Rationale and Objective
The purpose of this study was to evaluate themes related to patients’ experience in undergoing mammography, as expressed on Twitter.
Methods
A total of 464 tweets from July to December 2015 containing the hashtag #mammogram and relating to a patient’s experience in undergoing mammography were reviewed.
Results
Of the tweets, 45.5% occurred before the mammogram compared to 49.6% that occurred afterward (remainder of tweets indeterminate). However, in patients undergoing their first mammogram, 32.8% occurred before the examination, whereas in those undergoing follow-up mammogram, 53.0% occurred before the examination. Identified themes included breast compression (24.4%), advising other patients to undergo screening (23.9%), recognition of the health importance of the examination (18.8%), the act of waiting (10.1%), relief regarding results (9.7%), reflection that the examination was not that bad (9.1%), generalized apprehension regarding the examination (8.2%), interactions with staff (8.0%), the gown (5.0%), examination costs or access (3.4%), offering or reaching out for online support from other patients (3.2%), perception of screening as a sign of aging (2.4%), and the waiting room or waiting room amenities (1.3%). Of the tweets, 31.9% contained humor, of which 56.1% related to compression. Themes that were more common in patients undergoing their first, rather than follow-up, mammogram included breast compression (16.4% vs 9.1%, respectively) and that the test was not that bad (26.2% vs 7.6%, respectively).
Conclusion
Online social media provides a platform for women to share their experiences and reactions in undergoing mammography, including humor, positive reflections, and encouragement of others to undergo the examination. Social media thus warrants further evaluation as a potential tool to help foster greater adherence to screening guidelines.
Introduction
Early detection of breast cancer by screening mammography is associated with reduced breast cancer mortality . In addition, the American Cancer Society currently advises regular screening mammography in average risk patients . However, rates of screening mammography within the United States are suboptimal, with many women failing to undergo the examination . Reasons for guideline nonadherence are multifaceted. Of note, patients’ perceptions and attitudes regarding the test influence their decision whether to seek screening. For example, patients may be fearful of pain or discomfort during the examination, harbor anxiety of a possible unfavorable result, or lack awareness of screening guidelines and the examination’s health benefits .
Twitter is a public microblogging social media network with an estimated 500 million Tweets per day . Given its rapid and open discourse among any individuals with Internet access, as well as ease of accessing prior microblogging activity on a given topic, Twitter has developed into a valuable resource for health services research . One past study used Twitter to gain insights into the patient experience in undergoing magnetic resonance imaging . The dominant themes represented by the tweets differed somewhat from an earlier study using a more conventional data collection method . In a similar fashion, Twitter may provide a means of gaining deeper understanding of patients’ perception of the experience of undergoing mammography. Therefore, our aim in this study was to evaluate themes related to the patient experience in undergoing mammography, as expressed on Twitter.
Methods
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Results
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Table 1
Characteristics of 464 Included Tweets
Characteristic Frequency First mammogram 13.1% (61) Follow-up mammogram 14.2% (66) Tweeted before the examination 45.5% (211) Tweeted after the examination 49.6% (230) Link to other social media post 14.9% (69)
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Table 2
Frequency of Themes within Patient Tweets Regarding the Experience of Undergoing Mammography, Ranked in Order of Decreasing Overall Frequency
All
(464) First Mammogram
(61) Follow-Up Mammogram
(66) Before the Mammogram
(211) After the Mammogram
(69) Use of humor 31.9%(148) 19.7%(12) 12.1%(8) 36.5%(77) 27.4%(63) Compression 24.4%(113) 16.4%(10) 9.1%(6) 21.3%(45) 25.7%(59) Advising other women to undergo screening 23.9%(111) 24.6%(15) 25.8%(17) 20.4%(43) 26.5%(61) Recognition of examination’s health importance 18.8%(87) 23.0%(14) 18.2%(12) 17.5%(37) 19.6%(45) Indication of specific radiology practice 14.7%(68) 13.1%(8) 10.6%(7) 13.3%(28) 16.5%(38) Process of waiting
(whether for appointment, examination, or results) 10.1%(47) 9.8%(6) 6.1%(4) 13.3%(28) 7.8%(18) Relief regarding the results 9.7%(45) 4.9%(3) 16.7%(11) 0.0%(0) 19.6%(45) Reflection that examination was not that bad 9.1%(42) 26.2%(16) 7.6%(5) 0.0%(0) 17.8%(41) Generalized apprehension regarding undergoing screening 8.2%(38) 4.9%(3) 6.1%(4) 13.3%(28) 3.0%(7) Interactions with staff 8.0%(37) 11.5%(7) 3.0%(2) 2.8%(6) 12.2%(28) The gown 5.0%(23) 9.8%(6) 0.0%(0) 7.1%(15) 3.0%(7) Examination costs and access 3.4%(16) 6.6%(4) 3.0%(2) 6.2%(13) 0.9%(2) Offering or reaching out for online support from other patients 3.2%(15) 0.0%(0) 6.1%(4) 5.2%(11) 1.7%(4) Fear of the results 2.8%(13) 3.3%(2) 7.6%(5) 1.9%(4) 3.9%(9) Perception of screening as sign of aging 2.4%(11) 4.9%(3) 3.0%(2) 2.8%(6) 1.7%(4) The waiting room or waiting room amenities 1.3%(6) 1.6%(1) 1.5%(1) 1.9%(4) 0.9%(2)
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Discussion
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References
1. Feig S.A.: Screening mammography benefit controversies: sorting the evidence. Radiol Clin North Am 2014; 52: pp. 455-480.
