Chemotherapy Adherence Decision Making In Early Stage Breast Cancer

描述(申请人提供)：这项研究试图描述影响非裔美国人和高加索女性早期乳腺癌患者坚持推荐化疗的决定的因素。乳腺癌的诊断是一件非常有压力的事情，需要女性对自己的护理做出多项决定。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。由于观察到患有乳腺癌的高加索女性和非裔美国女性在治疗和生存方面的种族差异(2-4)，必须更好地了解这两组患者的依从率和影响治疗决策的变量的程度。这项研究的具体目的是：1.检验非裔美国人和白人早期乳腺癌妇女在接受化疗方面的差异与社会人口学因素、社会互动因素、癌症经历、乳腺癌知识和健康信念的关系；2.探索社会人口学因素、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，作为预测非裔美国人和白人早期乳腺癌妇女坚持化疗的因素。这项前瞻性预测性研究将使用120名女性样本来确定化疗决策的显著预测因素和种族差异。数据收集采用人口学量表、医生信任量表、诺贝克社会支持问卷、帕格特宗教应对量表、乳腺癌相关综合知识量表、纪念症状评定量表、POWE宿命论问卷、流行病学研究中心抑郁和冠军健康信念模式量表。国家护理研究所感兴趣的研究是确定影响决策的因素，从而导致促进健康的行为变化，并确定支持复杂疾病坚持治疗的行为(5)。这项研究与NINR的使命非常一致，因为它寻求实现我的长期目标，即在患者决策过程中建立必要的研究基础，以促进积极的健康结果，并减少患有乳腺癌的非裔美国女性的健康差距。这项研究与公共健康的相关性是为了减少患有乳腺癌的非裔美国女性生存结果中的健康差距。2010年《健康人》的首要目标是消除健康差距，特别是癌症存活率方面的种族差异。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裔美国女性提前终止推荐治疗的因素；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：在理论框架和现有文献的基础上，开发关于乳腺癌女性患者治疗依从性和决策过程的相关研究问题，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.