Chemotherapy Adherence Decision Making In Early Stage Breast Cancer

描述（由申请人提供）：本研究旨在描述影响非洲裔美国人和白人早期乳腺癌女性坚持推荐化疗治疗的决策的因素。乳腺癌的诊断是一个非常紧张的事件，需要妇女对她的护理做出多个决定。然而，他们的决定可能与医疗保健提供者的建议一致，也可能不一致。由于在白人和非洲裔美国乳腺癌女性之间观察到的治疗和生存率的种族差异（2-4），必须更好地了解两组中依从率和影响治疗决策的变量的程度。本研究的具体目的是：1.研究非裔美国人和白人女性早期乳腺癌患者化疗依从性的差异，这些差异与社会人口统计学因素、社会互动因素、癌症经历、乳腺癌知识和健康信念有关;和2.探讨社会人口因素、社会互动因素、癌症经历、乳腺癌知识和健康信念之间的关系，作为非洲裔美国人和白人早期乳腺癌妇女坚持化疗的预测因素。这项前瞻性预测研究将使用120名妇女的样本来确定化疗治疗决策的显著预测因素和种族差异。将使用人口统计学测量、医生信任量表、Norbeck社会支持问卷、Pargment宗教应对量表、综合乳腺癌相关知识量表、记忆症状评估量表简表、自杀宿命论量表、流行病学抑郁中心和冠军健康信念模型量表进行数据收集。国家护理研究所对确定影响决策的因素的研究感兴趣，这些因素会导致促进健康的行为变化，并定义支持复杂疾病治疗的行为（5）。这项研究与NINR的使命一致，因为它旨在实现我的长期目标，即在患者决策过程中建立必要的研究，以促进积极的健康结果，减少非裔美国乳腺癌妇女的健康差距。该研究与公共卫生的相关性是减少非裔美国乳腺癌妇女生存结果中的健康差异。《2010年健康人》的一个总体目标是消除健康差距，特别是在癌症生存方面的种族差异。公共卫生相关性：培训目标：获得与乳腺癌妇女决策研究相关的知识和技能，以便进行科学合理的研究。我的研究将集中在影响患有乳腺癌的非洲裔美国妇女提前终止其推荐治疗的因素上;鉴于这项人口研究的乳腺癌死亡率很高。这一目标将通过以下方式实现：基于理论框架和现有文献，制定有关乳腺癌妇女治疗依从性和决策过程的科学研究问题，设计和实施研究项目，采用适当的统计程序分析结果，并在科学文献中传播研究结果。

DESCRIPTION (provided by applicant): This study seeks to describe the factors that influence the decision making of African American and Caucasian women with early stage breast cancer to adhere to recommended chemotherapy treatment. The diagnosis of breast cancer is a very stressful event, requiring the woman to make multiple decisions about her care. However, their decisions may or may not be consistent with the recommendations of the healthcare provider. Because of ethnic differences observed in the treatment and survival between Caucasian and African American women with breast cancer (2-4), the extent to which adherence rates and the variables that effect treatment decision making in both groups must be better understood. The specific aims of this study are: 1. to examine differences in adherence to chemotherapy between African-American and Caucasian women with early stage breast cancer in relation to socio-demographic factors, social interaction factors, cancer experience, breast cancer knowledge, and health beliefs; and 2. to explore relationships among socio-demographic factors, social interaction factors, cancer experience, breast cancer knowledge, and health beliefs as predictors of adherence to chemotherapy in African American and Caucasian women with early stage breast cancer. This prospective predictive study will use a sample of 120 women to identify significant predictors and ethnic differences of chemotherapy treatment decision making. A Demographics Measure, Trust in Physician Scale, Norbeck Social Support Questionnaire, the Pargment Religious Coping Scale, the Comprehensive Breast Cancer Related Knowledge Scale, Memorial Symptom Assessment Scale Short Form, the Powe Fatalism Inventory, Center for Epidemiologic Studies-Depression and the Champion Health Belief Model Scale will be used for data collection. The National Institute of Nursing Research is interested in research that identify the factors that influence decision making that results in behavioral changes that promote health and to define the behaviors that support adherence to treatment for complex diseases(5). This study is well aligned with NINR's mission as it seeks to accomplish my long term goal to build on the necessary research needed for patients in their decision making process in order to promote positive health outcomes and reduce health disparities seen in African American women with breast cancer. The relevance to public health of the research is to reduce health disparities seen in survival outcomes among African American women with breast cancer. An overarching goal of Healthy People 2010 is to eliminate health disparities, specifically racial differences seen in cancer survival. PUBLIC HEALTH RELEVANCE: Training goals: To acquire the knowledge and skills related to the study of decision making in women with breast cancer in order to conduct scientifically sound research. My research will focus on the factors that influence African American women with breast cancer to terminate their recommended treatment early; given this population study has a high mortality rate from breast cancer. This goal will be accomplished by developing relevant research question on the science of treatment adherence and the decision making process of women with breast cancer, based on a theoretical framework and the current body of literature, designing and implementing a research project, analyzing the results with appropriate statistical procedures ,and disseminating the findings in the scientific literature.