Physical access barriers to care for diagnosis and treatment of breast cancer among women with mobility impairments.

Abstract

To explore the perceptions of patients with breast cancer with mobility impairments of the physical accessibility of healthcare facilities and equipment. Individual audiotaped interviews lasting one to two hours. Interviews in homes or workplaces or by telephone. 20 women with chronic mobility impairments who developed early-stage breast cancer prior to age 60. Three were recruited from oncologist panels and 17 from informal social networks of disabled women nationwide. Qualitative analyses of interview transcripts to identify common themes. Extent and nature of mobility impairments and concerns raised by patients about barriers to care. The 20 participants identified issues with inaccessible equipment, including mammography machines, examining tables, and weight scales. The patients sometimes needed to insist on being transferred to an examining table when physicians preferred to examine them seated in their wheelchairs. When staff would transfer them, patients feared injury or felt badly when clinical personnel were injured during transfers. Other issues included difficulties with positioning and handling patients' uncontrollable movements. Even when clinical sites had accessible equipment, this equipment was sometimes unavailable for the appointment. Women with major mobility issues who developed breast cancer confronted numerous physical barriers during the course of their breast cancer diagnosis and treatment. With the aging of the baby boomer generation, an increasing number of people with mobility impairments will be seeking healthcare services. Healthcare providers should be proactive in planning to accommodate these patients by considering accessibility whenever they acquire new equipment, renovate older structures, or build new facilities. They also should establish policies and procedures to ensure that equipment is available during appointments of patients with mobility issues and that staff are trained in safe transferring procedures. Ensuring accommodations and accessibility will benefit patients with impaired mobility and clinical staff.