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dc.contributor.advisorOzakinci, Gozde
dc.contributor.authorWhelehan, Patsy
dc.coverage.spatialxxiii, 263, LX p.en_US
dc.description.abstractIntroduction: Breast cancer is an important health problem with nearly 56,000 new invasive cases yearly in the UK. It is therefore the subject of a screening programme with mammography as the test. Screening programme effectiveness depends partly on acceptability of the test but mammography is not always acceptable to patients. This work aimed to improve upon current understandings of the impact of pain in mammography, and of the examination experience more broadly. Objectives: 1. To determine the relationship between mammography pain and repeat participation in breast screening; 2. To explore the contemporary experience of mammography in depth, from both patient and practitioner perspectives; 3. To develop and validate measures of patient experience in mammography. Methods: 1. A systematic review; 2. a qualitative interview study with Framework data management and thematic analysis; 3. an instrument development and measuring and modelling study incorporating the Rasch model. Findings: Painful mammography was the reason given by 11-46% of non-reattenders. Meta-analysis of a subset of studies showed a relative risk of non-reattendance after pain of 1.34 [95% CI 0.94-1.91]. Qualitative findings emphasised the importance of compassionate care and highlighted challenges practitioners face in providing it. Measures of adverse positioning and compassionate care in mammography were developed and validated, although further refinements are needed. Additional measures included general service quality and pain predisposition. In preliminary statistical analyses, mammography pain was associated with score on the pain predisposition measure. Compassionate care score was associated with general service quality score and showed some variation by mammographer. Conclusions/recommendations: Improved information and support interventions are required for women attending mammography for the first time and/or with high scores on the pain predisposition measure. An educational intervention to optimise compassionate care in mammography should be developed and tested, using a refined version of the compassionate care measure. The adverse positioning measure should be expanded and further validated.en_US
dc.description.sponsorship"This work was supported by: • The National Awareness and Early Detection Initiative (NAEDI), reference C29002/A12256. NAEDI was a consortium under the auspices of the National Cancer Research Institute (NCRI). Partners were Cancer Research UK, Department of Health (England), Economic and Social Research Council, Health & Social Care R&D Division, Public Health Agency (Northern Ireland), National Institute for Social Care and Health Research (Wales) and the Scottish Government. • The College of Radiographers Industry Partnership Scheme (CoRIPS), grant number 095 • The University of St Andrews School of Medicine Research Investment Fund • Charitable donations from fundraising by Mrs Fiona Edwards." -- Fundingen
dc.rightsCreative Commons Attribution-NonCommercial-NoDerivatives 4.0 International*
dc.subjectBreast cancer screeningen_US
dc.subjectPatient experienceen_US
dc.subjectRasch modelen_US
dc.titleWomen's experiences of mammography : fresh insights and novel measuresen_US
dc.contributor.sponsorNational Awareness and Early Detection Initiative (NAEDI)en_US
dc.contributor.sponsorCollege of Radiographers (Great Britain). Industry Partnership Scheme (CoRIPS)en_US
dc.contributor.sponsorUniversity of St Andrews. School of Medicine. Research Investment Funden_US
dc.type.qualificationnamePhD Doctor of Philosophyen_US
dc.publisher.institutionThe University of St Andrewsen_US
dc.rights.embargoreasonThesis restricted in accordance with University regulations. Restricted until 20th April 2027en
dc.identifier.grantnumberC29002/A12256 (NAEDI)en_US
dc.identifier.grantnumber095 (CoRIPS)en_US

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    Except where otherwise noted within the work, this item's licence for re-use is described as Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International