Thompson Hayley S, Valdimarsdottir Heiddis B, Winkel Gary, Jandorf Lina, Redd William
Ruttenberg Cancer Center, Mount Sinai School of Medicine, One Gustave Levy Place, Box 1130, New York, NY 10029, USA.
Prev Med. 2004 Feb;38(2):209-18. doi: 10.1016/j.ypmed.2003.09.041.
There is little research on medical mistrust as a barrier to breast cancer screening. This study investigated the psychometric properties of a new scale, the Group-Based Medical Mistrust Scale (GBMMS), and its association with cancer screening attitudes and breast cancer screening practices among African American and Latina women.
Participants were 168 African American and Latina urban women who completed the GBMMS and measures of sociodemographics, cancer screening pros and cons, acculturation, breast cancer screening practices and physician recommendation of such screening.
A principal components analysis of GBMMS items revealed three factors that were analyzed as subscales: (1) suspicion, (2) group disparities in health care, and (3) lack of support from health care providers. Convergent validity of the GBMMS was supported by its negative association with perceived benefits of cancer screening and acculturation and positive association with perceived disadvantages of cancer screening. Results further showed that women who reported no previous mammogram or a long-term lapse in mammography participation (>5 years) had significantly higher total GBMMS scores (P < 0.04) compared to women who were either adherent to mammography guidelines or nonadherent but reported a mammogram within the past 5 years. This analysis controlled for physician recommendation.
Results support the validity of the GBMMS and its association with breast cancer screening adherence. The GBMMS may be used to further investigate medical mistrust as a barrier to screening for cancers for which ethnic group disparities have been observed.
关于医疗不信任作为乳腺癌筛查障碍的研究较少。本研究调查了一种新量表——基于群体的医疗不信任量表（GBMMS）的心理测量特性，及其与非裔美国人和拉丁裔女性的癌症筛查态度和乳腺癌筛查行为之间的关联。
参与者为168名非裔美国人和拉丁裔城市女性，她们完成了GBMMS以及社会人口统计学、癌症筛查利弊、文化适应、乳腺癌筛查行为和医生对这种筛查的建议等测量。
对GBMMS项目的主成分分析揭示了三个因素，作为子量表进行分析：（1）怀疑，（2）医疗保健中的群体差异，（3）缺乏医疗保健提供者的支持。GBMMS的收敛效度得到了其与癌症筛查和文化适应的感知益处呈负相关，以及与癌症筛查的感知弊端呈正相关的支持。结果进一步表明，与遵循乳房X光检查指南或不遵循但在过去5年内进行过乳房X光检查的女性相比，报告以前没有进行过乳房X光检查或长期未参与乳房X光检查（>5年）的女性的GBMMS总分显著更高（P < 0.04）。该分析控制了医生的建议。
结果支持GBMMS的效度及其与乳腺癌筛查依从性的关联。GBMMS可用于进一步研究医疗不信任作为已观察到种族差异的癌症筛查障碍。
