An interview-based study of nonattendance at screening for cardiovascular diseases and diabetes in older women: Nonattendees' perspectives

Abstract

Aims and objectives: This study explored nonattendees' perspectives on a screening programme for cardiovascular disease and diabetes mellitus among women aged 60-77 years.

Background: Nonattendance in screening is a common concern and has been associated with increased morbidity and mortality. Whether nonattendees need targeted information to participate in screening is unknown. Thus, it is important to explore the reasons for nonattendance, particularly as nonattendees' perspectives have not been fully explored.

Design: An interview study.

Methods: The data were obtained through semistructured interviews with 10 women sampled from a population who declined to participate in a women's screening programme for cardiovascular disease and diabetes mellitus. Additionally, reflective notes on the interview context were documented. The data were collected in 2013. Kvale and Brinkmann's method for data analysis was applied.

Results: All informants found the screening offer personally irrelevant, but this belief was changeable. The informants' perceptions of screening were based on subjective health and risk beliefs, personal knowledge of diseases and the screening programme, and distrust in the healthcare system.

Conclusion: Personal experiences, beliefs and self-protective strategies influence individuals' subjective interpretations of a screening programme's relevance. The perception that screening is irrelevant seems to be rooted in nonattendees' personal health-related assessment and knowledge. Consequently, whether nonattendance is determined by an informed decision is questionable. Negative experiences with the healthcare system led to hesitation towards screening in general.

Relevance to clinical practice: This study is relevant to healthcare workers as well as decision-makers from a screening and preventive perspective. The findings highlight important issues that should be addressed to encourage invitees to accept screening invitations and to facilitate informed decision-making about screening participation.

Keywords: cardiovascular diseases; diabetes; interviews; nonattendance; nursing; patient experience; qualitative study; screening.