When health means suffering: mammograms, pain and compassionate care

Abstract

When health means suffering: mammograms, pain and compassionate careThe X-ray mammogram remains the cornerstone of most public health programmes aimed at the early diagnosis of breast cancer. Its virtues of safety, reliability and cheapness maintain its established position, and Western social and cultural traditions of ambivalence to pain push any questions concerning the painfulness of the procedure into the background. As part of a larger UK/USA-based empirical study, we undertook a qualitative analysis of women's accounts of pain experienced in mammograms and their reaction to it, comparing their accounts with professional views and advice to patients as reflected in interviews, patient leaflets and practice guidelines. We found considerable variability of experience and reaction to pain among patients, and indications of similar variability in professionals' views and practice, contrasting with a uniformly reassuring message in formal institutional advice. We suggest that in practice professional workarounds and patients' felt obligation to tolerate pain bridge this gap, but that action to tackle the problems of dropout and the emotional and operational costs of the current system is nonetheless needed. The need is for concerned groups to combine to establish a serious and sustained programme of amelioration and innovative technological development to assure more compassionate patient care and operational efficiency.

Experiences and perceptions about undergoing mammographic screening: a qualitative study involving women from a county in Sweden

“…However, the participants express similar experiences and perceptions concerning obstacles to undergoing mammographic screening, irrespective of the municipality of residence. This result indicates that the importance of early detection and treatment (Willis, 2008) may supersede the inconveniences and accompanying nuisance of planning, travel, costs, recall, pain (Morris, 2015) and nervousness experienced by the participants of this study. Other studies have reported similar findings, but the difference is that the county involved in this study only has one mammographic facility.…”

“…Similar to the findings of other Swedish studies, the screening procedure is perceived as standardized, with its focus on one body type, as well as sometimes being painful and automated (Johansson & Berterö, 2003; Lagerlund et al, 2001). However, the conduct of the staff may affect this experience (Morris, 2015; Whelehan, Evans, & Ozakinci, 2017). Hence, the importance of staff’s concern for the women’s feeling of comfort in an exposed situation cannot be underestimated (Van Goethem et al, 2003).…”

“Guys Don’t Have Breasts”: The Lived Experience of Men Who Have BRCA Gene Mutations and Are at Risk for Male Breast Cancer

“…Due to the dearth of literature on men and mammograms, the authors turned to the literature on women’s experiences of mammograms ( Brett, Bankhead, Henderson, Watson, & Austoker, 2005 ; Engelman, Cizik, & Ellerbeck, 2006 ; Fine, Rimer, & Watts, 1993 ; Hamilton & Barlow, 2003 ; Morris, 2014 ; Nekhlyudov, Ross-Degnan, & Fletcher, 2003 ; Watson et al, 2005 ). There are parallels between this body of literature and the findings of the current study related to the waiting room experience and anticipation of the procedure.…”

Client and practitioner perspectives on the screening mammography experience

“…The main strengths of our study are that it involved a heterogeneous sample and included mammographers as well as clients. While there has been one previous qualitative study with participation from both mammography clients and staff (Morris, 2015), only two mammographers were interviewed for that study. Recently, a broad-based sample of mammographers formed the basis of two analyses but the study differed from ours by using a focus-group design, not including clients, and exploring compression behaviours specifically (Murphy et al, 2015;Nightingale et al, 2014).…”