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A Transformative Decision‐Making Process for Mammography Screening Among Rural, Low‐Income Women
Author(s) -
Purtzer Mary A.
Publication year - 2012
Publication title -
public health nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 55
eISSN - 1525-1446
pISSN - 0737-1209
DOI - 10.1111/j.1525-1446.2011.00994.x
Subject(s) - transformative learning , perception , psychological intervention , cognition , psychology , mammography screening , medicine , mammography , applied psychology , nursing , developmental psychology , neuroscience , cancer , breast cancer
Objective The study objective was to expand theoretical knowledge of the mammography‐screening decision‐making process. The purpose of this article was to report the decision‐making process of participants who moved from nonscreening to screening. Design and Sample Grounded theory methodology was used. Seventeen rural, low‐income women aged 46–64 years were recruited. Measures In‐depth, face‐to‐face interviews were conducted. Semi‐structured questions focused on decision making, readiness for change, and health care experiences. Results Two phases of decision making were identified. Phase I, A Dormant Period of Nonscreening Behavior, is an inactive screening period characterized by (a) knowledge deficits, (b) unengaged cognition, and (c) misleading perceptions. Phase II, A Transformative Learning Process Resulting in Screening Behavior, is characterized by (a) aroused affective responses, (b) awakened cognitive responses, (c) new knowledge construction, and (d) changed perceptual responses. A catalytic event provides the stimulus to move from Phase I to Phase II. Transformative learning emerged as the central conceptual category underlying the decision to obtain screening. Transformative learning includes a triggering event that facilitates questioning previously held assumptions about mammography. Conclusion Participants demonstrated a transformative process resulting in movement from nonscreening to screening. Further study is needed regarding nursing interventions that serve as catalysts for transformation and subsequent screening.