Response costs of mammography adherence: Iranian women's perceptions.

Mahsa Khodayarian,Seyed Saied Mazloomi-Mahmoodabad,Mohammad Ali Morowatisharifabad,Hossein Tavangar,Minoor Lamyian

doi:10.15171/hpp.2016.15

Abstract

Background: Mammography as the most common secondary prevention method has known to be helpful in detecting breast cancer at the early stages. Low level of participation among women toward mammography uptake due to cultural beliefs is a great concern. This study aimed at exploring the perceptions of women about response costs of mammography adherence (MA) in Yazd, Iran. Methods: A qualitative study using semi-structured interviews was performed. Fourteen women,one oncology nurse, and a breast cancer survivor were purposefully interviewed. Interviews were transcribed verbatim and analyzed by directed content analysis method based on protection motivation theory (PMT). Results: One main theme was emerged from the analysis namely called "response costs".Two main categories were also emerged from the data; (1) psychological barriers with six subcategories including "embarrassment," "worry about being diagnosed with cancer," "preoccupation with underlying disease," "misconception about mammography," "need for an accompanying person," and "internalizing the experiences of the others," and (2) maladaptive coping modes which encompassed three subcategories: "religious faith," "fatalism," and"avoidance and denial." Conclusion: Useful information was provided about the response costs of mammography utilization based on the perceptions of women. Cognitive barriers may be decreased by conducting modifications in women’s awareness and attitude toward MA as well as changing the national health system infrastructures. Incorporating religious and cultural belief systems into MA educational programs through motivational messages is recommended.

Highlights

Breast cancer, as a global health problem, is a prevalent cancer among women, worldwide.[1] it is, the most frequently diagnosed cancer among women in countries of the Eastern Mediterranean Regional Office (EMRO) and the fifth common cause of death among women in Iran
The following key question was explored: What are the perceptions of women about the response costs of mammography adherence (MA)? The study participants were 12 women, one oncology nurse, and a breast cancer survivor, all from Yazd, Iran, who were invited to participate in the study through purposive sampling
Analysis of the understandings of the Iranian women about their perceived response costs of MA led to formation of one main theme, two categories, nine subcategories, and 143 initial codes

Summary

Introduction

As a global health problem, is a prevalent cancer among women, worldwide.[1] it is, the most frequently diagnosed cancer among women in countries of the Eastern Mediterranean Regional Office (EMRO) and the fifth common cause of death among women in Iran. Fundamental changes in the socioeconomic status among developing countries have made a shift in the lifestyles of people in these countries to those of the industrialized countries Such a shift in the lifestyle, which is associated with reproductive, hormonal, and dietary risk factors, has led to an increase in the burden of breast cancer.[2] It is noteworthy that the age of onset for breast cancer among Iranian women is reported to be up to ten years earlier than that in the developed countries.[3] Epidemiological studies based on the age-specific incidence in Yazd province showed breast cancer as the most prevalent cancer.[4] Despite the annual increase in the incidence rate of the disease among Iranian women, there is a lack of recent evidence on its various aspects in Yazd, Iran.[5] Mammography screening has been shown to be associated with early detection and, mortality and morbidity reduction of breast cancer.[6] mammography screening programs are being implemented for all older than 40 women in several countries like the United Kingdom and the United States,[7] there is no formal mammography screening program in Iran. Incorporating religious and cultural belief systems into MA educational programs through motivational messages is recommended

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