title: Processes inherent in mammography-screening decisions of rarely or never-screened women.
abstract: Breast cancer is a significant cause of mortality and morbidity. A strong association exists between survival and early detection through regular mammography. Impoverished women underuse this life-saving screening, resulting in a disproportionate cancer burden. The study purpose is to discover the process of rarely or never-screened women's mammography-screening decisions. The sample consists of five rural, low-income, uninsured, and rarely or never-screened women. Grounded theory methodology is used to generate a new theoretical explanation of mammography-screening decision making. Findings include the central conceptual categories, intuitive dominance and intuitive certainty, which contribute toward an intuitive decision-making default. This intuitive thinking style weaves throughout two interrelated categories: (a) scarce, supportive, relational resources for learning and (b) dichotomous health care-seeking behaviors. Implications focus on a nontraditional client assessment whereby nurses can facilitate relational-based knowledge construction. Recommendations for future research include examination of the process of integrating intuition with reasoned thought for more fully informed decisions.
authors.affiliation: Fay W. Whitney School of Nursing, College of Health Sciences, University of Wyoming, Dept. 3065, 1000 E. University Ave., Laramie, WY 82071-2000, USA. mpurtzer@uwyo.edu
authors.forename: Mary Anne
authors.initials: MA
authors.lastname: Purtzer
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000517:prevention & control; D003657:Decision Making; D005260:Female; D006801:Humans; D008327:Mammography / Q000523:psychology / Q000706:statistics & numerical data*; D008875:Middle Aged; D008960:Models, Psychological