Table 2. Illustrative quotes from interviews aligned to identified themes from interpretative phenomenological analysis*.
| Theme | Description | Illustrative quote |
|---|---|---|
| Ovarian cancer screening | Comfort gained from screening | I think it’s just a comforting fact that you know that if something’s going to happen you know they’re going to do something about it and you can come from there thinking, well, everything’s fine. So it’s that feel good factor isn’t it. (p7, immediate, w7) I think, ‘Yeah, that’s me, I’m sorted, I’m okay,’ and then I think it’s time to have another one. And I do and I don’t think about it. (p8, over 3 weeks, w8) |
| Continue to seek reassurance from screening | I have scans, ultrasound scans every year. I pay for them now because they used to be part of the study that I was taking part in and then that all stopped and the funding stopped and everything. So I thought I’d keep that up… so that’s my way of sort of keeping my eye on things. (p8, over 3 weeks, w8) I would rather be too cautious than dead, basically. I know that sounds really dramatic but I do keep on until, you know, I would rather keep on and keep on and keep on and say, look there’s nothing, rather than leave it lie and then say ‘Oh look, we’ve got a problem now’, which sometimes it’s too late isn’t it. (p7, immediate, w7) |
|
| Personal and familial experiences | Influence on perceptions | I suppose because of my sister having no symptoms… (p2, immediate, w6) … ‘cause I know when my cousin got it, she didn’t even realise, realise that she had it [ovarian cancer]. (p5, over 3 weeks, w5) |
| Experience influencing anticipated presentation | … having gone through it all [with Mother and Grandmother who had ovarian cancer] I know roughly what to look for and if there’s anything amiss then to go and find out straightaway. (p1, immediate, w3) I mean if you’ve been down the road before, you know… you just wouldn’t waste time, would you, because time is precious. (p6, immediate, w4) |
|
| Worry | I don’t want my children to go through that. Obviously they went through it with my mum, but I don’t want them to go through it with their mum. (p7, immediate, w7) | |
| Symptom monitoring behaviour | Body monitoring | I know I don’t look fit, but I go to the gym three times a week, I’m careful of what I eat, you know… we know our bodies so well, we know what we are doing to them. (p6, immediate, w4) I think that’s what happened with my grandmother and her two sisters. They were all big ladies; they didn’t see what going on inside them and it was all kinds of things, and they died of it, you know. So I think it’s because they couldn’t really see the physical changes... I’m sort of fairly slim across my belly, so I think I’d notice bloating. I know one of the ones was bloating that doesn’t go down, is it? I think I’d probably notice that, but with a lot of women that may be bigger, they wouldn’t actually see that. (p8, over 3 weeks, w8) |
| Monitoring techniques | I’d probably not make a diary, but make some notes of what my symptoms had been, where and when, yeah make a bit of a diary. (p4, 1 week, w3) I’d just sort of store it in my head probably, and then just go to the GP with general, you know general sort of symptoms and things rather than specific. (p8, over 3 weeks, w8) |
|
| Ovarian cancer symptom information sources | Information is useful | I think any information is a good thing isn’t it, prevention is better than cure…whatever information is quickly absorbed, because if it doesn’t apply to you, it could apply to another member of your family or a friend or something which could be useful. So I think any information is good whether it’s something you already knew or something new that you’ve learned. (p7, immediate, w7) If you want to check [the internet] that before you go to your GP, just ‘cause you think you’re worrying about nothing, you know, it’s private. (p8, over 3 weeks, w8) It could put some people off if they knew the statistics for success rates, survival rates. (p2,immediate, w6) …you can get rogue information and you can think, ‘Oh that’s alright then, they told me on the internet there’s no need to do so and so’, which if you had gone to the GP… he could have done something or helped something. (p7, immediate, w7) |
| Information is a source of worry | …It can be overwhelming sometimes, you get too much information. (p3, 1 week, w5) ‘Cause too much information could really put that wheel in your head turning... because I just wouldn’t want to go down the road of just Googling the word and no, no, that would just put my head into override I expect. (p6, immediate, w4) |
|
| Personal barriers and facilitators | Symptom nature as a barrier | They call it the silent killer for one reason. All the symptoms are there but they don’t know about it. They think oh well, it could be a period, it could be this, it could be that, it could be what I’ve eaten. (p6, immediate, w4) I mean, any young person like you, if you started to get those then you would really start to worry, wouldn’t you? Someone my age, you say, well, okay I’ll get back ache and get wind a lot, you know, and I get changes in bowel movements so, you know they’re always changing. (p2, immediate, w6) |
| Bodily changes as a facilitator | If I started to have any symptoms which I thought were unusual, I would immediately go to my doctor (p2, immediate, w6) If something was different from every day I would… I wouldn’t waste time. I’d go and get it checked straight away (p6, immediate, w4) |
|
| Confidence as facilitator | I might be over, sort of worrying about it, and [thinking] if I haven’t actually got the symptoms, but because I know I’m at risk, I get symptoms, twinges, and I think ‘I wonder’ all the time. (p8, over 3 weeks, w8) It does make you a stronger person [experiencing family members with OC] because you get more determined I do believe, because you get more determined in your way. (p7, immediate, w7) If you’re armed with that information then the doctors can’t say ‘oh you’ll be all right, love, you know, it’s just a bit of ageing and diverticulitis or whatever’. If you actually know that information it’s easier to push. (p4, 1 week, w3) |
|
| System barriers and facilitators | GP appointment barriers | They haven’t got time to see anyone, have they? They don’t, they’re spending so much time on paperwork. (p5, over 3 weeks, w5) |
| GP barriers | Some GPs don’t give a damn and others don’t know the information. (p4, 1 week, w3) They didn’t know anything about my family history at all. Okay, my file obviously would be that thick coming from when I was born, ‘cause they don’t have time to look at it do they? (p5, over 3 weeks, w5) You would have to go through it all [family history] and whatever… you’ve got to keep going through the same thing all the time. (p1, immediate, w3) |
|
| GP facilitators | It’s better to see the same one as you don’t have to keep going through the same thing all the time. (p1, immediate, w3) It seems to give me peace of mind, because you don’t have to continually repeat all the time. (p7, immediate, w7) |
*
Insertions to clarify topic content are denoted by square brackets. The removal of irrelevant information within the quotes is denoted by “….”. The characteristics of each participant are presented in parentheses after each quote in the following order: participant number (p1–p8), anticipated time to presentation (immediate, one week, over three weeks) and ovarian cancer worry score (w3–w8).