Hajian-Tilaki Karimollah, Auladi Sahar
Department of Social Medicine and Health, Babol University of Medical Sciences, Babol, Iran,
Breast Cancer. 2014 Jul;21(4):429-34. doi: 10.1007/s12282-012-0409-3. Epub 2012 Sep 19.
The objective of this study is to determine the role of different health belief model components in practice of breast cancer screening among Iranian women.
A cross-sectional study of 500 women aged 18-65 years was conducted in an urban population under the coverage of a health therapeutic system in Babol, northern Iran in 2012. Demographic data and data regarding practice of breast self-examination (BSE), breast clinical examination (BCE), and mammography were collected by interview, and a standard health belief model questionnaire was used to assess women's attitudes in six different domains based on a Likert scale that ranked from 1 to 5. The average score of each item for each domain was calculated. The Wilcoxon rank test and a multiple logistic regression model were used to estimate the odds ratio of each domain for performing breast cancer screening (BSE, BCE, and mammography).
The mean age of the women was 31.2 (9.4) years. Overall, the average scores in domains of perceived benefit, self-efficacy, and health motivation were significantly higher among those who performed BSE and BCE, but not for mammography. For the domains of perception of susceptibility, seriousness, and barriers, no significant differences were observed. Higher scores on the scales of perceived benefits, perceived confidence/self-efficacy, and health motivation showed significant positive association with performing BSE [adjusted OR (95 % confidence interval [CI]) 1.73 (1.11, 2.72), 4.01 (2.39, 6.73), and 2.01 (1.30, 3.08), respectively] and BCE [adjusted OR (95 % CI) 1.65 (1.0, 2.95), 2.33 (1.39, 3.91), and 1.58 (1.0, 2.53), respectively], but not for performing mammography. For perceived susceptibility, perceived seriousness, and barriers, no significant association was observed.
Positive attitudes toward perceived benefits, perceived confidence/self-efficacy, and health motivation have a strong association with performing BSE and BCE. The impact of health belief model subscales on breast cancer screening may vary with respect to culture and values.
本研究的目的是确定不同健康信念模型组成部分在伊朗女性乳腺癌筛查实践中的作用。
2012年在伊朗北部巴博勒一个处于健康治疗体系覆盖范围内的城市人群中，对500名年龄在18 - 65岁的女性进行了一项横断面研究。通过访谈收集人口统计学数据以及关于乳房自我检查（BSE）、乳房临床检查（BCE）和乳房X线摄影的实践数据，并使用一份标准的健康信念模型问卷，基于从1到5的李克特量表来评估女性在六个不同领域的态度。计算每个领域每个项目的平均得分。采用Wilcoxon秩和检验和多元逻辑回归模型来估计每个领域进行乳腺癌筛查（BSE、BCE和乳房X线摄影）的优势比。
女性的平均年龄为31.2（9.4）岁。总体而言，在进行BSE和BCE的人群中，感知益处、自我效能和健康动机领域的平均得分显著更高，但乳房X线摄影方面并非如此。在易感性感知、严重性感知和障碍领域，未观察到显著差异。在感知益处、感知信心/自我效能和健康动机量表上得分较高与进行BSE[调整优势比（95%置信区间[CI]）分别为1.73（1.11，2.72）、4.01（2.39，6.73）和2.01（1.30，3.08）]和BCE[调整优势比（95%CI）分别为1.65（1.0，2.95）、2.33（1.39，3.91）和1.58（1.0，2.53）]显著正相关，但与进行乳房X线摄影无关。对于易感性感知、严重性感知和障碍，未观察到显著关联。
对感知益处、感知信心/自我效能和健康动机持积极态度与进行BSE和BCE密切相关。健康信念模型子量表对乳腺癌筛查的影响可能因文化和价值观而异。
