The Determinants of Breast Cancer Screening Behavior: A Focus Group Study of Women in the United Arab Emirates
Purpose/Objectives: To explore perceptions, knowledge, attitudes, and beliefs about breast cancer and its screening among Emirati national women in Al Ain, United Arab Emirates.
Design: A qualitative study using focus group methods.
Setting: Primary healthcare centers and a communitybased women's association in the United Arab Emirates.
Sample: 41 women, aged 25-45 years.
Methods: Four 90-minute focus group discussions exploring perceptions, knowledge, attitudes, beliefs, and practices regarding breast cancer were audiotaped, transcribed, translated, and analyzed.
Main Research Variables: Social and cultural themes related to breast cancer and its screening.
Findings: Focus group methodology worked well in this setting. The women's perceptions, knowledge, attitudes, and beliefs regarding cancer and screening, together with aspects of the healthcare system and social milieu, appeared to strongly influence the women's preventive practices. Some of these factors had an encouraging effect on the women's practices, and others had a deterring effect. The encouraging factors included feelings of susceptibility, high levels of knowledge in some women, attitudes and beliefs about personal responsibility for health, and a supportive social milieu. Deterring factors included anxiety and fear leading to denial; lack of knowledge about cancer and the screening program; fear, embarrassment, and mistrust of health care; and belief in predestination.
Conclusions: Health planners and healthcare providers must capitalize on encouraging factors and minimize deterring factors to optimize breast cancer screening practices among these women.
Implications for Nursing: Identifying and accounting for the factors that encourage or deter women in their breast cancer screening practices will help to optimize screening programs.
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References
Al-Hosani, H. (2000). Health for all in the United Arab Emirates. Eastern Mediterranean Health Journal, 6, 838-840.
Alwash, R., & Abbas, A. (1999). Public health practice, the United Arab Emirates. Public Health Medicine, 1, 113-117.
Benedict, S., Williams, R., & Baron, P. (1994). Recalled anxiety: From discovery to diagnosis of a benign breast mass. Oncology Nursing Forum, 21, 1723-1727.
Caplan, L.S., Wells, B.L., & Haynes, S. (1992). Breast cancer screening among older racial/ethnic minorities and whites: Barriers to early detection. Journal of Gerontology, 47(Special issue), 101-110.
Coughlin, S.S., Uhler, R.J., & Blackman, D.K. (1999). Breast and cervical cancer screening practices among American Indian and Alaska Native women in the United States, 1992-1997. Preventive Medicine, 29, 287-295.
Davis, T.C., Arnold, C., Berkel, H.J., & Nandy, I. (1996). Knowledge and attitude on screening mammography among low-literate, low-income women. Cancer, 78, 1912-1920.
Denic, S., & Bener, A. (2001). Consanguinity decreases risk of breast cancer--Cervical cancer unaffected. British Journal of Cancer, 85, 1675-1679.
Erblich, J., Bovbjerg, D.H., & Valdimarsdottir, H.B. (2000). Psychological distress, health beliefs, and frequency of breast self-examination. Journal of Behavioral Medicine, 23, 277-292.
Fletcher, S.W., Black, W., Harriss, R., Rimer, B.K., & Shapiro, S. (1993). Report of the International Workshop on Screening for Breast Cancer. Journal of the National Cancer Institute, 85, 1644-1656.
Gotay, C.C., Issell, B.F., Hernandez, B.Y., & Serxner, S. (1996). Barriers to mammography in a low income, multiethnic clinic population. Hawaii Medical Journal, 55(8), 136-140.
Hoffman-Goetz, L., & Mills, S. (1997). Cultural barriers to cancer screening among African American women: A critical review of the qualitative literature. Women's Health: Research on Gender, Behavior and Policy, 3(3-4), 183-201.
Jemal, A., Thomas, A., Murray, T., & Thun, M. (2002). Cancer statistics, 2002. CA: A Cancer Journal for Clinicians, 52, 23-47.
Krueger, R.A. (1994). Focus groups (2nd ed.). Thousand Oaks, CA: Sage.
McPhee, S.J., Bird, J.A., Davis, T., Ha, N.T., Jenkins, C.N.H., & Lee, B. (1997). Barriers to breast and cervical cancer screening among Vietnamese-American women. American Journal of Preventive Medicine, 13, 205-213.
Morgan, C., Park, E., & Cortes, D.E. (1995). Beliefs, knowledge and behaviour about cancer among urban Hispanic women. Journal of the National Cancer Institute Monographs, 18, 57-63.
Pearlman, D.N., Clark, M.A., Rakowski, W., & Ehrich, B. (1999). Screening for breast and cervical cancers: The importance of knowledge and perceived cancer survivability. Women and Health, 28(4), 93-113.
Pham, C.T., & McPhee, S.J. (1992). Knowledge, attitudes, and practices of breast and cervical cancer screening among Vietnamese women. Journal of Cancer Education, 7, 305-310.
Philips, J.M., Cohen, M.Z., & Moses, G. (1999). Breast cancer screening and African American women: Fear, fatalism and silence. Oncology Nursing Forum, 26, 561-571.
Rakowski, W., Dube, C.E., Marcus, B.H., Prochaska, J.O., Velicer, W.F., & Abrams, D.B. (1992). Assessing elements of women's decisions about mammography. Health Psychology, 11, 111-118.
Remennick, L.I. (1999). Breast screening practices among Russian immigrant women in Israel. Women and Health, 28(4), 29-51.
Schweitzer, R.J. (1988). A cancer education and prevention center: A community program. Cancer, 15(Suppl. 8), 1821-1822.
Suarez, L., Roche, R.A., Nichols, D., & Simpson, D.M. (1997). Knowledge, behavior and fears concerning breast and cervical cancer among older low-income Mexican-American women. American Journal of Preventive Medicine, 13, 137-142.
Sung, J.F., Blumenthal, D.S., Coates, R.J., & Alema-Mensah, E. (1997). Knowledge, beliefs, attitudes, and cancer screening among inner-city African women. Journal of the National Medical Association, 89, 405-411.
Tang, T.S., Solomon, L.J., Yeh, C.J., & Worden, J.K. (1999). The role of cultural variables in breast self-examination and cervical cancer screening behavior in young Asian women living in the United States. Journal of Behavioral Medicine, 22, 419-436.
Tessaro, I., Eng, E., & Smith, J. (1994). Breast cancer screening in older African-American women: Qualitative research findings. American Journal of Health Promotion, 8, 286-292.
Underwood, S.M., Shaikha, L., & Bakr, D. (1999). Veiled yet vulnerable: Breast cancer screening and the Muslim way of life. Cancer Practice, 7, 285-290.
Vietri, V., Poskitt, S., & Slaninka, S.C. (1997). Enhancing breast cancer screening in the university setting. Cancer Nursing, 20, 323-329.
Weinberger, M., Saunders, A.F., Bearon, L.B., Gold., D.T., Brown, J.T., Samsa, G.P., et al. (1992). Physician-related barriers to breast cancer screening in older women. Journal of Gerontology, 47(Special issue), 111-117.
Yi, J.K., & Prows, S.L. (1996). Breast cancer screening practices among Cambodian women in Houston, Texas. Journal of Cancer Education, 11, 221-225.
Zapka, J.G., & Berkowitz, E. (1992). A qualitative study about breast cancer screening in older women: Implications for research. Journal of Gerontology, 47, 93-100.