Addressing the needs of young breast cancer survivors at the 5 year milestone: can a short-term, low intensity intervention produce change?
Addressing the needs of young breast cancer survivors at the 5 year milestone: can a short-term, low intensity intervention produce change?
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DOI：
10.1007/s11764-008-0058-x
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发表时间：
2008-09-01
期刊：
影响因子：
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通讯作者：
Banks, Priscilla J
中科院分区：
文献类型：
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作者：
Bloom, Joan R;Stewart, Susan L;Banks, Priscilla J
背景：今天，癌症的5年相对生存率为65%，有1050万幸存者。最大的幸存者群体是乳腺癌患者。与老年女性相比，50岁以下女性确诊时死亡率下降的速度更快。AIMS：我们的目标是为确诊时年龄在50岁或以下的5年幸存者设计一项社会教育干预措施，并检验这样的假设：干预组女性在以下方面比对照组有更大的进步：(1)乳腺癌的知识、治疗和长期健康问题；(2)生活习惯(即锻炼和饮食)；方法：采用前后设计的随机对照试验，将404名确诊5年后无癌症(有效率54%)的女性随机分为干预组和延迟干预组(对照组)，并在试验前(基线)和6个月后(96%保留)进行评估。干预包括三个6小时的讲习班，为期3个月。在大旧金山湾区的不同地理区域举办了四个系列讲习班。讲习班包括促进身体、社会、情感和精神健康的活动和信息。干预设计基于焦点小组的发现和对185名5年无癌症幸存者的调查，评估了自确诊后最初几个月在身体、社会、情感和精神方面的变化(响应率为73%)。结果：与我们的第一个假设一致，在后测试中，干预组女性平均比对照组更了解乳腺癌及其治疗和她们自己未来的健康(p=0.015)。假设2得到了部分支持，因为干预组的女性比对照组更有可能报告体力活动增加(p=0.036)，但饮食没有显著变化。社会支持与体力活动自我报告的增加有关。除最后一系列研讨会外，干预组没有报告与家人、朋友和医生的沟通改善(假设3)。结论：短期干预可以影响家庭的知识水平和体力活动，但不影响家庭中的饮食或沟通。癌症幸存者的应用：干预与更多的乳腺癌相关知识和更多的体力活动有关。该计划与报告的饮食或家庭沟通的变化无关。
BACKGROUND: Today, the 5-year relative survival rate for cancer is 65% and there are 10.5 million survivors. The largest group of survivors are those of breast cancer. Reductions in mortality are occurring at a greater rate for women under age 50 at diagnosis than among older women.AIMS: Our goal was to design a socio-educational intervention for 5-year survivors aged 50 or younger at diagnosis and test the hypotheses that women in the intervention group would show greater improvement than controls with respect to (1) knowledge of breast cancer, its treatment, and long-term health concerns; (2) lifestyle habits (i.e., exercise and diet); and (3) communication with family and physicians.METHODS: Using a randomized controlled trial with a pre-post design, 404 women who were 5 years from diagnosis and cancer-free (response rate 54%) were randomly assigned to an intervention or delayed intervention (control) group and were assessed at pre-test (baseline) and 6 months later (96% retention). The intervention consisted of three 6-h workshops over a 3 month period. Four series of workshops were held at different geographical areas in the greater San Francisco Bay Area. The workshops included activities and information to promote physical, social, emotional, and spiritual well-being. The intervention design was based on findings from focus groups and a survey of 185 cancer-free 5-year survivors that assessed changes since the early months after diagnosis in physical, social, emotional, and spiritual concerns (response rate 73%).RESULTS: Consistent with our first hypothesis, at post-test, women in the intervention group, on average, had greater knowledge regarding breast cancer, its treatment, and their own future health than did those in the control group (p = 0.015). Hypothesis 2 was partially supported as women in the intervention group were more likely than the control group to report an increased amount of physical activity (p = 0.036), but not significant dietary changes. Social support was related to increased self report of physical activity. With the exception of the last series of workshops, the intervention group did not report improved communications with family, friends, and physicians (hypothesis 3).CONCLUSIONS: A short-term intervention can affect knowledge levels and physical activity but not diet or communication in the family.IMPLICATIONS FOR CANCER SURVIVORS: The intervention was related to greater knowledge related to breast cancer, and increased report of physical activity. The program was not related to changes in reported diet or family communication.