Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Jane M. Georges, PhD, RN, Chair; Kathy Shadle James, DNSc, RN; Cynthia Gantt, PhD, RN, CFNP


Breast Cancer, intervention, Mammography, Nurse Practitioners, nursing, women


The use of mammography for the early identification of breast cancer when tumors are small and potentially curable has been well documented. Unfortunately, the rates at which women comply with their health care providers' recommendation for screening mammography remain low. Many reasons have been identified for the failure to adhere with this recommendation; pain with procedure, cost, lack of physician recommendation, perceived radiation exposure, and fear of results have been cited. The purpose of this study was to identify the effect of a specific intervention by a nurse practitioner on adherence with screening mammography in a healthy population of women ages 40 and older in North East Texas. Additionally, using Bandura's Social Learning Theory, the relationship between adherence with screening mammography and perceived self-efficacy were identified, as well as mammography adherence and attitude toward heath care approaches. The total sample for this study was 39 women in North East Texas of whom 20 participants were in the control group, 19 in the experimental group. The total sample adherence with mammogram was 56.4%, control group 43.6%, and 68% for the experimental group. Study findings identified a positive relationship between health motivation and intent to follow through with their health care providers' recommendation for a mammogram. Results also identified a positive relationship between intent to have a screening mammogram and self-efficacy. Women who identified intent to have their mammogram, and then did so, had a positive health locus of control. These findings suggest further research is needed to identify how to encourage women to follow through with their health care providers' recommendation for screening mammogram. Additional research to validate the findings of this study include identifying what type of specific intervention would best increase patient adherence with mammography, and further exploration of the role of the nurse practitioner encouraging adherence with screening mammography. Further research that tests specific interventions by nurse practitioners in practice is still needed, as very little research has been done in this area.

Document Type

Dissertation: Open Access



Included in

Nursing Commons