2. Loberg M., Lousdal M.L., Bretthauer M., et. al.: Benefits and harms of mammography screening. Breast Cancer Res 2015; 17: pp. 63.
3. Oeffinger K.C., Fontham E.T., Etzioni R., et. al.: Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society. JAMA 2015; 314: pp. 1599-1614.
4. Jiang M., Hughes D.R., Appleton C.M., et. al.: Recent trends in adherence to continuous screening for breast cancer among Medicare beneficiaries. Prev Med 2015; 73: pp. 47-52.
5. Dehkordy S.F., Hall K.S., Roach A.L., et. al.: Trends in breast cancer screening: impact of U.S. preventive services task force recommendations. Am J Prev Med 2015; 49: pp. 419-422.
6. Whelehan P., Evans A., Wells M., et. al.: The effect of mammography pain on repeat participation in breast cancer screening: a systematic review. Breast 2013; 22: pp. 389-394.
7. Miller S.J., O’Hea E.L., Lerner J.B., et. al.: The relationship between breast cancer anxiety and mammography: experiential avoidance as a moderator. Behav Med 2011; 37: pp. 113-118.
8. Madadi M., Zhang S., Yeary K.H., et. al.: Analyzing factors associated with women’s attitudes and behaviors toward screening mammography using design-based logistic regression. Breast Cancer Res Treat 2014; 144: pp. 193-204.
9. Tan A.S., Moldovan-Johnson M., Gray S.W., et. al.: An analysis of the association between cancer-related information seeking and adherence to breast cancer surveillance procedures. Cancer Epidemiol Biomarkers Prev 2013; 22: pp. 167-174.
10. InternetLiveStats.com : Twitter Usage Statistics. Available at: http://www.internetlivestats.com/twitter-statistics/ Accessed 16, 2016
11. Attai D.J., Cowher M.S., Al-Hamadani M., et. al.: Twitter social media is an effective tool for breast cancer patient education and support: patient-reported outcomes by survey. J Med Internet Res 2015; 17: pp. e188.
12. Prabhu V., Lee T., Loeb S., et. al.: Twitter response to the United States Preventive Services Task Force recommendations against screening with prostate-specific antigen. BJU Int 2015; 116: pp. 65-71.
13. Hewis J.: Do MRI patients tweet? Thematic analysis of patient tweets about their MRI experience. J Med Imaging Radiat Sci 2015; 46: pp. 396-402.
14. Dewey M., Schink T., Dewey C.F.: Claustrophobia during magnetic resonance imaging: cohort study in over 55,000 patients. J Magn Reson Imaging 2007; 26: pp. 1322-1327.
15. Symplur L.L.C.: Symplur. Available at: www.symplur.com Accessed May 2, 2016
16. Prabhu V., Rosenkrantz A.B.: Imbalance of opinions expressed on Twitter relating to CT radiation risk: an opportunity for increased radiologist representation. AJR Am J Roentgenol 2015; 204: pp. W48-W51.
17. Prabhu V., Rosenkrantz A.B.: Enriched Audience Engagement Through Twitter: Should More Academic Radiology Departments Seize the Opportunity?. J Am Coll Radiol 2015; 12: pp. 756-759.
18. Bairati I., Turcotte S., Doray G., et. al.: Development and validation of an instrument assessing women’s satisfaction with screening mammography in an organized breast cancer screening program. BMC Health Serv Res 2014; 14: pp. 9.
19. Drossaert C.H., Boer H., Seydel E.R.: Does mammographic screening and a negative result affect attitudes towards future breast screening?. J Med Screen 2001; 8: pp. 204-212.
20. Rosenkrantz A.B., Pysarenko K.: The service encounter in radiology: acing the “moments of truth” to achieve patient-centered care. Acad Radiol 2015; 22: pp. 259-264.
21. Almog R., Hagoel L., Tamir A., et. al.: Quality control in a National Program for the Early Detection of Breast Cancer: women’s satisfaction with the mammography process. Womens Health Issues 2008; 18: pp. 110-117.
22. Elwood M., McNoe B., Smith T., et. al.: Once is enough–why some women do not continue to participate in a breast cancer screening programme. N Z Med J 1998; 111: pp. 180-183.
23. Drossaert C.H., Boer H., Seydel E.R.: Monitoring women’s experiences during three rounds of breast cancer screening: results from a longitudinal study. J Med Screen 2002; 9: pp. 168-175.
24. Bakker D.A., Lightfoot N.E., Steggles S., et. al.: The experience and satisfaction of women attending breast cancer screening. Oncol Nurs Forum 1998; 25: pp. 115-121.
25. Laranjo L., Arguel A., Neves A.L., et. al.: The influence of social networking sites on health behavior change: a systematic review and meta-analysis. J Am Med Inform Assoc 2015; 22: pp. 243-256.
26. Birnbaum M.L., Candan K., Libby I., et. al.: Impact of online resources and social media on help-seeking behaviour in youth with psychotic symptoms. Early Interv Psychiatry 2014;
27. Mylod D.: Breast feeding a sick child; can social media influence practice?. Issues Compr Pediatr Nurs 2015; 38: pp. 77-84.
28. Kim A.E., Hansen H.M., Murphy J., et. al.: Methodological considerations in analyzing Twitter data. J Natl Cancer Inst Monogr 2013; 2013: pp. 140-146.