Satisfaction, discomfort, obligations, and concerns in population-based breast cancer screening: cross-sectional study in a Danish population

Pernille Gabel,Dorte Brandt Svendstrup,Berit Andersen,Mette Bach Larsen,Pernille Bjørnholt Nielsen

doi:10.1186/s12913-017-2438-2

Pernille Gabel, Dorte Brandt Svendstrup + Show 3 more

Open Access

https://doi.org/10.1186/s12913-017-2438-2

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Abstract

BackgroundPotential barriers to breast cancer screening adherence include patient satisfaction, as well as pain, feeling obliged to participate, and other concerns that might compromise the level of satisfaction.The present study aimed to assess the overall satisfaction of Danish citizens with their breast cancer screening experiences, as well as their level of discomfort, concerns, and feelings of obligation to participate. Furthermore, we analyzed the associations between overall satisfaction and the remaining outcomes.MethodsQuestionnaires were mailed to 3000 women in the Central Denmark Region who received screening examination results in the fall of 2013. The questionnaire assessed satisfaction (overall, telephone hot-line, and web-based self-service), discomfort (pain and boundaries of modesty), concerns (at invitation, while waiting for results, and after receiving results), and feelings of obligation to participate. Background information was retrieved from Statistics Denmark.Pearson’s chi-square test was used to test differences in outcomes and demographic characteristic distributions between respondents and non-respondents and highly satisfied vs. less satisfied participants. Prevalence ratios (PR) with 95% CI were assessed using Poisson regression with robust variance, to estimate associations between satisfaction and the remaining outcomes.ResultsAmong the participants, 70.3% and 29.4%, respectively, reported really good and good impressions of the screening program. Lower satisfaction was associated with feeling pain (prevalence ratio (PR), 0.82), feeling that modesty boundaries were transgressed (PR, 0.79), experiencing screening-induced concerns (PR, 0.84), and feeling obliged to participate (PR, 0.96). Of the participants, 36.2% and 12.9%, respectively, felt very much and moderately obliged to participate. A total of 72.6% reported no screening-induced concerns, including 73.3% of those with negative screening results and 38.1% of those with positive screening results.ConclusionsOverall satisfaction with breast cancer screening was very high, but discomfort, feelings of obligation, and concerns were associated with lower satisfaction levels. A continuing focus on high service in breast cancer screening is important for achieving the highest benefit from the program. This includes initiatives to employ the least painful techniques, to respect the patients’ modesty as much as possible, and to deliver fast screening results and thus minimize concerns among women awaiting results.

Highlights

Potential barriers to breast cancer screening adherence include patient satisfaction, as well as pain, feeling obliged to participate, and other concerns that might compromise the level of satisfaction
Main findings The results of this cross-sectional study revealed that almost all participants were satisfied with the breast cancer screening program
Jensen et al observed a similar association between educational level and screening participation in the Central Denmark Region (CDR)—with loweducational and high-educational women showing Prevalence ratios (PR) of nonparticipation of 1.1 and 1.15, respectively [29]. These findings suggest that medium-educated women participate more and are more satisfied with the screening program compared to other women in the CDR

Summary

Introduction

Potential barriers to breast cancer screening adherence include patient satisfaction, as well as pain, feeling obliged to participate, and other concerns that might compromise the level of satisfaction. The present study aimed to assess the overall satisfaction of Danish citizens with their breast cancer screening experiences, as well as their level of discomfort, concerns, and feelings of obligation to participate. Breast cancer screening aims to detect the disease at an early stage to improve prognosis, and can reportedly lead to a 15–20% reduction in breast cancer mortality [3, 4]. To achieve mortality reduction with breast cancer screening, the targeted population must adhere to the screening guidelines [8]. Several factors are reportedly associated with following recommendations for repeated mammographies—including satisfaction with clinic service and/or healthcare providers (e.g., communication and accessibility), low physical discomfort (e.g., experiencing pain), and low psychological distress (e.g., experiencing concerns or embarrassment) [9, 10]

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