Mitchell Jim, Lannin Donald R, Mathews Holly F, Swanson Melvin S
Center on Aging, School of Medicine, East Carolina University, Greenville, North Carolina 27858-4354, USA.
J Womens Health (Larchmt). 2002 Dec;11(10):907-15. doi: 10.1089/154099902762203740.
The mechanisms underlying a reported tendency for women who hold strong religious beliefs to seek medical help at more advanced stages of breast cancer are unknown. This study investigates further the effect of religious beliefs with other variables on breast cancer screening and the intended presentation of a self-discovered breast lump.
The study included 682 eastern North Carolina women aged 40 and over who were interviewed in their homes about religious and other beliefs about breast cancer, screening, and intended actions with a self-discovered breast lump.
Principal components factor analysis results suggested that a majority of women believe that God works through doctors to cure breast cancer. We labeled this dimension "religious intervention with treatment." A minority believed that medical treatment was unnecessary because only God could cure breast cancer. We labeled this dimension "religious intervention in place of treatment." The first dimension correlated with self-reported mammography but not clinical breast examination or women's intention to delay presentation of a self-discovered breast lump. The second dimension, significantly more common in African American women who were less educated and older, correlated strongly with the intention to delay presentation of a self-discovered breast lump.
Belief in "religious intervention in place of treatment" may help to explain why African American women delay presentation of palpable breast lumps, contributing to advanced-stage cancer diagnosis. We suggest that clinicians and clergy work together within the context of religious beliefs to enhance early detection and survival from breast cancer.
据报道,有强烈宗教信仰的女性倾向于在乳腺癌更晚期阶段寻求医疗帮助,其背后的机制尚不清楚。本研究进一步调查宗教信仰与其他变量对乳腺癌筛查以及自我发现乳腺肿块后的就诊意愿的影响。
该研究纳入了682名年龄在40岁及以上的北卡罗来纳州东部女性,研究人员在她们家中就她们对乳腺癌、筛查以及自我发现乳腺肿块后的预期行动的宗教和其他信念进行了访谈。
主成分因子分析结果表明,大多数女性认为上帝通过医生来治愈乳腺癌。我们将这一维度标记为“宗教介入治疗”。少数女性认为医疗治疗是不必要的,因为只有上帝才能治愈乳腺癌。我们将这一维度标记为“宗教介入取代治疗”。第一个维度与自我报告的乳房X光检查相关,但与临床乳腺检查或女性延迟自我发现乳腺肿块就诊的意愿无关。第二个维度在受教育程度较低和年龄较大的非裔美国女性中更为常见,与延迟自我发现乳腺肿块就诊的意愿密切相关。
对“宗教介入取代治疗”的信仰可能有助于解释为什么非裔美国女性会延迟出现可触及的乳腺肿块,从而导致晚期癌症诊断。我们建议临床医生和神职人员在宗教信仰的背景下共同努力,以提高乳腺癌的早期发现率和生存率。