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.


OBJECTIVE
The aim of this paper was to examine how community nurses and residential staff support women with ID to access breast screening services.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Institute of Nursing Research, University of Ulster, Coleraine, Northern Ireland, UK. l.taggart@ulster.ac.uk
L
L
Taggart
M
M
Truesdale-Kennedy
S
S
McIlfatrick
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000451:nursing* / Q000517:prevention & control; D003152:Community Health Nursing; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008607:Intellectual Disability / Q000451:nursing*; D008327:Mammography / Q000451:nursing*; D008403:Mass Screening / Q000451:nursing* / Q000458:organization & administration; D008875:Middle Aged; D009660:Northern Ireland; D024802:Nurse's Role; D012112:Residential Facilities; D012307:Risk Factors