Quality Control in a National Program for the Early Detection of Breast Cancer: Women’s Satisfaction With the Mammography Process
Received 19 February 2007; accepted 20 December 2007.
Introduction
The experience of the mammography testing process and related satisfaction influence women’s willingness to undergo the test again. The study goal was to assess women’s overall satisfaction with the mammography examination service provided by participating units in the National Program for the Early Detection of Breast Cancer in Israel.
Methods
Between August 2003 and March 2004, a random sample of 3,295 women from 38 mammography units nationwide was drawn. Women were interviewed within 48 hours of their mammography, regarding their assessment of the examination process: discomfort, overall satisfaction, and intention to rescreen. Overall satisfaction and process items were measured on an ordinal scale ranging from 1 (lowest) to 6 (highest). Multivariate binomial regression was performed to identify significant predictors of being less satisfied and to estimate the associated relative risks with 95% confidence interval (CI).
Results
A response of “very satisfied” (score 6), indicating overall satisfaction with the mammography process, was reported by 77% (95% CI, 73%–80%) of the women, 19% (95% CI, 17%–21%) said they were satisfied. Willingness to rescreen was reported by 95%. Negative assessment of staff attitude was the most influential predictor of being less satisfied. Twenty-six percent of women reported experiencing very discomforting pain. This response was associated with a diagnostic test indication, and with process items directly related to the test (technician’s attitude toward the patient; information provided by her; privacy during the test).
Conclusions
Women’s satisfaction was high, as was intention to rescreen. The gap between intention and rescreening begs further investigations as to other types of barriers preventing women from adherence to rescreening.
Department of Community Medicine and Epidemiology, Carmel Medical Center, The Faculty of Medicine, Technion, Haifa, Israel
Correspondence to: Dr Lea Hagoel, Carmel Medical Center, Department of Community Medicine and Epidemiology, 7 Michal Street, 34362 Haifa, Israel.
Supported by grants from the Israel Cancer Association, and the Israeli National Institute for Health Policy Research.
1 Ronit Almog, MD, MPH, is an epidemiologist. She directed the quality control project reported here at The Department of Community Medicine and Epidemiology, Carmel Medical Center & The Faculty of Medicine, Technion, Haifa, Israel. Her interests include cancer epidemiology, early detection of disease, and molecular epidemiology.
2 Lea Hagoel, PhD, is a medical sociologist at The Department of Community Medicine and Epidemiology, Carmel Medical Center & The Faculty of Medicine, Technion, Haifa, Israel. She is interested in adherence to breast and colorectal cancer screening, and in the interactions among scientific disciplines.
3 Ada Tamir, DSc, is a biostatistician at The Department of Community Medicine and Epidemiology, Carmel Medical Center & The Faculty of Medicine, Technion, Haifa, Israel. She takes part in design and statistical analysis of projects related to community medicine and public health.
4 Ofra Barnett-Griness, PhD, is a biostatistician at The Department of Community Medicine and Epidemiology, Carmel Medical Center & The Faculty of Medicine, Technion, Haifa, Israel. Her activities include, among others, the application of regression models.
5 Gad Rennert, MD, PhD, is Head of The Department of Community Medicine and Epidemiology, Carmel Medical Center & The Faculty of Medicine, Technion, Haifa, Israel. Professor Rennert is director of the Israeli National Program for the Early Detection of Breast Cancer, under the auspices of the Ministry of Health, and the Israeli Cancer Association.
ABSTRACT