BREAST CANCER IN YOUNGER WOMEN--IMPROVING LIFE QUALITY

乳腺癌是美国女性最常见的癌症。1992年， 18万新确诊病例占所有新确诊妇女的20% 年龄在50岁以下。患有乳腺癌的年轻女性有特殊的 对生殖、早产的长期后果等问题的关注 更年期，以及对身体形象和性行为的担忧。无报告 研究着眼于年轻女性特有的心理社会问题，但 一些人发现，年轻女性在适应方面有更多问题 乳腺癌。虽然之前测试过的针对女性的干预措施 对乳腺癌的治疗已经显示出不同程度的有效性，大多数 参与团体支持计划或强化健康专业人员 参与其中。这些干预措施的实施成本很高，许多妇女 没有机会、没有时间或没有意愿参与 心理治疗项目。支援组别的人口统计特征 与会者认为，低社会经济地位和少数族裔个人 都被低估了。拟议的研究解决了以下缺点 以往的干预措施以及年轻妇女的具体关切 通过一种创新的干预措施，所有女性都可以轻松获得 在社区中实施。在建立在 新英格兰研究所正在开发与健康有关的录像带 患者和普通公众，建议干预时间为30分钟 专注于年轻女性的具体关切的录像带。录像带 将以女性为模特，展示各种解决方案 他们遇到的压力和问题，以及验证共同的 担忧。它的目的是鼓舞士气，增强自尊，以及 改进应对策略。拟议项目的具体目标是： (1)找出并描述与 心理社会(身体形象、性行为、生殖、人际关系和 家庭关系)以及与医疗和残疾相关的后遗症 乳腺癌的诊断和治疗；(2)制作一个30分钟的 以年轻妇女特别关心的问题为重点的录像带；以及 (3)对录像带对妇女干预效果的随机评价 审判。录像带将通过随机分配250个新的 确诊的乳腺癌患者&50岁，从多个 站点转移到干预组或控制组。受试者将收到 基线访谈和随机化后的访谈将在6周、6周进行 MOS和1年后基线。生活质量是首要的结果。这个 建议的录像带有以下优点：大多数人都可以使用 女人，女人可以在心理准备好的时候看到它，可以在 一个人的家的隐私，可以向家人展示提供一种 在社区实践环境中容易应用的讨论刺激， 成本效益高的干预措施；一旦产生，实施成本低， 并且可以提供即时的心理益处。

Breast cancer is the most common cancer among women in the U.S. In 1992, 180,000 new cases were diagnosed with 20% of all newly-diagnosed women under 50 years of age. Younger women with breast cancer have particular concerns such as reproduction, long term consequences of premature menopause, and concerns about body image and sexuality. No reported studies have looked at psychosocial issues specific to younger women, yet several have found that younger women have more problems adjusting to breast cancer. While previously tested interventions directed at women with breast cancer have shown varying degrees of effectiveness, most involve group support programs, or intensive health professional involvement. These interventions are costly to implement, and many women do not have access, time, or the inclination to participate in a psychotherapeutic program. Demographic characteristics of support group attenders suggest that low socioeconomic status and minority individuals are underrepresented. The proposed study addresses the shortcomings of previous interventions as well as the specific concerns of younger women with an innovative intervention that is accessible to all women and easily implemented in the community. Building on the extensive experience at the New England Research Institute in developing health-related videotapes for patients and the general public, the proposed intervention is a 30-minute videotape focusing on specific concerns of younger women. The videotape will feature women serving as models to present various solutions to stresses and problems they encountered, as well as to validate common concerns. It will be designed to boost morale, increase self-esteem, and improve coping strategies. The specific aims of the proposed project are: (1) to identify and describe the key issues with respect to the psychosocial (body image, sexuality, reproduction, interpersonal and family relationships), as well as medical and disability related sequelae of breast cancer diagnosis and treatment; (2) to produce a 30 minute videotape focusing on issues of particular concern to younger women; and (3) to evaluate the videotape intervention for women in a randomized trial. The videotape will be evaluated by randomly assigning 250 newly diagnosed breast cancer patients <50 years of age recruited from multiple sites to an intervention or control group. Subjects will receive a baseline interview and after randomization will be followed at 6 wks, 6 mos, and 1-year post baseline. Quality of life is the primary outcome. The proposed videotape provides the following advantages: accessible to most women, women can view it when psychologically ready, can be viewed in the privacy of one's home, can be shown to family members to provide a stimulus for discussion, readily applied in community practice settings, a cost effective intervention; once produced, it is low cost to implement, and can provide immediate psychological benefit.