Design: A comparative descriptive design with a convenience sample of 98 women aged 60 years or older recruited from community settings and assisted-living sites in the United States.

Methods: Self-report interviews were completed in senior centers or assisted-living sites. Instruments included the Katz Activities of Daily Living scale (ADL) and Instrumental Activities of Daily Living scale (IADL) and an Activity Limitation (AL) scale modified from the Medical Outcomes Survey Short Form (MOS-SF36). Demographic variables, health status, and co-existing medical conditions (comorbidity) were also measured. Discriminant function analysis identified which variables functioned as significant predictors for mammography use or non-use. Narrative data regarding constraints to mammography underutilization were collected.

Findings: Predictors of age, ADL, IADL, AL, and comorbidity were significant for predicting group mammography use or non-use. Constraints to mammography among non-users were identified as lack of provider recommendation or a personal belief that a mammogram was not needed. Pain, fear of radiation, cost, and fear of finding cancer were not frequently identified constraints.

Conclusions: Women who are older, have more comorbid conditions and activity limitations, and who are limited in activities of daily living and instrumental activities of daily living should be targeted in breast cancer screening initiatives. Given the complexity of health issues prevalent in vulnerable communities of disabled elders, providers are encouraged to prioritize breast cancer screening and risk education for older women while considering relevant life expectancy and quality of life issues as age increases.

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Back to 15th International Nursing Research Congress
Sigma Theta Tau International
July 22-24, 2004