Abstract
BackgroundHealth care providers and educators who seek to create health promotion programs and individualized comprehensive care plans for women with schizophrenia are hindered by the lack of data to guide their efforts.PurposeThis study tested the hypothesis that women with schizophrenia adhere to mammography screening guidelines at the same rate as other same-age women. The study also investigated the validity of the Health Belief (HB) and Stages of Change (SOC) models for breast cancer screening among women with schizophrenia.MethodsSocio-demographic and clinical variables, as well as knowledge, attitudes, and barriers were assessed as a function of stage of change related to breast cancer screening in 46 women with schizophrenia.ResultsWomen with schizophrenia were statistically less likely to be adherent to the screening recommendations than those without schizophrenia. Some support was found for the validity of the HB and SOC models for breast cancer screening in women with schizophrenia. Women in the Precontemplation stage had significantly higher negative attitude scores compared to Contemplation and Action/Maintenance stages (59.7, 45.7, and 43.2, respectively), and there was a trend for more barriers in the Precontemplation group (4.6, 2.6, 2.7 respectively).ConclusionGiven the small sample size, further research on the rates of breast cancer screening in women with schizophrenia is warranted. Nonetheless, these data suggest that providers who care for women with schizophrenia may need to make take additional measures to ensure that this population receives appropriate screening so as to not put them at greater risk for a late-stage diagnosis of breast cancer. Furthermore, these pilot data suggest that HB and SOC theory-based interventions may be valid for increasing mammography rates in women with schizophrenia.
Highlights
Health care providers and educators who seek to create health promotion programs and individualized comprehensive care plans for women with schizophrenia are hindered by the lack of data to guide their efforts.Purpose: This study tested the hypothesis that women with schizophrenia adhere to mammography screening guidelines at the same rate as other same-age women
Given the small sample size, further research on the rates of breast cancer screening in women with schizophrenia is warranted. These data suggest that providers who care for women with schizophrenia may need to make take additional measures to ensure that this population receives appropriate screening so as to not put them at greater risk for a late-stage diagnosis of breast cancer. These pilot data suggest that Health Belief (HB) and Stages of Change (SOC) theory-based interventions may be valid for increasing mammography rates in women with schizophrenia
Post-hoc analysis of the individual items on the Decisional Balance questionnaire revealed that 55.6% of women in the Precontemplation group believed that a mammogram was not needed if a clinical breast exam was preformed compared to 18.5% of the women in the Action/Maintenance group and none in the Contemplation group. (Chisquare = 7.292, d.f, = 2, p = .026.) all of the women in the Precontemplation group indicated that they would not have a mammogram if the doctor seemed to doubt that one was needed
Summary
Health care providers and educators who seek to create health promotion programs and individualized comprehensive care plans for women with schizophrenia are hindered by the lack of data to guide their efforts.Purpose: This study tested the hypothesis that women with schizophrenia adhere to mammography screening guidelines at the same rate as other same-age women. Breast cancer screening has been steadily increasing since the late 1980's and overall rates are approaching the defined targets [i.e., Healthy People 2010 [6]], use of mammography in some groups of women is still low [1]. Underserved women include those who are poor, less educated, non-Caucasian, living in rural areas [7], lacking health insurance or a usual source of care, physically challenged [8], coping with cognitive limitations [9], and diagnosed with severe and persistent psychiatric disorders, such as schizophrenia and related psychotic disorders [10,11]. Little is known about the knowledge and benefits of, attitudes toward, and barriers to mammography in women with schizophrenia, and there is a similar paucity of interventions to promote screening in this group [13]
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