Factors Influencing Breast Cancer Screening Practices Among Arabic Women Living in the State of Qatar: The Health Care Providers' Perspective

Abstract

BACKGROUND: Breast cancer is the most common cancer contributing to morbidity and mortality among Arabic women in Qatar. Arabic women are at risk primarily due to their low participation rates in breast cancer screening practices and subsequent delayed diagnosis of the disease. Therefore, there must be a strong emphasis on the health care providers and the health care system to increase efforts in early detection of breast cancer. METHODS: This Master's thesis study is a part of a larger, mixed methods study entitled "Factors Influence Breast Cancer Screening Practices Amongst Arabic Women Living in the State of Qatar" conducted by Dr. Tam Truong Donnelly, the lead principal investigator, and funded by the Qatar National Research Fund under the National Priorities Research Program. Following the theoretical frameworks of the main research study, this qualitative research based its theoretical foundation on an ecological perspective and Kleinman's explanatory model to explore, understand, and describe factors influencing Arabic women's breast cancer screening practices from the health care providers' perspective. Using Carspecken's critical ethnography, fifteen health care providers from three health care sites who work at various levels of the health care system in Qatar were interviewed individually and face to face. RESULTS: An analysis of the data revealed factors that either hinder or facilitate women's breast health and health care practices in Qatar. The influences of the factors are coalesced into four major themes: influences of (a) knowledge and awareness, pain associated with mammogram, and perception of 'no pain, no illness', (b) cultural beliefs, attitudes, and practices with regard to female breasts, body, illness, and unhealthy women and religious beliefs regarding modesty, health, and illness (c) unequal gender relations of power, female roles and responsibilities, and spousal support, and (d) systemic (health care and social resource) factors on women's breast cancer screening practices. CONCLUSIONS: As with many women worldwide, the study findings suggest that Arabic women's health cannot be understood in isolation from the environment in which they live. Rather, the health of Arabic women in Qatar is both constrained and fostered by health care and social systems that are embedded in culture. Addressing problems on a personal level isolated from the context will not be adequate and effective. Therefore, what seems immediately personal must be examined within its context; solutions need to address the context and not be limited to the individual. Authors offer implications for the health care, health care professionals, education, and research.