Department of Family Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Genet Med. 2010 Apr;12(4):212-8. doi: 10.1097/GIM.0b013e3181d56ae6.
To determine whether family medical history as a risk factor for six common diseases is related to patients' perceptions of risk, worry, and control over getting these diseases.
We used data from the cluster-randomized, controlled Family Healthware Impact Trial (FHITr). At baseline, healthy primary care patients reported their perceptions about coronary heart disease, stroke, diabetes, and breast, ovarian, and colon cancers. Immediately afterward, intervention group participants used Family Healthware to record family medical history; this web-based tool stratified familial disease risks. Multivariate and multilevel regression analyses measured the association between familial risk and patient perceptions for each disease, controlling for personal health and demographics.
For the 2330 participants who used Family Healthware immediately after providing baseline data, perceived risk and worry for each disease were strongly associated with family history risk, adjusting for personal risk factors. The magnitude of the effect of family history on perceived risk ranged from 0.35 standard deviation for ovarian cancer to 1.12 standard deviations for colon cancer. Family history was not related to perceived control over developing diseases. Risk perceptions seemed optimistically biased, with 48-79% of participants with increased familial risk for diseases reporting that they were at average risk or below.
Participants' ratings of their risk for developing common diseases, before feedback on familial risk, parallels but is often lower than their calculated risk based on family history. Having a family history of a disease increases its salience and does not change one's perceived ability to prevent the disease.
确定家族病史作为六种常见疾病的风险因素是否与患者对这些疾病的风险感知、担忧和控制程度有关。
我们使用了来自聚类随机对照家庭健康影响试验（FHITr）的数据。在基线时，健康的初级保健患者报告了他们对冠心病、中风、糖尿病以及乳腺癌、卵巢癌和结肠癌的感知。之后，干预组参与者使用家庭健康软件记录家族病史；该基于网络的工具对家族疾病风险进行分层。多变量和多层次回归分析衡量了家族风险与每位患者对每种疾病的感知之间的关联，同时控制了个人健康和人口统计学因素。
对于 2330 名在提供基线数据后立即使用家庭健康软件的参与者，每种疾病的感知风险和担忧与家族史风险密切相关，调整了个人风险因素。家族史对感知风险的影响程度从卵巢癌的 0.35 个标准差到结肠癌的 1.12 个标准差不等。家族史与对疾病发展的感知控制无关。风险感知似乎存在乐观偏见，48%-79%的参与者在疾病家族风险增加的情况下报告自己处于平均风险或以下。
在反馈家族风险之前，参与者对自身患常见疾病风险的评估与基于家族史的计算风险相平行，但往往较低。家族病史增加了疾病的显著度，但不会改变人们对预防疾病的感知能力。
