Araştırma Makalesi
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Mamografi tarama yolculukları: Bir katılımcı eylem araştırması

Yıl 2021, Cilt: 8 Sayı: 1, 1 - 7, 01.03.2021

Öz

Amaç: Ulusal meme kanseri mamografi tarama rehberinde hedeflenen kadınların mamografilerini, uyum sürecine yönelik engelleri belirlemek amacıyla gözlemlemek.
Gereç ve Yöntem: Bu çalışma Aralık 2018 ile Mayıs 2020 arasında gerçekleştirildi. İstanbul'da yaşayan 40-69 yaşları arasında olan kadınların katıldığı 12 odak grubunda yürütülen çalışmadan rekrutman yapıldı. Randevu alma, tarama ve sonuç raporlama süreçlerinin gözlenmesi, eylem araştırması ile yapıldı. Bu yaklaşım ile, katılımcılara güçlenmelerini ve değişimlerini teşvik etmek için, araştırmacı, çalışma süresinde etkileşim içinde olabilir ve savunma yapabilir. Gözlemlere rehberlik etmek ve dokümante etmek için Susan G. Komen® Meme Kanseri Vakfı tarafından geliştirilen bir form kullanıldı.
Bulgular: İstanbul'da farklı kamu, vakıf ve özel kuruluşlarda 40-57 yaşları arasındaki on kadının mamografileri gözlendi. Randevu alma süresi iki ila yedi dakika arasında sürdü. İlk müsait randevular aynı günden 20 gün sonrasına kadar değişti. Erişime en büyük engel, muayene ve sevk önkoşulları olarak gözlendi. Dört tesiste imzalanmış onam formları istendi. Bekleme süreleri dahil tarama süresi sekiz ile 100 dakika arasında değişmekteydi. Cepten ödemeler 0-58 US$ arasındaydı. Sonuçların bekleme süreleri 15 dakika ile 33 gün arasında değişiyordu. Rapor formatları beş tesiste elektronikti; diğerleri ise kompakt disklerle kağıt raporlar halindeydi.
Sonuç: Bu çalışma, ulusal meme kanseri tarama rehberi tarafından hedeflenen on kadının gözünden mamografi taramasına gözlemledi. Gizlilik, rıza, sevk ve raporlama konularında kurum, ulusal ve politika düzeylerinde iyileştirme fırsatları belirlendi.

