Barriers to Surveillance Mammography Adherence in Korean Breast Cancer Survivors

Abstract

OBJECTIVES: To identify barriers to surveillance mammography adherence in Korean breast cancer survivors (BCSs), which is crucial forearly detection of recurrence and new cancers. SAMPLE & SETTING: 195 BCSs were recruited from a breast cancer clinic and its support groups at a South Korean hospital. METHODS & VARIABLES: This descriptive study used a cross-sectional design. Participants completed a self-administered multi-instrument survey based on a comprehensive framework for adherence, including individual characteristics, symptoms, quality of life, cognitive appraisal, social support, and healthcare system factors. RESULTS: Having had a mammogram within the past year was considered adherent (n = 177), and no mammography within the past yearwas considered nonadherent (n = 18). Logistic regression revealed that longer time since diagnosis (p < 0.001), greater depression (p = 0.024), and higher health services utilization (p < 0.001) were predictors of lower mammography adherence (X-2 = 76.618, p < 0.001, R-2 = 58%). IMPLICATIONS FOR NURSING: This is the first study to identify depression as a barrierto surveillance mammography in BCSs, suggestingthat depression screening and treatment may be important for increasing adherence.