PSYCHOLOGICAL AND BEHAVIORAL-IMPLICATIONS OF ABNORMAL MAMMOGRAMS
PSYCHOLOGICAL AND BEHAVIORAL-IMPLICATIONS OF ABNORMAL MAMMOGRAMS
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DOI：
10.7326/0003-4819-114-8-657
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发表时间：
1991-04-15
影响因子：
39.2
通讯作者：
ENGSTROM, PF
中科院分区：
文献类型：
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作者：
LERMAN, C;TROCK, B;ENGSTROM, PF
目的：评估女性对异常乳腺X线检查的心理反应及其对乳腺X线检查依从性的影响。确定乳腺X线检查正常或异常的妇女的心理反应和其他因素，预测乳腺X线检查依从性。设计：前瞻性分析乳腺X线检查依从性相关因素的调查研究。设置：宾夕法尼亚州和新泽西健康维护组织（HMO PA/NJ）。患者：研究患者，50岁或以上的HMO PA/NJ成员，3个月前进行了乳房X线摄影，包括乳房X线检查正常的妇女（n = 121），低怀疑乳房X线检查的妇女（n = 119），高怀疑乳房X线检查的妇女（n = 68），但不包括乳腺癌妇女。测量：评估乳房X线检查后3个月的心理反应和随后每年乳房X线检查的依从性。主要结果：高度怀疑乳房X光检查的女性有大量与乳房X光检查相关的焦虑（47%）和对乳腺癌的担忧（41%）。尽管诊断评估排除了恶性肿瘤，但这些担忧影响了这些妇女的情绪（26%）和日常功能（17%）。对于每个变量，乳腺X线异常程度的趋势一致（P > 0.05）。结果正常的妇女中有68%，低怀疑结果的妇女中有78%，高怀疑结果的妇女中有74%获得了随后的年度乳房X线检查（P > 0.05）。以前的乳房X光检查次数（比值比，3.2; 95%CI，1.6至6.2）以及先前结果对乳腺癌担忧的影响在logistic回归分析中，（比值比，0.5; CI，0.2 - 1.0）是依从性的独立预测因素结论：相当比例的可疑乳腺X线检查的妇女有心理困难，即使在得知她们没有癌症之后。这些后遗症似乎不会影响后续的依从性。
Objective: To evaluate women's psychological responses to abnormal mammograms and the effect on mammography adherence. To identify psychological responses and other factors that predict mammography adherence in women with normal or abnormal mammograms.Design: Survey study with prospective analysis of factors associated with mammography adherence.Setting: Health Maintenance Organization of Pennsylvania and New Jersey (HMO PA/NJ).Patients: Study patients, members of HMO PA/NJ who were 50 years of age or older, and who had had mammography done 3 months earlier, included women with normal mammograms (n = 121), women with low-suspicion mammograms (n = 119), and women with high-suspicion mammograms (n = 68), but not women with breast cancer.Measurements: Psychological responses 3 months after mammography and adherence to subsequent annual mammography were assessed.Main Results: Women with high-suspicion mammograms had substantial mammography-related anxiety (47%) and worries about breast cancer (41%). Such worries affected the moods (26%) and daily functioning (17%) of these women, despite diagnostic evaluation excluding malignancy. For each variable, a consistent trend (P > 0.05) was seen with degree of mammogram abnormality. Sixty-eight percent of women with normal results, 78% of women with low-suspicion results, and 74% of women with high-suspicion results obtained their subsequent annual mammograms (P > 0.05). The number of previous mammograms (odds ratio, 3.2; 95% CI, 1.6 to 6.2) and the effect of the previous results on concerns about breast cancer (odds ratio, 0.5; CI, 0.2 to 1.0) were independent predictors of adherence in logistic regression analyses (P < 0.05).Conclusions: A substantial proportion of women with suspicious mammograms have psychological difficulties, even after learning that they do not have cancer. Such sequelae do not appear to interfere with subsequent adherence.