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简短应对技能干预对新诊断乳腺癌患者一级亲属乳房自我检查依从性的影响。

The impact of a brief coping skills intervention on adherence to breast self-examination among first-degree relatives of newly diagnosed breast cancer patients.

作者信息

Audrain J, Rimer B, Cella D, Stefanek M, Garber J, Pennanen M, Helzlsouer K, Vogel V, Lin T H, Lerman C

机构信息

Lombardi Cancer Center, Georgetown University Medical Center, Washington DC 20007, USA.

出版信息

Psychooncology. 1999 May-Jun;8(3):220-9. doi: 10.1002/(SICI)1099-1611(199905/06)8:3<220::AID-PON370>3.0.CO;2-C.

Abstract

The present investigation sought to determine (1) the impact of a single session stress management/coping intervention (problem-solving training; PST) versus a general health counseling (GHC) control condition on breast self-examination (BSE) adherence among relatives of newly diagnosed breast cancer patients, and (2) whether women with heightened perceived risk of breast cancer and/or cancer specific distress at baseline were more likely to improve their BSE adherence following PST. The participants were 510 women age 20-75 who had at least one first-degree relative with breast cancer. All of the participants completed a baseline telephone interview, an intervention (PST versus GHC), and a 3-month follow-up telephone interview. The results revealed a 36% overall improvement in BSE adherence, with no significant between-group difference in improvement (chi 2 = 0.03, p = 0.87). The logistic regression analysis of improvement in BSE adherence revealed a statistically significant cancer-specific distress by treatment interaction (p = 0.04). Among women who received PST, those with high levels of cancer-specific distress were two times more likely to improve in BSE adherence than women low in cancer-specific distress. There was no effect of cancer-specific distress in the control condition. These results suggest that women with a family history of breast cancer who have high levels of distress may be most likely to benefit from behavioral coping skills intervention to promote adherence to breast cancer screening.

摘要

本研究旨在确定

(1)单次应激管理/应对干预(问题解决训练;PST)与一般健康咨询(GHC)对照条件对新诊断乳腺癌患者亲属进行乳房自我检查(BSE)依从性的影响;(2)基线时乳腺癌感知风险和/或癌症特异性困扰较高的女性在接受PST后是否更有可能提高其BSE依从性。参与者为510名年龄在20 - 75岁之间、至少有一位患乳腺癌的一级亲属的女性。所有参与者均完成了一次基线电话访谈、一次干预(PST与GHC)以及一次为期3个月的随访电话访谈。结果显示,BSE依从性总体提高了36%,组间改善情况无显著差异(卡方 = 0.03,p = 0.87)。对BSE依从性改善情况的逻辑回归分析显示,治疗与癌症特异性困扰之间存在统计学显著的交互作用(p = 0.04)。在接受PST的女性中,癌症特异性困扰程度高的女性BSE依从性改善的可能性是癌症特异性困扰程度低的女性的两倍。在对照条件下,癌症特异性困扰没有影响。这些结果表明,有乳腺癌家族史且困扰程度高的女性可能最有可能从行为应对技能干预中受益,以促进乳腺癌筛查的依从性。

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