Inoue Megumi, Pickard Joseph G, Welch-Saleeby Patricia, Johnson Sharon
Graduate School of Social Work, Boston College, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA.
Health Educ Res. 2009 Oct;24(5):735-47. doi: 10.1093/her/cyp008. Epub 2009 Mar 23.
This study utilizes a stress and coping framework which includes cognitive appraisal, personal and environmental resources, coping and stress to examine factors related to African-American caregivers' breast cancer screenings, including mammograms, clinical examinations and self-examinations. Using data from the Black Rural and Urban Caregivers Mental Health and Functioning Study, we performed separate logistic regressions for each type of breast cancer screening. Results reveal that having a regular doctor checkup (coping), care recipients having a cancer diagnosis (cognitive appraisal, and living in urban areas (environment resources) are associated with receiving a mammogram. Having greater income, having at least a high school degree (both personal resources) and having a regular doctor checkup (coping) are associated with receiving a clinical examination. Increased caregiver strain (stress), being 40 years old or older, social support (coping) and living in rural areas are associated with performing a self-examination. Targeting African-American caregivers, particularly in rural areas, for increased education on the importance of receiving breast cancer screenings is crucial to addressing health disparities. Making resources available, encouraging caregivers to get a clinical examination and a mammogram and directing public education toward caregivers are important points of intervention.
本研究采用了一个压力与应对框架,该框架包括认知评估、个人和环境资源、应对方式以及压力,以考察与非裔美国护理者乳腺癌筛查相关的因素,包括乳房X光检查、临床检查和自我检查。利用来自《黑人城乡护理者心理健康与功能研究》的数据,我们针对每种乳腺癌筛查类型分别进行了逻辑回归分析。结果显示,进行定期医生检查(应对方式)、受照顾者被诊断患有癌症(认知评估)以及居住在城市地区(环境资源)与接受乳房X光检查相关。收入较高、至少拥有高中学历(均为个人资源)以及进行定期医生检查(应对方式)与接受临床检查相关。护理者压力增加(压力)、年龄在40岁及以上、社会支持(应对方式)以及居住在农村地区与进行自我检查相关。针对非裔美国护理者,尤其是农村地区的护理者,加强关于接受乳腺癌筛查重要性的教育,对于解决健康差距至关重要。提供资源、鼓励护理者进行临床检查和乳房X光检查以及将公共教育导向护理者是重要的干预要点。