Prerequisiti della Convivenza entro i contesti di promozione e tutela della salute. Lo screening mammografico al Nord e al Sud d’Italia

Abstract

Promotion and Health Care in Various Coexistence Contexts. Breast Screening in the North and South of Italy

The effectiveness of early detections of cancer masses has been widely demonstrated by medical research; this kind of diagnosis is particularly important in the cases of breast cancer. A diagnosis of this form of cancer at its early phases, in the 97% of cases allows women to survive at least five years after it. For this reason the Italian healthcare system promotes and finances a breast cancer screening program - that consists in a free mammogram every two years - addressed to all women living in Italy ranging in age between 48 and 69 years. Although this important program, statistics shown by the Osservatorio Nazionale Screening reveal a big numeric gap, comparing the regions of the North and the South of the country, referring to the adherence rate. This study aims at exploring the reasons for this discrepancy, assuming that the trust in health care facilities is a prerequisite for a stable relationship between people and institutions and, therefore, the basis of social coexistence; so the trust, or not, in the local hospitals determines women’s access to the national screening program. In order to answer the research questions of this study we chose to use the focus group technique: 32 Italian women, ranging in age between 48 and 65 years (M= 53, SD= 5.26), 17 living in the North (in or around Milan) and 15 living in the South (in or around Naples) of Italy, took part to a 5 Focus Group concerning breast cancer prevention. The analysis on the groups’ verbatim, done with software allowing a text analysis (ATLAS.ti and T-LAB), highlighted important differences in the way northern and southern subjects emotionally symbolize the context where they live and coexist. The southern hospitals are considered, by the women who live in this geographic area, as places characterized by “incompetence”; this consideration limits the probability that the need of an early detection “coexists” with the possibility that these hospitals would give an appropriate answer to it.