Health beliefs and personality correlates of breast cancer: from screening to mastectomy adjustment - a cross-cultural study between Scotland and Greece
The present thesis consists of three thematic parts in relation to breast cancer: (a)
practice of breast self - examination (BSE), (b) screening mammography attendance
and (c) adjustment to breast cancer surgery / mastectomy. The aims of the respective
studies are (a) to examine attitudes, beliefs and practices regarding BSE in younger
(30 years old or under) and older women (over 30 years old), (b) to explore attitudes
and beliefs regarding mammography and identify factors associated with screening
mammography attendance and (c) to explore factors associated with adjustment to
breast cancer surgery. The above aims are explored in two different cultural contexts,
by comparing samples from Scotland and Greece. Samples consisted (a) of 205
younger and 258 older women, university staff and students in Scotland and 85
younger women, university students in Greece, (b) 283 women who attended and 72
women who did not attend the National Breast Screening in Scotland, and 72 women
undergoing mammography in Greece and (c) 19 women in Scotland and 27 women in
Greece, who have undergone surgery for breast cancer. All participants were assessed
on a variety of measures. These included demographics, health history, health beliefs
and health - related personality variables.
Results indicated that:
1. BSE was predicted by different variables across age and cultural groups.
2. In particular, practice of BSE in younger women was predicted by knowledge
about breast cancer, perceived barriers, health motivation and cues for action,
whereas practice in older women was predicted by knowledge about BSE,
perceived barriers and cues for action.
3. BSE rates in both countries were higher than previously reported but did not differ
between women in Scotland and Greece. However, the two groups differed in
knowledge and attitudes, regarding BSE, and in personality. Women in Scotland
appeared more knowledgeable regarding BSE, felt less susceptible to breast
cancer and were less active in coping with health issues than women in Greece.
Women in Greece valued their health more and scored higher in chance health
locus of control beliefs than women in Scotland.
4. The best predictor of breast screening mammography attendance in Scotland was
knowledge about mammography. Attenders appeared to have more knowledge
about breast cancer and about mammography and to focus more on emotional
coping, in order to deal with health stresses.
5. The two cultural groups differed in health-related decision making and health -
related coping styles. Attenders in Scotland were more knowledgeable about risk
factors related to breast cancer and about mammograms and perceived
significantly more pain/discomfort associated with the procedure, than attenders in
Greece. Attenders in Greece resorted more to acceptance and denial and were
more likely to seek emotional support, in order to cope with health stressors than
attenders in Scotland.
6. Health beliefs of breast cancer patients, in relation to their condition, and their
style of coping with threatening information, concerning their breast problem, are
highlighted as important factors to their adjustment in both cultures. However,
adjustment to breast cancer surgery appears culture-specific, as different factors
seem to determine it in different cultural contexts.
7. Patients in Scotland and Greece did not differ in their overall adjustment.
However, Greek patients were significantly less well adjusted sexually postoperatively
than patients in Scotland.
Findings are discussed in relation to theoretical and practical implications