Barriers and Facilitators to Breast Cancer Screening: A Qualitative Study of Women with Multiple Sclerosis.

PURPOSE: Recent literature indicates that women with various types of chronic disabling conditions are less likely to participate in routine breast cancer screening compared to those without disabling conditions. The purpose of this study is to identify the barriers and facilitators related to breast cancer screening among women with MS.

METHODS

After receiving approval from the IRB, a semi-structured interview in a private setting was conducted with 36 women with MS, whose mean age was 55. Interviews were audio-taped and transcribed verbatim. The interview questions informed by the Health Belief Model, addressed knowledge, experience, barriers and facilitators related to breast cancer screening. Qualitative descriptive techniques were used to analyze the data. The majority of the women in the sample were White, 67% were married, 47% had at least a bachelor's degree and about 31% were unemployed due to their disability. FINDINGS: Findings show that 70% of these women had received annual mammograms and 50% had performed monthly breast self-exams. Of the women who had not received mammograms, most (80%) had mobility limitations. Some of the women in this study described various environmental and intrapersonal barriers to breast cancer screening. Among these were barriers related to transportation, difficulty in positioning for the exam, health care provider attitudes, not remembering, fear, discomfort, and "having enough to handle." Facilitators included annual reminders and helpful health care providers.