EXPLANATORY MODELS FOR CANCER AMONG AFRICAN-AMERICAN WOMEN AT 2 ATLANTA NEIGHBORHOOD HEALTH CENTERS - THE IMPLICATIONS FOR A CANCER SCREENING-PROGRAM
EXPLANATORY MODELS FOR CANCER AMONG AFRICAN-AMERICAN WOMEN AT 2 ATLANTA NEIGHBORHOOD HEALTH CENTERS - THE IMPLICATIONS FOR A CANCER SCREENING-PROGRAM
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DOI：
10.1016/0277-9536(94)90094-9
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发表时间：
1994-08-01
影响因子：
5.4
通讯作者：
CURRY, RH
中科院分区：
文献类型：
--
作者：
GREGG, J;CURRY, RH
本文研究了40岁以上低收入非洲裔美国妇女乳腺癌和宫颈癌的文化模式，以更好地了解这些模式如何影响癌症筛查行为。这项研究是社区癌症筛查项目的一部分，该项目由埃默里大学、格雷迪纪念医院和美国癌症协会赞助。筛查项目试图在40岁或40岁以上的妇女中增加使用乳房X光检查、乳房临床和自我检查以及宫颈巴氏涂片检查，这些妇女主要是非洲裔美国人、低收入、低教育水平的人口，目前没有得到任何筛查活动的服务。如果要使这些人得到充分的服务，那么，就必须克服文化和后勤方面的障碍。患者和临床医生必须相互了解对方如何看待癌症、预防和治疗。只有在这种相互理解的基础上，医生和他们的客户才能合作提高癌症筛查率。我们的研究结果表明，患者群体持有的癌症模型与临床医生持有的癌症模型有很大不同。参加诊所的妇女要忍受癌症筛查测试，对她们来说，这些测试似乎只是一种最终会杀死她们的疾病的预兆。大多数妇女怀疑是否有治愈癌症的方法，尽管有些人相信如果及时发现这种疾病，一个人可能会活下来。即便如此，“及时”发现癌症可能意味着在乳房X光检查中发现一个斑点或在子宫颈抹片检查中发现异型增生细胞之前就发现了疾病。如果癌症没有被及时发现，而一名妇女被诊断患有这种疾病，有些人认为，她患有这种疾病的知识可能会导致精神恶化，并可能加速她的死亡。据许多接受采访的妇女说，即使她的思想没有受到影响，她仍然面临着可能使她贫穷的治疗选择，而且似乎肯定会进一步损害她的健康。她对上帝的信仰似乎是为数不多的完全良性和真正强大的治疗方案之一。
This paper examines cultural models for breast and cervical cancer among low-income African-American women over 40, in order to better understand how those models might affect cancer screening behavior. The study is part of The Community-Based Cancer Screening Project, which is sponsored by Emory University, Grady Memorial Hospital, and the American Cancer Society. The Screening Project attempts to increase the use of mammography, clinical and self-examination of the breast, and cervical Pap smear among women aged 40 or older in a predominantly African-American, low-income, low educational level population that is currently underserved by any screening activities.The study of cultural models of cancer within the project was prompted by the recognition that if screening programs targeted at specific, underserved, populations are to succeed, cultural as well as logistical barriers to screening must be overome. Patients and clinicians must each understand how the other perceives cancer, its prevention, and its treatment. Only with this mutual understanding as a foundation, can physicians and their clients cooperate to improve cancer screening rates.Our research results indicate that the cancer models held by the patient population differ significantly from those held by clinicians. Women attending the clinics endure cancer screening tests that to them seem to serve only as heralds of a disease that will ultimately kill them. Most women doubt there is a cure for cancer, though some believe a person may live if the disease is caught in time. Even then, though, catching cancer 'in time' may mean somehow discovering the disease before it can even be detected as a spot on a mammogram or as dysplastic cells from a pap smear. If the cancer is not caught in time, and a woman is diagnosed as having the disease, some argue that the knowledge that she has it may cause mental deterioration and may speed her death. Even if her mind is unaffected, according to many women interviewed, she still faces treatment choices that may make her poor and seem certain to erode her health even further. Her faith in God seems to be one of the few completely benign and truly powerful treatment alternatives available to her.