Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA.
Stress Health. 2012 Dec;28(5):389-96. doi: 10.1002/smi.2464.
Associations between stress and breast cancer highlight stressful life events as barriers to breast cancer screening, increased stress due to a breast cancer scare or diagnosis, or the immunosuppressive properties of stress as a risk factor for breast cancer occurrence. Little is known, however, about how women's reactions to stressful life events impact their breast health trajectory. In this study, we explore how reactions to stressors serve as a potential barrier to breast cancer screening among Black women. We apply a gender-specific, culturally responsive stress-process framework, the Stress and 'Strength' Hypothesis ("strength hypothesis"), to understand links between the 'Strong Black Woman role' role, Black women's stress reactions and their observed screening delays. We conceptualize strength as a culturally prescribed coping style that conditions resilience, self-reliance and psychological hardiness as a survival response to race-related and gender-related stressors. Using qualitative methods, we investigate the potential for this coping mechanism to manifest as extraordinary caregiving, emotional suppression and self-care postponement. These manifestations may result in limited time for scheduling and attending screening appointments, lack of or delay in acknowledgement of breast health symptoms and low prioritization of breast care. Limitations and future directions are discussed.
压力与乳腺癌之间的关联强调了生活压力事件是乳腺癌筛查的障碍，乳腺癌的恐慌或诊断会增加压力，或者压力的免疫抑制特性是乳腺癌发生的一个风险因素。然而，人们对女性对生活压力事件的反应如何影响其乳房健康轨迹知之甚少。在这项研究中，我们探讨了压力源的反应如何成为黑人女性乳腺癌筛查的潜在障碍。我们应用了一种性别特定的、文化响应的压力过程框架，即“压力和‘力量’假说”（“力量假说”），以了解“坚强的黑人女性角色”、黑人女性的压力反应以及她们观察到的筛查延迟之间的联系。我们将力量概念化为一种文化规定的应对方式，这种应对方式可以作为一种生存反应，调节韧性、自力更生和心理坚韧，以应对与种族和性别相关的压力源。我们使用定性方法，研究这种应对机制是否可能表现为非凡的照顾、情绪压抑和自我保健推迟。这些表现可能会导致安排和参加筛查预约的时间有限，对乳房健康症状的认识不足或延迟，以及对乳房护理的重视程度较低。讨论了局限性和未来的方向。
