School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
Cancer. 2010 Oct 1;116(19):4646-55. doi: 10.1002/cncr.25378.
The current study was conducted to assess screening behaviors in relation to cultural and environmental barriers among Palestinian women in the West Bank.
The participants were 397 women, ages 30 to 65 years, residing in the Palestinian Authority, and a stratified sample method was used (98.3% participation rate). The participants completed questionnaires on breast examination behaviors and knowledge, on perceived cancer fatalism and health beliefs, and on environmental barriers scales.
Greater than 70% of the women had never undergone mammography or clinical breast examination (CBE), whereas 62% performed self breast examination (SBE). Women were more likely to undergo mammography if they were less religious (odds ratio [OR], 0.59; 95% confidence interval [95% CI], 0.47-0.81) and if they expressed lower personal barriers (OR, 0.59; 95% CI, 0.29-0.76) and lower fatalism (OR, 0.39; 95% CI, 0.28-0.63). A higher likelihood for CBE was related to being Christian (OR, 2.91; 95% CI, 1.49-5.73) and being less religious (OR, 0.32; 95% CI, 0.13-0.78), to perceived higher effectiveness of CBE (OR, 1.46; 95% CI, 1.20-1.79), and to perceived lower cancer fatalism (OR, 0.35; 95% CI, 0.28-0.60). Women were more likely to perform SBE if they were more educated, resided in cities, were Christian, were less religious, had a first-degree relative with breast cancer, perceived higher effectiveness and benefits of SBE, and perceived lower barriers and fatalism.
Participants reported a combination of personal, cultural, and environmental barriers, which should be addressed by educational programs and followed by the allocation of resources for early detection and treatment of breast cancer.
本研究旨在评估巴勒斯坦妇女在约旦河西岸面临的文化和环境障碍与筛查行为之间的关系。
研究对象为 397 名年龄在 30 至 65 岁之间、居住在巴勒斯坦权力机构的妇女，采用分层抽样方法（参与率为 98.3%）。参与者完成了关于乳房检查行为和知识、对癌症宿命论和健康信念的认知，以及环境障碍量表的问卷调查。
超过 70%的女性从未进行过乳房 X 光检查或临床乳房检查，而 62%的女性进行过自我乳房检查。如果女性的宗教信仰程度较低（比值比 [OR]，0.59；95%置信区间 [95%CI]，0.47-0.81），表达的个人障碍和宿命论较低（OR，0.59；95%CI，0.29-0.76），则更有可能进行乳房 X 光检查。进行 CBE 的可能性较高与基督教信仰（OR，2.91；95%CI，1.49-5.73）和较低的宗教信仰（OR，0.32；95%CI，0.13-0.78）有关，与感知到 CBE 的更高有效性（OR，1.46；95%CI，1.20-1.79）和感知到的较低癌症宿命论（OR，0.35；95%CI，0.28-0.60）有关。如果女性受教育程度较高、居住在城市、是基督教徒、宗教信仰较低、有一级亲属患有乳腺癌、感知到 SBE 的更高有效性和益处，以及感知到较低的障碍和宿命论，则更有可能进行 SBE。
参与者报告了个人、文化和环境障碍的综合情况，这应通过教育计划加以解决，并随后为早期发现和治疗乳腺癌分配资源。
