Trust or Distrust Toward Healthcare Services: Breast Screening in the North and South of Italy

This article follows a previous study that has recently been published in Narrare I Gruppi and explored the reasons for the large numeric gap between the regions of the North and South of Italy, referring to the breast cancer screening program adherence rate sponsored by the Italian Healthcare System, that addresses all women living in Italy ranging in age between 48 and 69 years, and proposes a free mammogram every two years. The effectiveness of cancer early detections has been widely demonstrated by medical research; this kind of diagnosis is particularly important in the case of breast cancer. A diagnosis of this form of cancer at its early phases in 97% of cases allows women to survive at least five years after it. However, the different level of trust women feel for healthcare structures is the discriminating element between the North and South of Italy for their access to the screening program. This topic will be thoroughly analyzed by presenting the results of research aimed at evaluating the meaning given to the outcomes of a first exploratory study, this second study also offers the opportunity to share our results within the social context that has generated them. The outcomes of the present research have been presented to a group of “privileged witnesses” living in the South (Naples and its surroundings): 12 women aging from 49 to 65, and 5 healthcare workers (one doctor, 25 two nurses, and two Local Health Authority supervisors); they took part in three Focus Groups for an in-depth look of the theme in question. The analyses of the groups’ debates, carried out by means of a software for text analysis (T-LAB), confirmed the results of the previous research: the diffidence and lack of synergy between institutions and healthcare workers are the causes of southern women’s lack of participation to the breast cancer screening program. In particular, the comparison between women’s and workers’ viewpoints shows a different emotional connotation about the possibility to improve participation to the screening: the workers’ optimism countervails women’s distrust and pessimism.