Exploring the actual and potential role of the primary care nurse in the prevention of cancer: a mixed methods study.

The aim of this study was to investigate the actual and the potential role of the primary care nurse (PCN) in the prevention of cancer. International studies have indicated that a range of strategies can have an impact on the incidence of cancer. Due to their frequent front-line contact with the public, PCNs can play an important role in the primary prevention of cancer. Nonetheless, there is a lack of information on their actual and potential role in cancer prevention. A sequential confirmatory mixed methods approach was used. Postal questionnaires were administered to PCNs [n = 500; 225 returns (response rate 45%)] followed by semi-structured interviews (n = 15). PCNs provided high levels of cancer prevention activities, specifically focusing on smoking cessation, obesity and cervical screening. They considered that their cancer prevention role could be improved through additional practice-based training and more collaborative inter-professional working. They also identified the need for a better understanding of how to change people's attitudes and behaviours regarding cancer prevention. Evidence from this study provide important insights into the potential of the PCN to empower individuals to take responsibility for their own health and make more informed lifestyle choices.

Exploring women's knowledge, experiences and perceptions of cervical cancer screening in an area of social deprivation.

Despite the strong evidence that cervical screening does save lives, evidence suggests that the uptake for cervical screening for women from socially deprived areas still remains low. A qualitative approach using four focus groups was undertaken with 48 women living in socially deprived areas who had accessed a mobile screening unit to receive cervical screening. Analysis of the data was undertaken using thematic content analysis. The women's knowledge of cervical cancer including associated risks, and preventative factors were extremely limited. The women expressed a negative attitude towards their experiences of cervical screening, describing negative feelings of 'fear', 'embarrassment' and feeling 'stigmatised'. Practical issues such as the timing of the appointments, issues of time and having to find child care were identified as the main barriers to screening for this group. This study highlights that practices and beliefs about screening are variable and access to health care is poorly tailored to meet the needs of the socially deprived. There is a need for accessible targeted information and strategies in order to enhance knowledge and awareness of cervical cancer and screening for women living in socially deprived areas.

Supporting women with intellectual disabilities to access breast cancer screening: a healthcare professional perspective.

Cancer prevention has been identified as the most cost-effective strategy for cancer control. This should extend to all groups including women with intellectual disability, seeking to access breast cancer screening. The purpose of this study was to explore the role of healthcare professionals, such as primary healthcare staff (n= 8) and breast care staff (n= 10), on supporting women with intellectual disability to access breast screening in one region in the UK. A qualitative approach using focus groups and telephone interviews was adopted. Healthcare professionals identified that not only was it important that women with intellectual disability undergo regular breast screening but that they should have the same rights as other women to access breast screening services. While many varied risk factors for breast cancer in women with intellectual disability were noted, the level of cognitive functioning was clearly significant. Barriers to accessing breast screening included literacy problems, consent issues and physical health; practical barriers such as transport and timing of appointment; and barriers attributed to healthcare professionals, including staff attitude and lack of awareness and training. The participants identified the need to raise awareness and health promotion education not only for the women with intellectual disability but also for healthcare professionals, alongside developing more interdisciplinary practice.

The role of community nurses and residential staff in supporting women with intellectual disability to access breast screening services.

BACKGROUND: Women with intellectual disability (ID) are surviving to the age group at greatest risk of developing breast cancer (50-69 years). These women are more likely to experience a greater number of risk factors placing them at an advanced threat of developing breast cancer. However, as a result of cognitive deficits and communication difficulties these women are dependent upon staff to support them to attend the breast screening clinics. AIM: The aim of this paper was to examine how community nurses and residential staff support women with ID to access breast screening services. METHODOLOGY: Six focus groups were held with community nurses and residential staff who work in the field of ID in one region of the UK. The focus groups were tape recorded and the transcriptions were subjected to a thematic content analysis. FINDINGS: Although many of the participants recognised the risk factors and signs/symptoms of breast cancer, there was still a deficit of knowledge. Both positive and negative experiences of women with ID attending for breast screening were reported; however, greater discussion focused on the latter. The participants identified 'a lack of health educational material' and also negative 'emotions, attitudes and physical barriers' as inhibiting factors for attendance. DISCUSSION: This paper highlights the need for developing a health promotion programme for women with ID focusing on breast awareness and information on screening, and also healthier lifestyles. Breast awareness via visual checks was identified for women with ID who refused to attend the breast clinics; however, issues of informed 'consent' and 'vulnerability' were raised for staff and also family carers having to undertake these checks. Development of user-friendly health educational literature using 'pictures, symbols, signs' and simplified words should be accessible to all ID staff, healthcare staff, and also women with ID.