Me. Kurtz et al., RELATIONSHIPS OF BARRIERS AND FACILITATORS TO BREAST SELF-EXAMINATION, MAMMOGRAPHY, AND CLINICAL BREAST EXAMINATION IN A WORKSITE POPULATION, Cancer nursing, 16(4), 1993, pp. 251-259
The American Cancer Society recommends a regimen for breast cancer scr
eening that includes mammograms, clinical breast examination, and brea
st self-examination. Compliance with breast cancer screening guideline
s has been linked to a number of barriers and facilitators. These barr
iers and facilitators seem to lie within the cognitive framework and g
eneralized beliefs of women, and in the situational contexts in which
they lead their lives. A comprehensive study was designed to investiga
te variables related to breast cancer screening behaviors (breast self
-examination, mammography, and clinical breast examination) of working
women greater-than-or-equal-to 35 years of age at their worksite envi
ronments. A factor analysis identified similar sets of composite varia
bles related to each of the screening modalities, and a discriminant a
nalysis was performed for each screening technique to identify those v
ariables that were most significant in predicting compliance with scre
ening guidelines. The variables discomfort, perceived efficacy, and de
sire for control over health were significant for all three screening
behaviors. Perceived importance was identified as a fourth variable fo
r mammography and clinical breast examination, and lack of knowledge w
as a fourth variable for breast self-examination. Effective breast can
cer screening programs involve all three screening techniques. In the
design of education and intervention programs at worksites, it is crit
ical to emphasize the commonalities of the variables that emerged in t
his study as important for each screening technique. Health-care profe
ssionals who implement such intervention programs need to explore and
bring into the open these common barriers and facilitators to maximize
working women's compliance with breast screening guidelines.