"Couldn't you have done just as well without the screening?". A qualitative study of benefits from screening as perceived by people without a high cardiovascular risk score.

OBJECTIVE: To explore how individuals whose health screening does not reveal a high cardiovascular risk score (CRS) interpret and respond to this result. DESIGN: Qualitative semi-structured interviews. Purposeful sampling reflected variations in age, gender, and self-rated health within the sample. Analysis and interpretation were informed by the Health Belief Model concerning individuals' cues to act when told there is a health threat, and by Hollnagel and Malterud's theories about personal self-assessed health resources. SETTING: Participants were recruited among participants without a high cardiovascular risk score in a Danish health-screening project. SUBJECTS: Seven men and 15 women aged 36-50 years with a low or moderate cardiovascular risk score. RESULTS: The screening confirmed the participants' feeling of being in good health and they put emphasis on this acquired peace of mind. Participants used the results to eliminate worries and confirm their lifestyle up to now but were aware that the results gave no guarantee that there was nothing the matter elsewhere. Some paid a price for the reassurance since they had to undergo further examinations, had unfulfilled expectations, or were irritated at not being left in peace with their reassurance. CONCLUSION: Screened individuals who were shown not to have a high risk score appear to be reassured and confirmed in their own feeling of being healthy, and to be aware of the limitations of the screening. Consideration should be given to the possible risk of creating either insecurity or over-complacency through population screening.

You can't prevent everything anyway: a qualitative study of beliefs and attitudes about refusing health screening in general practice.

OBJECTIVE: The aim of this study was to explore beliefs and attitudes about refusing health screening in general practice. METHODS: In 1991, in Ebeltoft, Denmark people aged between 30 and 50 years were invited to participate in a 5-year randomized, controlled, population-based project testing the value of health screenings and health discussions in general practice. In 1994, non-participants who declined the offered health screening but expressed willingness to be contacted in the future were asked to participate in a qualitative interview. They were drawn by stratified purposeful sampling which reflected variation in perceived health, body mass index, age and sex. The sample comprised six men and 12 women RESULTS: Some had not participated because they were busy, felt healthy or had recently been examined. The non-participants emphasized the limitations of health screening and did not want possible risk factors to be revealed, or their feeling of good health to be disturbed. They stressed the individual's own responsibility for maintaining good health and believed that a positive attitude promoted health. They would contact their GP if they had symptoms. CONCLUSION: Non-participants have rational views on risk factor testing and on their own responsibility for maintaining health. Non-attendance was due to a conscious choice which included consulting their own GP.