Kaynakça

  • 1. WHO International Agency for Research on Cancer (2020), Global Cancer Observatory, Cited 18/07/2020, https://gco.iarc.fr/
  • 2. Republic of Turkey Ministry of Health (2018), Health Statistics Yearbook, Cited 18/07/2020, https://www.saglik.gov.tr/TR,62400/saglik-istatistikleri-yilligi-2018-yayinlanmistir.html
  • 3. Jemal, A., Torre, L., Soerjomataram, I., Bray, F., editors (2019), The Cancer Atlas, 3rd ed, Atlanta: American Cancer Society.
  • 4. Turkish Statistical Institute (2018), Population Projections, 2018-2080. News Bulletin No. 30567, Cited 18/07/2020, http://www.tuik.gov.tr/PreHaberBultenleri.do?id=30567
  • 5. The National Breast Cancer Coalition (2011), Mammography for Breast Cancer Screening: Harm/Benefit Analysis, Cited 18/07/2020, http://www.stopbreastcancer.org/breast-cancer-information/breast-cancer-information-and-positions/mammography-for-breast-cancer.pdf
  • 6. Lauby-Secretan, B., Scoccianti, C., Loomis, D., Benbrahim-Tallaa, L., Bouvard, V., Bianchini, F., Straif, K. (2015), Breast-Cancer Screening — Viewpoint of the IARC Working Group, New England Journal of Medicine, 372(24), 2353-2358.
  • 7. The American Society of Breast Surgeons (2019), Position Statement on Screening Mammography, Cited 18/07/2020, https://www.breastsurgeons.org/docs/statements/Position-Statement-on-Screening-Mammography.pdf
  • 8. World Health Organization (2016), IARC Handbooks of Cancer Prevention: Breast Cancer Screening Volume 15, Geneva, International Agency for Research on Cancer, Available from: https://publications.iarc.fr/Book-And-Report-Series/Iarc-Handbooks-Of-Cancer-Prevention
  • 9. Schünemann H.J. (2020), Breast Cancer Screening and Diagnosis: A Synopsis of the European Breast Guidelines, Annals of Internal Medicine,172(1), 45-56.
  • 10. World Health Organization (2014), WHO Position Paper on Mammography Screening, Geneva, World Health Organization, https://apps.who.int/iris/handle/10665/137339
  • 11. Centers for Disease Control (2016), The Breast Cancer Screening Chart. Cancer Screening Guidelines, Cited 18/07/2020, https://www.cdc.gov/cancer/health-care-providers/resources.htm
  • 12. Oeffinger, K.C., Fontham, E.T.H., Etzioni, R., Herzig, A., Michaelson, J.S., Ya-Chen, T.S., et al. (2015), Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society, JAMA, 314(15), 1599-614.
  • 13. Republic of Turkey Ministry of Health (2020), Department of Cancer, Cited 18/07/2020, https://hsgm.saglik.gov.tr/tr/kanser-anasayfa
  • 14. OECD (2018), Health at a Glance 2018: OECD Indicators, Paris, OECD Publishing.
  • 15. EUROSTAT (2019), Healthcare Activities Statistics- Preventive Services, Cited 18/07/2020, https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Healthcare_activities_statistics_-_preventive_services#Breast_cancer_screening
  • 16. Aker, S., Öz, H., Tunçel, E.K. (2015), Practice of Breast Cancer Early Diagnosis Methods among Women Living in Samsun, and Factors Associated with This Practice, Journal of Breast Health, 11(3), 115-22.
  • 17. Aksoy, Y.E., Turfan, E.Ç., Sert, E., Mermer, G. (2015), Barriers on Breast Cancer Early Detection Methods, Journal of Breast Health, 11(1), 26-30.
  • 18. Avci, İ.A., Altay, B., Rızalar, S., Özdelikara, A., Öz, H. (2015), Attitudes of women about breast cancer and cervical cancer screening, TAF Preventive Medicine Bulletin,14(3), 235-239.
  • 19. Şen, C. (2015), Beyond Demographics: Personality, Norms, and Mechanisms of Women's Cancer Screening. Istanbul: Koç University Graduate School of Social Sciences and Humanities, Doctoral Thesis.
  • 20. Ozmen, V., Boylu, S., Ok, E., Canturk, N.Z., Celik, V., Kapkac, M., et al. (2015), Factors affecting breast cancer treatment delay in Turkey: a study from Turkish Federation of Breast Diseases Societies, European Journal of Public Health, 25(1), 9-14.
  • 21. Winter, R., Munn-Giddings, C. (2001), A Handbook for Action Research in Health and Social Care, London, Routledge.
  • 22. Whitehead, D., Taket, A., Smith, P. (2003), Action research in health promotion, Health Education Journal, 62(1), 5-22.
  • 23. Bowling, A. (2014), Research Methods in Health: Investigating Health and Health Services, 4th ed. Berkshire, Open University Press.
  • 24. Susan G. Komen (2015), Susan G. Komen Breast Cancer Foundation Community Profile Guidebook Module 4a Toolkit-Qualitative Data Support Materials, Cited 18/07/2020, https://ww5.komen.org/uploadedFiles/Content/ResearchGrants/AffiliateCommunityHealth/CP_Guidebook_and_Toolkits/2015%20Community%20Profile%20Guidebook.pdf
  • 25. Republic of Turkey Ministry of Health (2016), Turkey Cancer Control Program, Cited 18/07/2020, https://hsgm.saglik.gov.tr/depo/birimler/kanser-db/yayinlar/Kitaplar/TURKIYE_KANSER_KONTROL_PROGRAMI_2016.pdf

