Radecki Breitkopf Carmen, Asiedu Gladys B, Egginton Jason, Sinicrope Pamela, Opyrchal Seung M L, Howell Lisa A, Patten Christi, Boardman Lisa
Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA,
Support Care Cancer. 2014 Sep;22(9):2517-25. doi: 10.1007/s00520-014-2245-9. Epub 2014 Apr 13.
Cancer is a shared family experience and may provide a "teachable moment" to motivate at-risk family members to adopt cancer prevention and health promotion behaviors. This study explored how a diagnosis of colorectal cancer (CRC) is experienced by family members and may be used to develop a family-based CRC prevention program. Preferences regarding content, timing, and modes of program delivery were examined. Social cognitive theory provided the conceptual framework for the study.
This study employed mixed methodology (semi-structured interviews and self-report questionnaires). Participants included 73 adults (21 patients, 52 family members) from 23 families (two patients were deceased prior to being interviewed). Most patients (n = 14; 67 %) were interviewed 1-5 years post-diagnosis. Individual interviews were audio-recorded, transcribed, and content analyzed.
For many, a CRC diagnosis was described as a shared family experience. Family members supported each other's efforts to prevent CRC through screening, exercising, and maintaining a healthy diet. Teachable moments for introducing a family-based program included the time of the patient's initial cancer surgery and post-chemotherapy. Reported willingness to participate in a family-based program was associated with risk perception, self-efficacy, outcome expectancies, and the social/community context in which the program would be embedded. Program preferences included cancer screening, diet/nutrition, weight management, stress reduction, and exercise. Challenges included geographic dispersion, variation in education levels, generational differences, and scheduling.
CRC patients and family members are receptive to family-based programs. Feasibility concerns, which may be mitigated but not eliminated with technological advances, must be addressed for successful family-based programs.
癌症是一种家庭共同经历，可能提供一个“可教时刻”，以激励有风险的家庭成员采取癌症预防和健康促进行为。本研究探讨了家庭成员如何体验结直肠癌（CRC）诊断，以及如何利用这一诊断来制定基于家庭的CRC预防计划。研究考察了对计划内容、时机和实施方式的偏好。社会认知理论为该研究提供了概念框架。
本研究采用混合方法（半结构化访谈和自我报告问卷）。参与者包括来自23个家庭的73名成年人（21名患者，52名家庭成员）（两名患者在接受访谈前已去世）。大多数患者（n = 14；67%）在确诊后1至5年接受访谈。对个体访谈进行录音、转录和内容分析。
对许多人来说，CRC诊断被描述为一种家庭共同经历。家庭成员通过筛查、锻炼和保持健康饮食来支持彼此预防CRC的努力。引入基于家庭的计划的可教时刻包括患者初次癌症手术时和化疗后。报告的参与基于家庭的计划的意愿与风险认知、自我效能感、结果期望以及计划实施的社会/社区背景相关。计划偏好包括癌症筛查、饮食/营养、体重管理、减压和锻炼。挑战包括地域分散、教育水平差异、代际差异和日程安排。
CRC患者及其家庭成员愿意接受基于家庭的计划。对于成功的基于家庭的计划，必须解决可行性问题，技术进步可能会缓解但无法消除这些问题。
