title: Transformative learning theory: facilitating mammography screening in rural women.
abstract: OBJECTIVE
  To use transformative learning to investigate what experiences serve as catalysts for mammography screening, the cognitive and affective responses that result from the catalyst, and how screening behavior is impacted.
  
  
  METHODS
  A descriptive qualitative study.
  
  
  METHODS
  Southeastern Wyoming.
  
  
  METHODS
  25 low-income, rural women aged 40 years and older.
  
  
  METHODS
  Four focus group interviews.
  
  
  RESULTS
  Cancer experiences triggered universal responses of fear by screeners and nonscreeners. The manner in which that fear response was interpreted was a critical factor in the facilitation of, or impedance to, screening. Dichotomous interpretations of fear responses provided the context for screening behavior. Immobilizing and isolating experiences were associated with nonscreening behavior, whereas motivation and self-efficacy were associated with screening behavior.
  
  
  CONCLUSIONS
  Transformative learning theory is a useful framework from which to explain differences in mammography screening behavior. Creating opportunities that facilitate dialogue and critical reflection hold the potential to change immobilizing and isolating frames of reference in nonscreening women.
  
  
  CONCLUSIONS
  To help women transcend their fear and become self-efficacious, nurses can assess how cancer and the screening experience is viewed and, if indicated, move beyond standard education and offer opportunities for dialogue and critical reflection.
authors.affiliation: Fay W. Whitney School of Nursing, University of Wyoming in Laramie.
authors.forename: Mary Anne
authors.initials: MA
authors.lastname: Purtzer
authors.affiliation: Social Work Department, University of Wyoming in Laramie.
authors.forename: Lindsey
authors.initials: L
authors.lastname: Overstreet
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000451:nursing* / Q000517:prevention & control* / Q000523:psychology; D005239:Fear / Q000523:psychology; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008327:Mammography / Q000451:nursing* / Q000523:psychology; D008403:Mass Screening / Q000451:nursing* / Q000523:psychology; D009042:Motivation; D015404:Nursing Methodology Research; D009742:Nursing Theory; D010342:Patient Acceptance of Health Care / Q000523:psychology; D036301:Qualitative Research; D012424:Rural Population; D014959:Wyoming
keywords: breast cancer; nursing research; prevention and detection; qualitative research; rural issues