BREAST CANCER IN YOUNGER WOMEN--IMPROVING LIFE QUALITY

乳腺癌是美国女性中最常见的癌症。1992年， 新增确诊18万例，占全部新增确诊女性的20% 年龄在50岁以下。 患有乳腺癌的年轻女性 关注诸如生殖、早产儿的长期后果 更年期，以及对身体形象和性行为的关注。未报告 研究关注了年轻女性特有的心理社会问题， 一些人发现，年轻女性在适应 乳腺癌虽然以前测试过的针对妇女的干预措施 乳腺癌的治疗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。这些干预措施的实施成本很高，许多妇女 没有机会，时间，或倾向于参与一个 心理治疗计划。支持群体的人口统计学特征 与会者认为，低社会经济地位和少数民族的个人， 代表性不足。拟议的研究解决了以下缺点： 以前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， 在社区实施。 根据在联合国的广泛经验， 新英格兰研究所在开发与健康有关的录像带， 患者和公众，建议的干预是30分钟 录像带，重点关注年轻妇女的具体关切。录像带 将以女性为模特，提出各种解决方案， 他们遇到的压力和问题，以及验证共同的 性问题它的目的是鼓舞士气，提高自尊， 改进应对策略。拟议项目的具体目标是： (1)确定和说明与《公约》有关的关键问题， 社会心理学（身体形象、性、生殖、人际关系和 家庭关系），以及医疗和残疾相关后遗症 乳腺癌的诊断和治疗;（2）制作30分钟的 以年轻妇女特别关注的问题为重点的录像带; (3)在一个随机的， 审判录像带将通过随机分配250个新的 年龄<50岁的确诊乳腺癌患者从多个 干预组或对照组。受试者将接受 基线访谈和随机化后，将在6周、6周和6周后进行随访。 MOS和基线后1年。生活质量是主要结果。的 建议的录像带提供了以下优点： 女人，女人可以在心理准备好的时候看， 一个人的家的隐私，可以显示给家庭成员提供一个 鼓励讨论，在社区实践环境中随时适用， 具有成本效益的干预措施;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.