Background Effective screening can prevent cervical cancer, but many women choose not to attend their screening tests. Objective This study aimed to investigate behavioural influences on cervical screening participation using the Theoretical Domains Framework (TDF) and COM‐B models of behaviour change. Design A qualitative study and semistructured phone interviews were conducted with women invited for routine screening tests within the national cervical screening programme in Ireland. Setting and Participants Forty‐eight women aged 25–65 years were recruited from the national screening register. Results Seven core themes were identified that mapped to three COM‐B components and 11 TDF domains: (1) knowledge of cervical cancer and screening, (2) coping with smear tests, (3) competing motivational processes—automatic and reflective, (4) cognitive resources, (5) role of social support, (6) environmental influences and (7) perceputal and practical influences. A range of knowledge about screening, perceived risk of cervical cancer and human papillomavirus infection was evident. Factors that influenced screening behaviours may be hierarchical—some were assigned greater importance than others. Positive screening behaviours were linked to autonomous motivation. Deficits in physical and psychological capability (inadequate coping skills) were barriers to screening, while physical and social opportunity (e.g. healthcare professional ‘champions’) could facilitate participation. Older women raised age‐related issues (e.g. screening no longer necessary) and had more negative attitudes to screening, while younger women identified practical barriers. Conclusions This study provides insight into screening participation and will aid development of theoretically informed interventions to increase uptake. Patient or Public Contribution Women invited for screening tests through the national screening programme were interviewed. A Public & Patient Involvement (PPI) Panel, established to provide input into all CERVIVA research projects, advised the research team on recruitment materials and were given the opportunity to review and comment on the interview topic guide. This panel is made up of six women with various cervical screening histories and experiences.
Aim: To determine the use and perceived value of different information sources that patients may use to support identification of medicine side effects; to explore associations between coping styles and use of information sources. Background: Side effects from medicines can have considerable negative impact on peoples’ daily lives. As a result of an ageing UK population and attendant multi-morbidity, an increasing number of medicines are being prescribed for patients, leading to increased risk of unintended side effects. Methods: A cross-sectional survey of patients who use medicine, recruited from community pharmacies. The survey sought views on attributes of various information sources, their predicted and actual use, incorporating a shortened Side Effects Coping Questionnaire (SECope) scale and the abbreviated Miller Behavioural Style Scale (MBSS). Findings: Of 935 questionnaires distributed, 230 (25.0%) were returned, 61.3% from females; 44.7% were retired and 84.6% used at least one medicine regularly. 69.6% had experienced a side effect, resulting in 57.5% of these stopping the medicine. Patient information leaflets (PILs) and GPs were both predicted and actually most widely used sources, despite GPs being judged as relatively less accessible and PILs less trustworthy, particularly by regular medicine users. Pharmacists, considered both easy to access and trustworthy, were used by few in practice, while the internet was considered easy to access, but less trustworthy and was also little used. SECope sub-scales for non-adherence and information seeking showed positive associations with stopping a medicine and seeking information from a health professional. More high monitors than low monitors stopped a medicine themselves, but there were no differences in use of information sources. Information seeking following a side effect is a common strategy, potentially predicted by the SECope, but not the MBSS. Limited GP accessibility could contribute to high internet use. Further research could determine how the trustworthiness of PILs can be improved.
Objectives: An aging UK population and multi-morbidity means patients are receiving an increasing number of medicines. This can lead to greater risk of unintended side effects. The aim of this study was to increase understanding of how people identify and manage side effects from their medicines. Design: A qualitative interview study with patients who had experienced side effects, recruited from community pharmacies. Methods: This study examined patients' experiences of side effects and the impact of these effects on their daily life. Fifteen participants were interviewed-10 females and 5 males, with ages that ranged between 25 and 80 years, using different types and numbers of medicines. Results: Thematic analysis revealed six themes: side effect experience, identification, adherence, information use, coping and body awareness. Participants described a wide range of physical and psychological symptoms which had both explicit and implicit impact on their lives. A system of identification based on constructed cognitive processes was common across participants. A variety of strategies were used by participants to cope with their side effects which included information seeking, social support seeking and non-adherent behaviours. Conclusions: Psychological factors, such as medication beliefs, symptom interpretation and body awareness, contribute to cognitive and behavioural processes used to identify and manage side effects. These processes can have significant impacts on an individual's decisions about adherence.
The debate about the emerging discipline of IS has been continuing at least since Banville and Landry questioned the possibility of “disciplining” MIS in 1989. Recent papers such as those in the book by Mingers and Stowell introduce fresh viewpoints and reopen the discussion along a new frontier. It would appear that an ontological framework to define a discipline could assist in making sense of what it is that information systems are all about. To this end, we develop a framework which derives from Heidegger’s concept of a regional ontology informed by the fundamental ontology of Dasein. This framework draws from Heidegger’s work and contends that a discipline also has Dasein’s kind of being. Following Heidegger, we arrive at a static model of a discipline in which the two constitutive parts are the cultural structure and the context of significance. A discipline is a totality, which emerges from and integrates these two components which are simultaneously irreducible to one another, and nonseparable in the whole. We then utilise Heidegger’s four ways of being, to show how change in a discipline can be incorporated in the framework. Finally, we reflect on how the framework could contribute towards the understanding of the discipline of information systems.
There is a paucity of data on trust of service users in cervical screening. A significant controversy in Ireland’s national cervical cancer screening programme emerged in 2018. The Health Service Executive (HSE) confirmed that a clinical audit had revealed that more than 200 women who developed cancer had not been told of earlier misdiagnosed smear tests. During this high profile controversy we conducted qualitative interviews exploring factors that influence cervical screening participation. Women who had been invited for routine screening tests were recruited from the national screening register. Telephone interviews were conducted with 48 women aged 25–65 years; with a range of screening histories – 34 were adequately screened (attended all routine screening tests) and 14 were inadequately screened (attended some/no screening tests). Thematic analysis was conducted and all interviewees spontaneously raised the screening controversy revealing that the crisis had resulted in serious loss of trust, faith and confidence in the screening programme. Publicity surrounding the controversy had some beneficial effects, including increased awareness of the value of screening and beliefs that intense focus on the programme will improve the service long-term. Strategies which incorporate these findings could help rebuild trust in screening.
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