Department of Medical Psychology, Pharmaceutical Education Research Center, Kitasato University School of Pharmacy, Minato, Tokyo, Japan.
Fam Cancer. 2011 Dec;10(4):681-9. doi: 10.1007/s10689-011-9464-8.
The purpose of this study was to reveal characteristics that underlie patients' expressions of concern about their genetic risk of breast cancer at an initial outpatient clinic visit prior to a definitive diagnosis of cancer. A total of 233 women, at their initial outpatient clinic visits, participated in semi-structured and open-ended interviews that surveyed their anxieties, worries, thoughts, and feelings. Each patient completed a self-administered survey comprising questions about her family history of breast cancer and responded to a questionnaire that assessed psychological distress. Patients were divided into those who expressed concerns about inherited risk of breast cancer during the interview (expression group, n = 39) and those who did not (non-expression group, n = 194). Although patients in the expression group tended to have higher rates of breast cancer in their families, patients without a family history of breast cancer also expressed concerns. We used qualitative content analysis to identify the emotions and thoughts of patients expressing these concerns. Patients with a family history of breast cancer experienced anxiety/worry, risk-reducing behavior, acceptance, objective fact, and denial, whereas patients without a family history of breast cancer experienced anxiety/worry, risk-reducing behavior, surprise/shock, acceptance, objective fact, denial, optimistic thought, regret, and realistic thought. Some patients in the breast clinic had concerns about their inherited risk of cancer, despite lacking a family history of breast cancer. Health care professionals should inquire about family histories and provide appropriate support and counseling to patients as needed, regardless of the patient's genetic risk for the disease.
本研究旨在揭示患者在癌症确诊前首次门诊就诊时表达对乳腺癌遗传风险的担忧的特征。共有 233 名女性在首次门诊就诊时接受了半结构化和开放式访谈，调查了她们的焦虑、担忧、想法和感受。每位患者都完成了一份自我管理的调查问卷，其中包括有关其乳腺癌家族史的问题，并回答了一份评估心理困扰的问卷。患者分为在访谈中表达对乳腺癌遗传风险担忧的患者（表达组，n=39）和未表达担忧的患者（非表达组，n=194）。尽管表达组患者的家族乳腺癌发病率较高，但没有乳腺癌家族史的患者也表达了担忧。我们使用定性内容分析来确定表达这些担忧的患者的情绪和想法。有乳腺癌家族史的患者经历了焦虑/担忧、降低风险行为、接受、客观事实和否认，而没有乳腺癌家族史的患者则经历了焦虑/担忧、降低风险行为、惊讶/震惊、接受、客观事实、否认、乐观思考、遗憾和现实思考。尽管一些患者没有乳腺癌家族史，但他们对自己的遗传癌症风险表示担忧。医疗保健专业人员应询问家族史，并根据需要为患者提供适当的支持和咨询，无论患者的疾病遗传风险如何。
