Iskandarsyah Aulia, de Klerk Cora, Suardi Dradjat R, Sadarjoen Sawitri S, Passchier Jan
Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Clinical Psychology, VU University, Amsterdam, the Netherlands; Department of Clinical Psychology, Padjadjaran University, Bandung, Indonesia.
Psychooncology. 2014 Oct;23(10):1118-24. doi: 10.1002/pon.3534. Epub 2014 Mar 24.
The aim of the present study was to test the association between psychosocial factors and delay in uptake of treatment and treatment non-adherence in Indonesian women with breast cancer.
Seventy consecutive patients with breast cancer who were treated at the Hasan Sadikin Hospital in Indonesia were recruited. They completed a demographic form, the non-adherence questionnaire, the Breast Cancer Knowledge Test, the Brief Illness Perception Questionnaire, the Multidimensional Health Locus of Control Scales, the Satisfaction with Cancer Information Profile and the Distress Thermometer.
Seventeen (24%) out of 70 patients reported that they had delayed initiating treatment at the hospital, and nine (13%) out of 70 patients had missed two or more consecutive treatment sessions. In the bivariate analyses, we found no significant differences on any of the psychological variables between patients who delayed initiating treatment and those patients who did not, whereas patients who had missed two or more consecutive sessions had lower satisfaction with the type and timing of information provided and more negative illness perceptions than patients who had not missed their sessions. In multivariate regression analyses, consulting a traditional healer before diagnosis was associated with treatment delay (β = 1.27, p = 0.04). More negative illness perceptions (β = 0.10, p = 0.02) and whether a traditional healer had been consulted after diagnosis (β = 1.67, p = 0.03) were associated with missing treatment sessions.
Indonesian health professionals need to be aware of patients' negative illness perceptions and their unrealistic belief in traditional healers.
本研究旨在检验心理社会因素与印度尼西亚乳腺癌女性患者治疗延迟及治疗不依从之间的关联。
招募了印度尼西亚哈山·萨迪金医院连续收治的70例乳腺癌患者。她们填写了一份人口统计学表格、不依从问卷、乳腺癌知识测试、简易疾病认知问卷、多维健康控制点量表、癌症信息满意度概况以及苦恼温度计。
70例患者中有17例（24%）报告称在医院延迟了治疗开始时间，70例患者中有9例（13%）连续错过两次或更多次治疗。在双变量分析中，我们发现延迟开始治疗的患者与未延迟的患者在任何心理变量上均无显著差异，而连续错过两次或更多次治疗的患者对所提供信息的类型和时间的满意度低于未错过治疗的患者，且疾病认知更消极。在多变量回归分析中，诊断前咨询传统治疗师与治疗延迟相关（β = 1.27，p = 0.04）。更消极的疾病认知（β = 0.10，p = 0.02）以及诊断后是否咨询过传统治疗师（β = 1.67，p = 0.03）与错过治疗相关。
印度尼西亚的卫生专业人员需要意识到患者消极的疾病认知以及他们对传统治疗师的不切实际的信任。
