Norfjord van Zyl Maria, Tillgren Per, Asp Margareta
Division of Public Health Sciences, School of Health, Care and Social Welfare, Mälardalen University, Box 883, 721 23, Västerås, Sweden.
Division of Caring Sciences and Health Care Pedagogics, School of Health, Care and Social Welfare, Mälardalen University, Box 883, 721 23, Västerås, Sweden.
Arch Public Health. 2021 Apr 17;79(1):52. doi: 10.1186/s13690-021-00576-6.
Breast cancer is the most common cancer type among women globally. To facilitate early detection, all 40-74-year-old female residents of Sweden are invited to participate in a population-based mammographic screening programme. Approximately 20% of all invited women decline the offer, and if this is due to systematic differences that can be adjusted, it can indicate inequity in healthcare. Assessment of and being updated about the health and healthcare of the residents are largely the responsibilities of the self-governed regions in Sweden. The understanding of the residents' health serves as a basis for decision making and priority setting. This study aims to describe how politicians representing a region in Sweden perceive women's participation in mammographic screening and the politicians' own possibility to promote such participation.
Qualitative thematic analysis was conducted on the data obtained from individual semi-structured interviews held in 2019. The interviewees comprised ten politicians (six women and four men, 38-71 years old) representing a sub-committee focusing on public health and healthcare issues.
Two main themes have been identified: 1) expected actions and 2) expected conditions for acting, including a total of four sub-themes. According to the politicians, the expected actions, such as obtaining information and being updated about matters regarding mammographic screening, concern both the women invited to the screening and the politicians themselves. Additionally, for both the individual and the healthcare organisation, here represented by the politicians, expected actions entail a shared commitment to maintain health. The expected conditions for acting refer to the politician's awareness of the factors influencing the women's decision to undergo or refuse the screening and having the resources to enable taking actions to facilitate participation.
Expected actions and expected conditions for acting are tightly connected and entail some form of prioritisation by the politicians. Setting the priorities can be based on information about the purpose of the screening and an understanding of social determinants' impacts on women's decision to refrain from mammographic screening, as well as available resources.
乳腺癌是全球女性中最常见的癌症类型。为促进早期检测，瑞典邀请所有40至74岁的女性居民参加基于人群的乳房X线筛查项目。所有受邀女性中约有20%拒绝邀请，如果这是由于可以调整的系统性差异导致的，那么这可能表明医疗保健存在不公平现象。评估并了解居民的健康状况及医疗保健情况在很大程度上是瑞典自治地区的职责。对居民健康状况的了解是决策和确定优先事项的基础。本研究旨在描述代表瑞典一个地区的政治家如何看待女性参与乳房X线筛查以及政治家自身促进这种参与的可能性。
对2019年进行的个人半结构式访谈所获数据进行定性主题分析。受访者包括代表一个关注公共卫生和医疗保健问题的小组委员会的十名政治家（六名女性和四名男性，年龄在38至71岁之间）。
确定了两个主要主题：1）预期行动和2）行动的预期条件，包括总共四个子主题。据政治家们称，预期行动，如获取有关乳房X线筛查事项的信息并了解最新情况，既涉及受邀参加筛查的女性，也涉及政治家自身。此外，对于个人和由政治家代表的医疗保健组织而言，预期行动都需要共同致力于维护健康。行动的预期条件是指政治家意识到影响女性决定接受或拒绝筛查的因素，并拥有采取行动促进参与的资源。
预期行动和行动的预期条件紧密相连，需要政治家进行某种形式的优先排序。确定优先事项可基于有关筛查目的的信息、对社会决定因素对女性拒绝乳房X线筛查决定的影响的理解以及可用资源。