Mammography screening journeys: An action research study

Yıl 2021, Cilt: 8 Sayı: 1, 1 - 7, 01.03.2021

Öz

Objective: To observe mammographies of women targeted by the national breast cancer mammography screening guidelines in order to identify process-based barriers to compliance.
Materials and Methods: This study was conducted between December of 2018 and May of 2020. Recruitment was done during a larger study that conducted 12 focus groups of women between the ages of 40-69 living in Istanbul. Observation of scheduling, screening, and reporting processes were done using action research, an approach that allows the researcher to fully interact with, and advocate for, study subjects to stimulate empowerment and change. A form developed by the Susan G. Komen® Breast Cancer Foundation was used to guide and document observations.
Results: Mammographies for ten women aged 40-57 at distinct public, foundation, and private facilities in Istanbul were observed. Scheduling duration ranged from two to seven minutes. Earliest available appointments ranged from same day to 20 days later. The largest barrier to access was a prerequisite examination and referral. Signed consent forms were required at four facilities. Screening duration, including wait times, ranged from eight to 100 minutes. Out-of-pocket costs ranged from $US 0-58. Wait times for results ranged from 15 minutes to 33 days. Report formats were electronic at five facilities; others provided paper reports with compact discs.
Conclusion: This study looked at mammography screenings through the eyes of ten women targeted by national breast cancer prevention guidelines. Opportunities for improvement were identified at facility, national, and policy levels in the areas of privacy, consent, referrals, and reporting.

