Country of origin and prevention of breast cancer: beliefs, knowledge and barriers.

This study describes the concept of prevention and identifies the knowledge, perceived benefits and barriers, as well as the practices of early detection of breast cancer among women from different cultural backgrounds and socioeconomic levels. A socioconstructivist qualitative study was conducted in Barcelona. The study population consisted of women who were either native (Spanish) or immigrants from low income countries, aged 40 to 69 years. Narrations of the 68 informants were subjected to sociological discourse analysis. Place and culture of origin, social class and the migratory process can either facilitate or constitute barriers to breast cancer prevention.

Estrategias para reclutar mujeres inmigrantes para participar en una investigación cualitativa / Strategies to recruit immigrant women to participate in qualitative research

Objetivo: El objetivo de este trabajo es describir el proceso de selección y reclutamiento de las mujeres de distintos orígenes socioculturales que participaron en una investigación cualitativa, detallando las dificultades encontradas según su procedencia. Métodos: La investigación se realizó en Barcelona durante 2007–2008, con el fin de conocer la influencia de la cultura en la participación en un programa de prevención del cáncer de mama. Resultados: La población de estudio fueron mujeres de 40 a 69 años residentes en Barcelona, autóctonas e inmigrantes procedentes de países en vías de desarrollo. Se planeó el reclutamiento de las participantes mediante múltiples estrategias: informantes clave, mediadoras culturales, personal sanitario, asociaciones, entidades de culto, prensa, carteles informativos, escuelas de adultos y de idiomas, y el padrón de habitantes. Conclusiones: El proceso de captación no se puede limitar a una sola vía, y las asociaciones, entidades de culto y mediadoras culturales son los recursos más eficaces (AU)

Objective: The present article aims to describe the process of selecting and recruiting women from distinct sociocultural backgrounds who participated in a qualitative research project and to outline the difficulties encountered according to the women's origin. Methods: Research was carried out in Barcelona from 2007 to 2008 to identify how culture influences participation in a breast cancer early detection program. Results: The study population consisted of native women and immigrant women from developing countries aged 40 to 69 years old resident in Barcelona. Participants were recruited through multiple strategies: key informants, cultural mediators, healthcare professionals, associations, religious institutions, the media, posters, adult education and language schools, and the population census. Conclusions: The recruitment process cannot be confined to a single source and associations, religion institutions and cultural mediators are the most effective resources (AU)

[Strategies to recruit immigrant women to participate in qualitative research]. / Estrategias para reclutar mujeres inmigrantes para participar en una investigación cualitativa.

OBJECTIVE: The present article aims to describe the process of selecting and recruiting women from distinct sociocultural backgrounds who participated in a qualitative research project and to outline the difficulties encountered according to the women's origin. METHODS: Research was carried out in Barcelona from 2007 to 2008 to identify how culture influences participation in a breast cancer early detection program. RESULTS: The study population consisted of native women and immigrant women from developing countries aged 40 to 69 years old resident in Barcelona. Participants were recruited through multiple strategies: key informants, cultural mediators, healthcare professionals, associations, religious institutions, the media, posters, adult education and language schools, and the population census. CONCLUSIONS: The recruitment process cannot be confined to a single source and associations, religion institutions and cultural mediators are the most effective resources.

[Reasons for attending emergency departments. People speak out]. / Razones para acudir a los servicios de urgencias hospitalarios. La población opina.

OBJECTIVE: To ascertain why people attend hospital emergency departments (ED) for low complexity health problems. METHOD: A phenomenological, interactionist, qualitative study was performed. A theoretical sample that selected one urban and one rural area from Catalonia (Spain) was designed. In each setting, persons (n = 36) who had used the ED or a primary care emergency service 1 month before the beginning of the study were chosen. Data were obtained through 8 focus groups. An interpretative content analysis was performed, and emergent categories were constructed through research triangulation. RESULTS: Five categories emerged: symptoms, whether or not self-diagnosis was involved, perception of needs, awareness of the health services available, and the overall context of the person. Symptoms generated feelings of failing health and thus initiated care seeking. Self-diagnosis determined perceived need and the type of care sought. People contrasted their self-perception of need with their own opinion about the health services available. The decision to go to one or other service was made as a result of this contrast, but the individual's family, work, and social situations also played a part. Informants were more familiar with the service provided by the ED than with that provided by primary care. Time consumption also figured heavily in decision making. CONCLUSIONS: The presence or absence of self-diagnosis is a determining factor in attendance at EDs. Other factors that influence demand are the level of awareness of the health services available, previous experiences, and the life situation of the individual.

Razones para acudir a los servicios de urgencias hospitalarios. La población opina / Reasons for attending emergency departments. People speak out

Objetivo: Conocer por qué las personas acuden a los servicios de urgencia hospitalarios (SUH) por problemas de salud de baja complejidad. Método: Se realizó una investigación cualitativa de tipo fenomenológica interaccionista. La muestra teórica pertenecía a un área urbana y otra rural de Cataluña. Se escogieron personas (n = 36) que habían acudido a los SUH o a servicios de urgencia de la atención primaria de salud (SUAP) en el mes previo a su selección. Se recogieron datos en 8 grupos focales. Se realizó un análisis inductivo descriptivo-interpretativo, construyendo categorías emergentes a partir de la triangulación. Resultados: Emergieron 5 categorías: síntomas, elaboración de autodiagnóstico, percepción de necesidad, conocimiento de la oferta y contexto global de la persona. Los síntomas generan la consideración de pérdida de salud y desencadenan la acción. La elaboración del autodiagnóstico determina la necesidad-tipo de atención. Del contraste entre la percepción-tipo de necesidad y el conocimiento de la oferta de los servicios, así como de la situación vital de la persona, surge la decisión de acudir a un servicio u otro y se genera la acción. El conocimiento de la oferta de los SUH es mejor que el de los SUAP. El tiempo parece básico en la toma de decisiones. Conclusiones: La elaboración de un autodiagnóstico es crítica en la determinación de la acción, pero el conocimiento de la oferta de los servicios, las experiencias previas y la situación vital de la persona modulan el tipo de demanda

Objective: To ascertain why people attend hospital emergency departments (ED) for low complexity health problems. Method: A phenomenological, interactionist, qualitative study was performed. A theoretical sample that selected one urban and one rural area from Catalonia (Spain) was designed. In each setting, persons (n = 36) who had used the ED or a primary care emergency service 1 month before the beginning of the study were chosen. Data were obtained through 8 focus groups. An interpretative content analysis was performed, and emergent categories were constructed through research triangulation. Results: Five categories emerged: symptoms, whether or not self-diagnosis was involved, perception of needs, awareness of the health services available, and the overall context of the person. Symptoms generated feelings of failing health and thus initiated care seeking. Self-diagnosis determined perceived need and the type of care sought. People contrasted their self-perception of need with their own opinion about the health services available. The decision to go to one or other service was made as a result of this contrast, but the individual's family, work, and social situations also played a part. Informants were more familiar with the service provided by the ED than with that provided by primary care. Time consumption also figured heavily in decision making. Conclusions: The presence or absence of self-diagnosis is a determining factor in attendance at EDs. Other factors that influence demand are the level of awareness of the health services available, previous experiences, and the life situation of the individual