Powe Barbara D, Finnie Ramona
Behavioral Research Center, American Cancer Society, Atlanta, Ga 30329, USA.
Cancer Nurs. 2003 Dec;26(6):454-65; quiz 466-7. doi: 10.1097/00002820-200312000-00005.
Cancer fatalism--the belief that death is inevitable when cancer is present--has been identified as a barrier to participation in cancer screening, detection, and treatment. Yet this literature has not been reviewed in a comprehensive and systematic manner. Therefore, this literature review addressed (1) philosophical and theoretical underpinnings of cancer fatalism; (2) relationships among demographic factors, cancer fatalism, and cancer screening; (3) the role of cancer fatalism for patients diagnosed with cancer; and (4) intervention strategies. Most of the reviewed studies were descriptive or correlational, did not have an explicit theoretical framework, had varied definitions of fatalism, and reported screening as "intent to screen" or as "past screening behaviors." Review of the studies suggests that cancer fatalism develops over time and is most frequently reported among medically underserved persons and those with limited knowledge of cancer. Cancer fatalism may be modified through culturally relevant interventions that incorporate spirituality. Emphasis must be placed on recognizing the role of cancer fatalism when planning health promotion activities. Future studies should focus on the consistent measurement of cancer fatalism and testing intervention strategies.
癌症宿命论——即认为患癌后死亡不可避免的信念——已被视作参与癌症筛查、检测及治疗的障碍。然而，尚未有人对这方面的文献进行全面系统的综述。因此，本综述探讨了以下内容：（1）癌症宿命论的哲学和理论基础；（2）人口统计学因素、癌症宿命论与癌症筛查之间的关系；（3）癌症宿命论对癌症确诊患者的影响；（4）干预策略。大多数被综述的研究都是描述性或相关性的，没有明确的理论框架，对宿命论的定义各不相同，且将筛查报告为“筛查意向”或“过去的筛查行为”。对这些研究的综述表明，癌症宿命论是随着时间形成的，在医疗服务不足的人群以及癌症知识有限的人群中最为常见。可以通过纳入精神层面内容的文化相关干预措施来改变癌症宿命论。在规划健康促进活动时，必须重视认识癌症宿命论的作用。未来的研究应侧重于对癌症宿命论进行一致的测量，并测试干预策略。
