Adult ; Aged ; Breast Neoplasms* / psychology ; Cancer Survivors* / psychology ; Cancer Survivors* / statistics & numerical data ; Cross-Sectional Studies ; Early Detection of Cancer / psychology ; Early Detection of Cancer / statistics & numerical data ; Female ; Humans ; Mammography* / psychology ; Mammography* / statistics & numerical data ; Middle Aged ; Patient Compliance* / psychology ; Patient Compliance* / statistics & numerical data ; Republic of Korea ; Surveys and Questionnaires
Keywords
adherence ; breast neoplasms ; cancer care ; mammography ; survivors ; survivorship
Abstract
Objectives: To identify barriers to surveillance mammography adherence in Korean breast cancer survivors (BCSs), which is crucial for early 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 year was 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 (chi square = 76.618, p < 0.001, R2 = 58%).
Implications for nursing: This is the first study to identify depression as a barrier to surveillance mammography in BCSs, suggesting that depression screening and treatment may be important for increasing adherence.