br While some participants reported their own positive in te
While some participants reported their own positive in-terpretations of fatalism, that Allah directed individuals to take con-trol of their own health, in both social groups there were some women who believed that breast cancer is predetermined and trust in God
and reading the holy Quran may act as both a preventative measure and a potential cure.13,17,43,44 This strong belief in fatalism has also been reported by Muslim women living outside the Middle East.26 Several participants in focus group 1 stressed that Islam would
allow them to uncover intimate body parts for medical examina-tion and that a positive reflection on the concept of fatalism directed them to engage in activities which would preserve health and please Allah:
“If I felt any abnormal symptoms and my doctor advised me to do the breast test I will do it, Allah said: do not throw yourselves into destruction, and do good” P1 (focus group 1)
The concept of having modesty breached during MS and subse-
quent embarrassment has been widely reported in the literature, yet this was not supported in the current study.13,15,46 The reason might
be that, in Kuwait, it Vaborbactam is recognised that all the screening services are performed by female physicians and health care providers.
Family and social support
Being told of a friend's or family members positive experience of MSS had a significant positive personal impact for some of the participants with a greater tendency to discuss the need for screening and recounting their decision to attend for MS.
“When my sister went to the surgery room to remove the tumour, I saw her doctor and I asked her many questions about BC and she told me about breast screening” P3 (focus group 2)
“I know some friends who attend breast screening every year, some of them said it is painful, but you should go.’’ P2 (focus group 1)
These findings are consistent with results of a study of Mexican women living in the United States in which women revealed that the positive recommendations of families and friends had a strong influence on their decision to attend for MS.47 Any negative testimony of BC care or MS from participant's
“My friend had a mammography test because she has a lump, she said this the worst test ever, I don't want to do it” P6 (focus group 1)
One participant explained that a very strong family history of cancer in her family had negatively affected her attitude towards attending for MS.
“I have a strong family history of cancer diseases, my brother, my sister, my mother and my father all of them developed cancer. I would not go for screening’‘ P12 (focus group 1)
The role of the participants' physician in recommending atten-dance at BCS as well as the accessibility and organisation of MSS formed part of a theme identified as ‘medical provision and social environment’.
Despite the fact the physicians have an important role in educating women about the importance of MS and recommending to women the necessity to attend MS, the current study demonstrated that participants felt that physicians are not active in recommending that women attend MSS. This lack of guidance and encouragement to attend acted as a barrier to attend screening opportunities.14,36
“The doctors themselves do not recommend this to women and do not talk to them about breast screening” P3 (focus group 1)
Such lack of physician recommendation to attend screening mammography may allow the development of a role for radiogra-phers in Kuwait, acting as a source of information about mammography screening.25
Knowledge of awareness campaigns
Participants particularly from Focus group 1, identified that they were aware of campaigns aimed at encouraging women to attend for MS, however such campaigns did not appear convincing enough to promote attendance at MSS. Participants in focus group 2 revealed that any awareness campaigns were not suitable for women who could not read or write.