, University of Bergen, Norway

Correspondence to Karen-Dorthe Bach Nielsen, The Ebeltoft Health Promotion Project, Nørreport 4, DK-8400 Ebeltoft, Denmark; E-mail: karen-dorthe.bach.nielsen{at}dadlnet.dk

Objective. The aim of this study was to explore beliefs and attitudes about refusing health screening in general practice.

Methods. In 1991, in Ebeltoft, Denmark people aged between 30 and 50 years were invited to participate in a 5-year randomized, controlled, population-based project testing the value of health screenings and health discussions in general practice. In 1994, non-participants who declined the offered health screening but expressed willingness to be contacted in the future were asked to participate in a qualitative interview. They were drawn by stratified purposeful sampling which reflected variation in perceived health, body mass index, age and sex. The sample comprised six men and 12 women

Results. Some had not participated because they were busy, felt healthy or had recently been examined. The non-participants emphasized the limitations of health screening and did not want possible risk factors to be revealed, or their feeling of good health to be disturbed. They stressed the individual's own responsibility for maintaining good health and believed that a positive attitude promoted health. They would contact their GP if they had symptoms.

Conclusion. Non-participants have rational views on risk factor testing and on their own responsibility for maintaining health. Non-attendance was due to a conscious choice which included consulting their own GP.

Keywords. Attitude to health, general practice, multiphasic screening, personal autonomy, qualitative research.


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