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Educational differences in responses to breast cancer symptoms: A qualitative comparative study

Marcu, Afrodita, Black, G, Vedsted, P, Lyratzopoulos, G and Whitaker, Katriina (2016) Educational differences in responses to breast cancer symptoms: A qualitative comparative study British Journal of Health Psychology, 22 (1). pp. 26-41.

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Abstract

Objective. Advanced stage at diagnosis for breast cancer is associated with lower socio-economic status (SES). We explored what factors in the patient interval (time from noticing a bodily change to first consultation with a health care professional) may contribute to this inequality.Design. Qualitative comparative study.Methods. Semi-structured interviews with a sample of women (≥47 years) from higher(n = 15) and lower (n = 15) educational backgrounds, who had experienced at least one potential breast cancer symptom. Half the participants ( n = 15) had sought medical help,half had not (n = 15). Without making breast cancer explicit, we elicited women’s sense-making around their symptoms and help-seeking decisions.Results. Containment of symptoms and confidence in acting upon symptoms emerged as two broad themes that differentiated lower and higher educational groups. Women from lower educational backgrounds tended to attribute their breast symptoms to trivial factors and were reticent in using the word ‘cancer’. Despite ‘knowing’ that symptoms could be related to cancer, women with lower education invoked lack of medical knowledge – ‘I am not a doctor’ – to express uncertainty about interpreting symptoms and accessing help. Women with higher education were confident about interpreting symptoms, seeking information online, and seeking medical help.Conclusions. Our findings suggest that knowledge of breast cancer alone may not explain socio-economic differences in how women respond to breast cancer symptoms as women with lower education had ‘reasons’ not to react. Research is needed on how to overcome a wider spectrum of psycho-social factors to reduce future inequality.

Item Type: Article
Subjects : Medical Science
Divisions : Faculty of Health and Medical Sciences > School of Health Sciences
Authors :
NameEmailORCID
Marcu, Afroditaafrodita.marcu@surrey.ac.uk
Black, G
Vedsted, P
Lyratzopoulos, G
Whitaker, Katriinak.whitaker@surrey.ac.uk
Date : 29 September 2016
Identification Number : 10.1111/bjhp.12215
Copyright Disclaimer : © 2016 The British Psychological Society. This is the peer reviewed version of the following article: Afrodita Marcu Georgia Black Peter Vedsted Georgios Lyratzopoulos Katriina L. Whitaker, Educational differences in responses to breast cancer symptoms: A qualitative comparative study, 22(1)DOI:10.1111/bjhp.12215 which has been published in final form at https://onlinelibrary.wiley.com/doi/abs/10.1111/bjhp.12215. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving
Depositing User : Symplectic Elements
Date Deposited : 13 Sep 2016 14:08
Last Modified : 04 May 2018 08:19
URI: http://epubs.surrey.ac.uk/id/eprint/812149

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