NURSE AND PHYSICAN INTERVENTIONS TO IMPROVE BSE

尽管乳房自我检查(BSE)作为一种直观的 乳腺癌控制中的辅助工具，观察到女性的能力 从业者比例较低(20%-25%)，目前尚不清楚医疗培训 实践环境导致疯牛病的长期大幅改善 表现，特别是对于因年龄而处于危险中的妇女。因此，我们， 建议在实践环境中进行为期一年的随机对照试验 确定三个实践导向教学的长效 40~60岁女性肿块发现能力的干预研究 女性增加了40到60人，她们是内科小组的成员 在一所大学的教学医院实习，将接受预试 确定检查乳房肿块的能力。每个女人的侦测 能力将通过在有限时间内检测到的次数来衡量 包含18个模拟乳房模型的6个人造乳房模型的试探性研究 三种不同尺寸(1.0、0.5、0.3厘米)、三种硬度(60、 40和20个硬度计)，以及两个放置深度(中、深)。女性 发现少于8个肿块(这是一项关于医生肿块的研究建立的标准 检测)将随机分配到五个处理组中的一个或 对照组。将测试三种不同的干预策略： (1)RN-Model，使用录像带进行45分钟的护理教学干预， 乳房模型和方法，由Pennypacker和同事在 佛罗里达大学；(2)RN-ACS，一种基于 由美国癌症协会开发的小册子、小册子和方法； 以及(3)MD，三到四分钟的医生增援干预 用示范和鼓励的方式。这三种策略将被使用 单独和组合(RN-ACS+MD，RN-Model+MD)形成五个 治疗组。 在进入试验一年后，妇女将接受重新测试以评估 肿块检测能力的变化。检测方面的平均改进 将对所有五个治疗组进行检查，以确定BSE教学是否 和/或医生增援导致至少增加33% 与平均值相比，组内平均进步的百分比 对照组改善情况。我们还将比较每个项目的改进情况 治疗组行BSE的平均次数/过去6个月(a 自我报告)与对照组进行比较，以确定是否 干预措施导致至少2.0BSE的实施/上次增加 六个月。

Although breast self-examination (BSE) is intuitively appealing as an adjunct in breast cancer control, observed competency among women practitioners is low (20-25%), and it is not clear that training in medical practice settings results in substantial long-term improvement in BSE performance, especially for women at risk due to age. We, therefore, proposed a year long randomized controlled trial in a practice setting to determine the long-term effects of three practice-oriented teaching interventions on the lump detection abilities of women aged 40 to 60. Women added 40 to 60, who are members of an internal medicine group practice at a university teaching hospital, will undergo a pre-test to determine competency in detecting breast lumps. Each woman's detection ability will be measured by the number of detections in a limited time trial search of six manufactured breast models containing 18 simulated lumps of three different sizes (1.0, 0.5, 0.3 cm.), three hardnesses (60, 40, and 20 durometers), and two placement depths (medium, deep). Women who find less than eight lumps (a norm established by a study of physician lump detection) will be randomly allocated to one of five treatment groups or to a control group. Three different intervention strategies will be tested: (1) RN-Model, a 45 minute nursing-teaching intervention using videotapes, breast models, and methods developed by Pennypacker and associates at the University of Florida; (2) RN-ACS, a nursing-teaching intervention based on booklets, pamphlets, and methods developed by the American Cancer Society; and (3) MD, a three to four minute physician reinforcement intervention using demonstration and encouragement. These three strategies will be used alone and in combination (RN-ACS + MD, RN-Model + MD) to form five treatment groups. One year after entry into the trial, women will be re-tested to assess changes in their lump detection ability. The mean improvement in detection of all five treatment groups will be examined to determine if BSE teaching and/or physician reinforcement results in an increase of at least 33 percentage points in a group's mean improvement when compared to the mean improvement of the control group. We will also compare improvement in each treatment groups's mean number of BSE's performed/last six months (a self-report) with that of the control group to determine if the interventions resulted in an increase of at least 2.0 BSE's performed/last six months.