Religiosity, Spirituality, and Cancer Fatalism Beliefs on Delay in Breast Cancer Diagnosis in African American Women
Religiosity, Spirituality, and Cancer Fatalism Beliefs on Delay in Breast Cancer Diagnosis in African American Women
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DOI：
10.1007/s10943-008-9232-8
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发表时间：
2010-03-01
影响因子：
2.8
通讯作者：
Mooney, Kathi
中科院分区：
文献类型：
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作者：
Gullatte, Mary Magee;Brawley, Otis;Mooney, Kathi
与其他种族或族裔群体相比，非裔美国女性在初次诊断时更有可能出现晚期乳腺癌。乳腺癌检测的延迟是后期诊断的关键因素。现有数据表明，延迟 3 个月或更长时间是乳腺癌死亡率的一个重要因素。据报道，导致就医时间延误的因素有很多，包括宗教信仰、灵性和宿命论信念。这项研究调查了宗教信仰、灵性和癌症宿命论对自我发现乳房症状的非裔美国女性的诊断延迟和乳腺癌分期的影响。采用描述性相关性回顾性方法，使用开放式问卷和三个经过验证的测量量表：宗教问题解决量表（RPSS）、宗教应对活动量表（RCAS）测量基于精神的应对方式的子量表以及改良的鲍威宿命论量表（mPFI）。该研究纳入了 129 名年龄在 30 岁至 84 岁之间的女性的方便样本，她们在诊断乳腺癌之前的 12 个月内自我报告检测到乳房症状。结果变量是寻求医疗护理的时间和乳腺癌分期。其他感兴趣的变量包括婚姻状况、收入、教育、保险状况以及女性向谁谈论她们的乳房症状。使用描述性统计、逻辑回归分析、Pearson r 相关性、Mann-Whitney U 分析和卡方分析对数据进行分析。研究发现，参与者具有高度的宗教信仰和精神信仰，但并不宿命论。虽然大多数女性延迟就医时间超过 3 个月，但未发现这三个预测变量与就医时间之间存在关联。从自我发现乳房症状到寻求医疗护理的平均延迟时间为 5.5 个月。受教育程度较低、未婚且只与上帝谈论乳房变化的女性更有可能推迟寻求医疗护理。研究发现，仅向上帝透露乳房症状与延迟寻求医疗护理之间存在关联。相比之下，告诉别人自己的乳房症状的女性更有可能更快地寻求医疗护理。与发现症状后 3 个月内就医的女性相比，延迟就医超过 3 个月的非裔美国女性更有可能出现晚期乳腺癌。
African American women are more likely than any other racial or ethnic group to present with a later stage of breast cancer at initial diagnosis. Delay in breast cancer detection is a critical factor in diagnosis at a later stage. Available data indicate a delay of 3 months or more is a significant factor in breast cancer mortalty. Numerous factors have been reported as contributing to delay in time to seek medical care including religiosity, spirituality, and fatalistic beliefs. This study examined the influence of religiosity, spirituality, and cancer fatalism on delay in diagnosis and breast cancer stage in African American women with self-detected breast symptoms. A descriptive correlation, retrospective methodology using an open-ended questionnaire and three validated measurement scales were used: the Religious Problem Solving Scale (RPSS), the Religious Coping Activity Scale (RCAS) subscale measuring spiritually based coping, and the modified Powe Fatalism Inventory (mPFI). A convenience sample of 129 women ages between 30 and 84 years who self-reported detecting a breast symptom before diagnosis of breast cancer within the preceding 12 months were included in the study. Outcome variables were time to seek medical care and breast cancer stage. Other variables of interest included marital status, income, education, insurance status, and to whom the women spoke about their breast symptoms. Data were analyzed using descriptive statistics, logistic regression analysis, Pearson r correlations, Mann-Whitney U analysis, and Chi Square analysis. Participants were found to be highly religious and spiritual but not fatalistic. While most women delayed more than 3 months in seeking medical care, no associations were found between the three predictor variables and time to seek medical care. The median delay in time from self detection of a breast symptom to seeking medical care was 5.5 months. Women who were less educated, unmarried, and talked to God only about their breast change were significantly more likely to delay seeking medical care. An association was found between disclosing a breast symptom to God only and delay in seeking medical care. In contrast, women who had told a person about their breast symptom were more likely to seek medical care sooner. African American women who delayed seeking medical care for longer than 3 months were more likely to present with a later stage of breast cancer than women who sought care within 3 months of symptom discovery.