Meechan G T, Collins J P, Moss-Morris R E, Petrie K J
Department of Health Psychology, University of Auckland, New Zealand.
Psychooncology. 2005 Mar;14(3):239-46. doi: 10.1002/pon.841.
Many women fail to be reassured about their breast symptom following benign diagnosis. Identification of the factors contributing to this continued anxiety is important in order that appropriate intervention can be incorporated into the care of women undergoing diagnosis. In this study, we measured levels of anxiety, depression, stress, perceived personal risk of breast cancer, fear of breast cancer treatment and general health anxiety along with clinical and demographic variables in women undergoing investigation of breast symptoms. We then assessed if these factors were associated with reassurance about the breast symptom immediately following benign diagnosis.
Women attending a specialist 'one-stop' breast clinic completed a questionnaire in the clinic prior to diagnosis and a reassurance measure post-benign breast symptom diagnosis.
Post-diagnosis, 67% of women were reassured however, 33% were not reassured about their breast symptom despite a benign diagnosis. Women who were not reassured were more likely to be educated only to high school level and have presenting symptoms of a change in breast shape/dimpling of the breast. There was a trend for women who were not reassured to have breast pain and be diagnosed with a benign breast cyst. Examination of the psychological variables showed that women who were not reassured compared to reassured women had higher levels of health anxiety, perceived stress, fear of breast cancer treatment and general anxiety. Logistic regression analysis entering all the predictors suggests that level of education was the strongest predictor of lack of reassurance following benign diagnosis.
This study found that a significant proportion of women who undergo investigation and receive a benign diagnosis of their breast symptom experience uncertainty. Our finding that women who were not reassured were more likely to be educated only to high school level suggests that this group may benefit from additional information about breast symptoms and benign diagnosis. Additionally, our results indicate that women with high levels of anxiety, perceived stress and general worry about their health may need further reassurance in the immediate diagnosis phase. Further research focussing on how reassurance is interpreted in the context of women's perceptions about breast symptoms and breast disease is important so that appropriate support can be offered for women undergoing diagnosis of breast symptoms.
许多女性在被诊断为良性乳腺疾病后,仍对自己的乳腺症状感到不安。识别导致这种持续焦虑的因素很重要,以便能在对接受诊断的女性的护理中纳入适当的干预措施。在本研究中,我们测量了接受乳腺症状检查的女性的焦虑、抑郁、压力水平、感知到的个人患乳腺癌风险、对乳腺癌治疗的恐惧以及一般健康焦虑水平,同时还测量了临床和人口统计学变量。然后我们评估了这些因素是否与良性诊断后对乳腺症状的安心程度相关。
在专科“一站式”乳腺诊所就诊的女性在诊断前在诊所完成一份问卷,并在乳腺症状被诊断为良性后完成一项安心程度测量。
诊断后,67%的女性感到安心,然而,尽管诊断为良性,仍有33%的女性对自己的乳腺症状感到不安。未感到安心的女性更有可能仅接受过高中教育,且有乳房形状改变/乳房酒窝状等症状。未感到安心的女性有乳房疼痛且被诊断为良性乳腺囊肿的情况有一定趋势。对心理变量的检查表明,与感到安心的女性相比,未感到安心的女性有更高水平的健康焦虑、感知到的压力、对乳腺癌治疗的恐惧和一般焦虑。将所有预测因素纳入的逻辑回归分析表明,教育水平是良性诊断后缺乏安心感的最强预测因素。
本研究发现,相当一部分接受乳腺症状检查并被诊断为良性的女性经历了不确定性。我们的发现是,未感到安心的女性更有可能仅接受过高中教育,这表明这一群体可能会从有关乳腺症状和良性诊断的更多信息中受益。此外,我们的结果表明,焦虑、感知到的压力和对自身健康普遍担忧程度较高的女性在诊断初期可能需要进一步的安心措施。专注于研究在女性对乳腺症状和乳腺疾病的认知背景下,安心感是如何被理解的进一步研究很重要,以便能为接受乳腺症状诊断的女性提供适当的支持。