Kaynakça

  • 1. WHO International Agency for Research on Cancer (2020), Global Cancer Observatory, Cited 18/07/2020, https://gco.iarc.fr/
  • 2. Republic of Turkey Ministry of Health (2018), Health Statistics Yearbook, Cited 18/07/2020, https://www.saglik.gov.tr/TR,62400/saglik-istatistikleri-yilligi-2018-yayinlanmistir.html
  • 3. Jemal, A., Torre, L., Soerjomataram, I., Bray, F., editors (2019), The Cancer Atlas, 3rd ed, Atlanta: American Cancer Society.
  • 4. Turkish Statistical Institute (2018), Population Projections, 2018-2080. News Bulletin No. 30567, Cited 18/07/2020, http://www.tuik.gov.tr/PreHaberBultenleri.do?id=30567
  • 5. The National Breast Cancer Coalition (2011), Mammography for Breast Cancer Screening: Harm/Benefit Analysis, Cited 18/07/2020, http://www.stopbreastcancer.org/breast-cancer-information/breast-cancer-information-and-positions/mammography-for-breast-cancer.pdf
  • 6. Lauby-Secretan, B., Scoccianti, C., Loomis, D., Benbrahim-Tallaa, L., Bouvard, V., Bianchini, F., Straif, K. (2015), Breast-Cancer Screening — Viewpoint of the IARC Working Group, New England Journal of Medicine, 372(24), 2353-2358.
  • 7. The American Society of Breast Surgeons (2019), Position Statement on Screening Mammography, Cited 18/07/2020, https://www.breastsurgeons.org/docs/statements/Position-Statement-on-Screening-Mammography.pdf
  • 8. World Health Organization (2016), IARC Handbooks of Cancer Prevention: Breast Cancer Screening Volume 15, Geneva, International Agency for Research on Cancer, Available from: https://publications.iarc.fr/Book-And-Report-Series/Iarc-Handbooks-Of-Cancer-Prevention
  • 9. Schünemann H.J. (2020), Breast Cancer Screening and Diagnosis: A Synopsis of the European Breast Guidelines, Annals of Internal Medicine,172(1), 45-56.
  • 10. World Health Organization (2014), WHO Position Paper on Mammography Screening, Geneva, World Health Organization, https://apps.who.int/iris/handle/10665/137339
  • 11. Centers for Disease Control (2016), The Breast Cancer Screening Chart. Cancer Screening Guidelines, Cited 18/07/2020, https://www.cdc.gov/cancer/health-care-providers/resources.htm
  • 12. Oeffinger, K.C., Fontham, E.T.H., Etzioni, R., Herzig, A., Michaelson, J.S., Ya-Chen, T.S., et al. (2015), Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society, JAMA, 314(15), 1599-614.
  • 13. Republic of Turkey Ministry of Health (2020), Department of Cancer, Cited 18/07/2020, https://hsgm.saglik.gov.tr/tr/kanser-anasayfa
  • 14. OECD (2018), Health at a Glance 2018: OECD Indicators, Paris, OECD Publishing.
  • 15. EUROSTAT (2019), Healthcare Activities Statistics- Preventive Services, Cited 18/07/2020, https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Healthcare_activities_statistics_-_preventive_services#Breast_cancer_screening
  • 16. Aker, S., Öz, H., Tunçel, E.K. (2015), Practice of Breast Cancer Early Diagnosis Methods among Women Living in Samsun, and Factors Associated with This Practice, Journal of Breast Health, 11(3), 115-22.
  • 17. Aksoy, Y.E., Turfan, E.Ç., Sert, E., Mermer, G. (2015), Barriers on Breast Cancer Early Detection Methods, Journal of Breast Health, 11(1), 26-30.
  • 18. Avci, İ.A., Altay, B., Rızalar, S., Özdelikara, A., Öz, H. (2015), Attitudes of women about breast cancer and cervical cancer screening, TAF Preventive Medicine Bulletin,14(3), 235-239.
  • 19. Şen, C. (2015), Beyond Demographics: Personality, Norms, and Mechanisms of Women's Cancer Screening. Istanbul: Koç University Graduate School of Social Sciences and Humanities, Doctoral Thesis.
  • 20. Ozmen, V., Boylu, S., Ok, E., Canturk, N.Z., Celik, V., Kapkac, M., et al. (2015), Factors affecting breast cancer treatment delay in Turkey: a study from Turkish Federation of Breast Diseases Societies, European Journal of Public Health, 25(1), 9-14.
  • 21. Winter, R., Munn-Giddings, C. (2001), A Handbook for Action Research in Health and Social Care, London, Routledge.
  • 22. Whitehead, D., Taket, A., Smith, P. (2003), Action research in health promotion, Health Education Journal, 62(1), 5-22.
  • 23. Bowling, A. (2014), Research Methods in Health: Investigating Health and Health Services, 4th ed. Berkshire, Open University Press.
  • 24. Susan G. Komen (2015), Susan G. Komen Breast Cancer Foundation Community Profile Guidebook Module 4a Toolkit-Qualitative Data Support Materials, Cited 18/07/2020, https://ww5.komen.org/uploadedFiles/Content/ResearchGrants/AffiliateCommunityHealth/CP_Guidebook_and_Toolkits/2015%20Community%20Profile%20Guidebook.pdf
  • 25. Republic of Turkey Ministry of Health (2016), Turkey Cancer Control Program, Cited 18/07/2020, https://hsgm.saglik.gov.tr/depo/birimler/kanser-db/yayinlar/Kitaplar/TURKIYE_KANSER_KONTROL_PROGRAMI_2016.pdf
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma
Yazarlar

Kirstin Ozturk 0000-0002-1746-6689

Mehveş Tarım 0000-0002-3726-9439

Yayımlanma Tarihi 1 Mart 2021
Kabul Tarihi 31 Ağustos 2020
Yayımlandığı Sayı Yıl 2021 Cilt: 8 Sayı: 1

Kaynak Göster

APA Ozturk, K., & Tarım, M. (2021). Mammography screening journeys: An action research study. Sağlık Akademisyenleri Dergisi, 8(1), 1-7.
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