School of Nursing, Tianjin Medical University, Tianjin, China.
Int Nurs Rev. 2010 Mar;57(1):128-34. doi: 10.1111/j.1466-7657.2009.00756.x.
The aim of this study was to test community-based nursing education about breast self-examination to see whether self-examination frequency could be increased.
Breast cancer rates in China are rising rapidly, especially in cities. The majority of Chinese women does not know about breast self-examination, and the Chinese health care system cannot provide mammograms for the millions of at-risk women throughout China.
This study was a randomized clinical trial of nurse-provided, community-based teaching of breast self-examination in the urban and rural areas of Tianjin and urban and suburban areas of Shanghai. Women (n = 1510) never diagnosed with breast cancer and 40 years and older were randomized by community and stratified by urban vs. other residences.
At baseline, 9% of the intervention and 6% of the control groups did breast self-examination at least every other month. After 12 months, 34% of the intervention, but only 11% of the control, group did breast self-examination that often (P < 0.001). There was a significant impact in urban, suburban and rural areas, and intervention effects were stronger than any of the other influences tested.
The clinical trial showed a statistically significant increase in breast self-examination after the nursing education intervention. As no other breast cancer screening method is available in most of China, this method is best suited for the masses of people currently at risk in China.
本研究旨在检验基于社区的乳腺癌自检健康教育，以观察其能否提高自检频率。
中国的乳腺癌发病率正在迅速上升，尤其是在城市。大多数中国女性不了解乳腺自检，而中国的医疗保健系统无法为数百万处于高危的中国女性提供乳房 X 光检查。
本研究是一项在天津市城乡和上海市城乡地区进行的、由护士提供的、基于社区的乳腺癌自检教学的随机临床试验。从未被诊断患有乳腺癌且年龄在 40 岁及以上的女性按社区随机分组，并按城市与其他居住地分层。
在基线时，干预组中 9%的女性和对照组中 6%的女性每两个月至少进行一次乳腺自检。12 个月后，干预组中有 34%的女性经常进行乳腺自检，但对照组中只有 11%的女性经常进行（P<0.001）。在城市、郊区和农村地区均有显著影响，且干预效果强于任何其他测试的影响。
临床试验显示，在护理教育干预后，乳腺自检的比例显著增加。由于在中国的大部分地区都没有其他的乳腺癌筛查方法，因此这种方法最适合目前处于高危状态的广大民众。
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