PSYCHOLOGICAL DISTRESS AND SURVEILLANCE BEHAVIORS OF WOMEN WITH A FAMILY HISTORY OF BREAST-CANCER
PSYCHOLOGICAL DISTRESS AND SURVEILLANCE BEHAVIORS OF WOMEN WITH A FAMILY HISTORY OF BREAST-CANCER
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DOI：
10.1093/jnci/84.1.24
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发表时间：
1992-01-01
期刊：
影响因子：
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通讯作者：
MILLER, DG
中科院分区：
文献类型：
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作者：
KASH, KM;HOLLAND, JC;MILLER, DG
有乳腺癌家族史的女性患乳腺癌的风险增加。本研究调查了乳腺癌高危女性（一名或多名患有乳腺癌的一级亲属）对其乳腺癌风险的信念，以及这些信息对她们的监测行为和心理困扰的影响。本研究使用了健康信念模型和恐惧唤起沟通理论。参加乳房保护计划的 217 名女性完成了一份有关健康信念和行为、社会支持和心理困扰的调查问卷。虽然 94% 的人定期进行乳房 X 光检查，但只有 69% 的人定期进行临床乳房检查。判别函数分析显示，癌症焦虑的增加会减少定期临床检查（系数 = -.65）。只有40%的人每月进行乳房自查，10%的人从未进行过乳房自查，50%的人没有定期进行乳房自查。参加该计划之前的高乳房自我检查表现是当前乳房自我检查的最佳预测因素，而高度焦虑则预示着每月乳房自我检查的依从性较差（多重 R = 0.61）。超过 27% 的高危女性被定义为心理困扰程度符合咨询需求。报告筛查障碍较多、社会支持较少和社会期望较低的女性有更多的心理困扰（多重 R = 0.75）。较高的焦虑程度与临床乳房检查的出席率和每月乳房自我检查的依从性差直接相关。这些数据支持对乳腺癌高危女性制定心理干预措施的必要性，以减少痛苦、改善监测行为并确保尽早发现乳腺癌。
Women with a family history of breast cancer are at increased risk for developing the disease. This study investigated the beliefs of women at high risk for breast cancer (one or more first-degree relatives with breast cancer) about their breast cancer risk and the impact of this information on their surveillance behaviors and psychological distress. The Health Belief Model and the Fear Arousing Communications Theory were used in this study. Two hundred and seventeen women, enrolled in a breast protection program, completed a questionnaire regarding health beliefs and behaviors, social support, and psychological distress. While 94% came in for regularly scheduled mammograms, only 69% came in for regular clinical breast examinations. A discriminant function analysis revealed that increased cancer anxiety decreased regular clinical examinations (coefficient = -.65). Only 40% performed breast self-examination monthly, 10% never performed breast self-examination, and 50% did not perform breast self-examination regularly. High breast self-examination performance prior to coming to the program was the best predictor of current breast self-examination, and high anxiety predicted poor adherence to monthly breast self-examination (multiple R = .61). More than 27% of the women at high risk were defined as having a level of psychological distress consistent with the need for counseling. Women reporting more barriers to screening, fewer social supports, and low social desirability had more psychological distress (multiple R = .75). Higher anxiety was directly related to poor attendance at a clinical breast examination and poor adherence to monthly breast self-examination. These data support the need for developing psychological interventions for women at high risk for breast cancer in an effort to reduce distress, improve surveillance behaviors, and assure the earliest detection of breast cancer.