Ormseth Sarah R, Wellisch David K, Aréchiga Adam E, Draper Taylor L
Department of Psychiatry and Biobehavioral Sciences,David Geffen School of Medicine at UCLA,Los Angeles,California.
Department of Psychology,Loma Linda University,Loma Linda,California.
Palliat Support Care. 2015 Oct;13(5):1441-8. doi: 10.1017/S1478951515000164. Epub 2015 Mar 5.
The research about follow-up patterns of women attending high-risk breast-cancer clinics is sparse. This study sought to profile daughters of breast-cancer patients who are likely to return versus those unlikely to return for follow-up care in a high-risk clinic.
Our investigation included 131 patients attending the UCLA Revlon Breast Center High Risk Clinic. Predictor variables included age, computed breast-cancer risk, participants' perceived personal risk, clinically significant depressive symptomatology (CES-D score ≥ 16), current level of anxiety (State-Trait Anxiety Inventory), and survival status of participants' mothers (survived or passed away from breast cancer).
A greater likelihood of reattendance was associated with older age (adjusted odds ratio [AOR] = 1.07, p = 0.004), computed breast-cancer risk (AOR = 1.10, p = 0.017), absence of depressive symptomatology (AOR = 0.25, p = 0.009), past psychiatric diagnosis (AOR = 3.14, p = 0.029), and maternal loss to breast cancer (AOR = 2.59, p = 0.034). Also, an interaction was found between mother's survival and perceived risk (p = 0.019), such that reattendance was associated with higher perceived risk among participants whose mothers survived (AOR = 1.04, p = 0.002), but not those whose mothers died (AOR = 0.99, p = 0.685). Furthermore, a nonlinear inverted "U" relationship was observed between state anxiety and reattendance (p = 0.037); participants with moderate anxiety were more likely to reattend than those with low or high anxiety levels.
Demographic, medical, and psychosocial factors were found to be independently associated with reattendance to a high-risk breast-cancer clinic. Explication of the profiles of women who may or may not reattend may serve to inform the development and implementation of interventions to increase the likelihood of follow-up care.
关于高危乳腺癌诊所女性患者随访模式的研究较少。本研究旨在描述乳腺癌患者女儿中可能返回高危诊所接受后续护理的人群与不太可能返回的人群的特征。
我们的调查纳入了131名就诊于加州大学洛杉矶分校露华浓乳腺癌中心高危诊所的患者。预测变量包括年龄、计算得出的患乳腺癌风险、参与者感知到的个人风险、具有临床意义的抑郁症状（CES - D评分≥16）、当前焦虑水平（状态 - 特质焦虑量表）以及参与者母亲的生存状况（死于乳腺癌或存活）。
复诊可能性增加与年龄较大（调整优势比[AOR]=1.07，p = 0.004）、计算得出的患乳腺癌风险（AOR = 1.10，p = 0.017）、无抑郁症状（AOR = 0.25，p = 0.009）、既往有精神科诊断（AOR = 3.14，p = 0.029）以及母亲死于乳腺癌（AOR = 2.59，p = 0.034）有关。此外，发现母亲的生存状况与感知风险之间存在交互作用（p = 0.019），即母亲存活的参与者中，复诊与较高的感知风险相关（AOR = 1.04，p = 0.002），而母亲去世的参与者则不然（AOR = 0.99，p = 0.685）。此外，观察到状态焦虑与复诊之间存在非线性倒“U”关系（p = 0.037）；中度焦虑的参与者比低焦虑或高焦虑水平的参与者更有可能复诊。
发现人口统计学、医学和心理社会因素与高危乳腺癌诊所的复诊独立相关。阐明可能复诊或不复诊的女性的特征，可能有助于为增加后续护理可能性的干预措施的制定和实施提供信息。
