NURSE AND PHYSICAN INTERVENTIONS TO IMPROVE BSE

护士和医生的干预措施以改善疯牛病

• 批准号: 3371268
• 负责人: SUZANNE W FLETCHER
• 金额: $ 12.54万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 1985
• 资助国家: 美国
• 起止时间: 1985-07-01 至 1988-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3371268
• 关键词: breast neoplasm /cancer diagnosis; cancer prevention; diagnosis quality /standard; early diagnosis; human middle age (35-64); human subject; longitudinal human study; neoplasm /cancer education; nurses; nursing intervention; nursing research; physical model; physicians; self care

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.

虽然乳房自我检查（BSE）是直观的吸引力， 乳腺癌控制辅助人员，观察到妇女的能力 从业人员的比例很低（20-25%），目前尚不清楚医疗培训是否 实践环境导致BSE的实质性长期改善 特别是对于因年龄而面临风险的妇女。 因此，我们 在实践环境中提出了一项为期一年的随机对照试验， 确定三个实践导向教学的长期效果 对40至60岁妇女的肿块检测能力进行干预。 妇女增加了40至60人，她们是一个内科小组的成员 在大学教学医院实习，将接受预测试， 确定检测乳房肿块的能力。 每个女人的发现 能力将通过在有限时间内探测到的数量来衡量 对6个含有18个模拟乳房的人工乳房模型进行了试验性检索 三种不同大小的块状物（1.0、0.5、0.3 cm），三种硬度（60， 40和20硬度）和两个放置深度（中等、深）。 的妇女 发现少于8个肿块（由医生肿块研究建立的标准） 检测）将被随机分配到五个治疗组之一，或 一个对照组。 将测试三种不同的干预战略： (1)RN模型，45分钟的护理教学干预，使用录像带， 乳房模型，以及由Pennypacker及其同事在 佛罗里达大学;（2）RN-ACS，一种基于 美国癌症协会开发的小册子、小册子和方法; 和（3）MD，三到四分钟的医生强化干预 通过示范和鼓励。 这三种策略将被使用 单独和组合（RN-ACS + MD，RN-Model + MD）以形成五个 治疗组。 进入试验一年后，妇女将重新测试，以评估 它们的肿块检测能力的变化。 检测的平均改善 将检查所有五个治疗组，以确定是否BSE教学 和/或医师强化导致至少33 与平均值相比，一组平均改善的百分比 对照组的改善。 我们还将比较每种方法的改进情况， 治疗组进行BSE的平均次数/过去6个月（a 自我报告）与对照组，以确定是否 干预导致至少2.0例BSE/末次增加 六个月