The self-reported likelihood of patient delay in breast cancer: New thoughts for early detection
The self-reported likelihood of patient delay in breast cancer: New thoughts for early detection
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DOI：
10.1006/pmed.2001.0998
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发表时间：
2002-04-01
影响因子：
5.1
通讯作者：
Paul, SM
中科院分区：
文献类型：
--
作者：
Facione, NC;Miaskowski, C;Paul, SM
背景资料。自我发现的乳房症状出现延迟会影响诊断时的癌症分期，降低乳腺癌的存活率。共有699名无症状女性(黑人、白人和拉丁裔)被招募到社区环境中，并按年龄、收入和教育水平进行分层，调查了她们在发现乳房症状时延迟的可能性(J-Delay量表)。采用Logistic回归分析对似然模型进行检验。共有166名女性(23.7%)报告了推迟的可能性。较低的收入、较低的教育水平、自我认同为拉丁裔或黑人、在护理服务方面经历偏见、感觉到缺乏获得医疗保健的机会、对乳腺癌的宿命论、不良的医疗保健利用习惯、自我护理行为、配偶/伴侣和雇主感觉到的限制、解决问题的方式以及对乳腺癌症状缺乏了解与延迟的可能性有关。联合样本多元Logistic回归模型正确预测了40.6%的女性报告延迟的可能性，94.9%的不可能延迟的女性，以及82.4%(551/669)的病例。自我报告的患者延误的可能性在症状发生之前是可以衡量的，这一衡量标准与之前诊断时与晚期乳腺癌有关的行为和知识变量是一致的。(C)2002年美国健康基金会和爱思唯尔科学公司(美国)。
Background. Delayed presentation of self-discovered breast symptoms influences stage of cancer at diagnosis and decreases breast cancer survival.Methods. A total of 699 asymptomatic women (black, white, and Latino), recruited in community settings and stratified by age, income, and educational level, were surveyed for their likelihood to delay (J-Delay scale) in the event of a breast symptom discovery. Models of likelihood were tested with logistic regreission analyses.Results. A total of 166 women (23.7%) reported likelihood to delay. Lower income, lower educational level, self identification as Latino or black, experienced prejudice in care delivery, perceived lack of access to health care, fatalism about breast cancer, poor health care utilization habits, self-care behavior, spouse/partner and employer perceived constraints, problem-solving style, and a lack of knowledge of breast cancer's presenting symptoms were associated with likelihood to delay. A combined sample multiple logistic regression model correctly predicted 40.6% of women reporting a likelihood to delay, 94.9% of those not likely to delay, and 82.4% (551 of 669) of cases overall.Conclusions. Self-reported likelihood of patient delay is measurable in advance of symptom occurrence, and this measure is consistent with behavioral and knowledge variables previously linked with advanced breast cancer at diagnosis. (C) 2002 American Health Foundation and Elsevier Science (USA).