Sophia Zackrisson

The aim of this article is to reach a deeper understanding of women's decision-making process regarding non-attendance at mammography screenings. The article also discusses the health care social workers' role in providing support to women during this decision. Eighteen qualitative semi-structured interviews were conducted with women who had abstained from mammography screening in Malmö, Sweden. Thematic analyses were used as a method and The Rational Choice Theory, The Health Belief Model and the notion of Cross-Pressure were used as a theoretical framework. A prominent feature was that the relationship between the women's decision to abstain and the normative perception that mammography is an important examination led to ambivalent thoughts. It can be seen as an adjustment to the structure to be invited and a cross-pressure between performed and expected actions. Moreover, the decision to abstain from mammography screening was preceded by thoughts about the right choice, specifically in relation to what would happen to these women if they got breast cancer. Women who abstain need to think about their decision to a larger extent than women who attend the screening and we argue that they should be offered support by health care social workers in the invitation letter to mammography screening.