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日本乳腺癌筛查的心理影响。

Psychological impact of breast cancer screening in Japan.

作者信息

Kitano Atsuko, Yamauchi Hideko, Hosaka Takashi, Yagata Hiroshi, Hosokawa Keiko, Ohde Sachiko, Nakamura Seigo, Takimoto Masafumi, Tsunoda Hiroko

机构信息

Department of Medical Oncology, St. Luke's International Hospital, Tokyo, Japan.

Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan.

出版信息

Int J Clin Oncol. 2015 Dec;20(6):1110-6. doi: 10.1007/s10147-015-0845-0. Epub 2015 May 26.

Abstract

OBJECTIVE

The purpose of this study was to evaluate the psychological impact of breast cancer screening by use of mammography and/or ultrasound, and to reveal factors related to psychological distress.

METHODS

Three hundred and twenty women were recalled to our hospital because of suspicious malignant findings from breast cancer screening between March and November 2012. They were asked to complete three questionnaires: the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression, the Brief Coping Orientations to Problems Experienced scale (Brief COPE) for coping styles, and an original questionnaire for personal information.

RESULTS

Complete data were available for 312 of 320 women (97.5 %). The median age was 45 years (range 23-73). The HADS revealed borderline or clinically significant anxiety for 70 % of the women. Family history of breast cancer, area of residence, number of times screened, number of recalls, and the period before the first visit were significantly related to psychological distress (p < 0.05). Brief COPE scores showed that self-blame, behavioral disengagement, self-distraction, use of emotional support, venting, denial, and less acceptance were related to increased anxiety.

CONCLUSION

Seventy percent of women who were recalled after breast cancer screening experienced psychological distress. Thus, negative psychological impact should be regarded as an adverse effect of breast cancer screening.

摘要

目的

本研究旨在评估乳腺钼靶摄影和/或超声筛查乳腺癌对心理的影响,并揭示与心理困扰相关的因素。

方法

2012年3月至11月期间,320名因乳腺癌筛查发现可疑恶性病变而被召回我院的女性,被要求完成三份问卷:用于评估焦虑和抑郁的医院焦虑抑郁量表(HADS)、用于评估应对方式的简易应对方式问卷(Brief COPE)以及一份关于个人信息的原始问卷。

结果

320名女性中有312名(97.5%)提供了完整数据。中位年龄为45岁(范围23 - 73岁)。HADS显示70%的女性存在临界或具有临床意义的焦虑。乳腺癌家族史、居住地区、筛查次数、召回次数以及首次就诊前的时间段与心理困扰显著相关(p < 0.05)。Brief COPE得分表明,自责、行为脱离、自我分心、使用情感支持、宣泄、否认以及较少的接受与焦虑增加有关。

结论

乳腺癌筛查后被召回的女性中,70%经历了心理困扰。因此,负面心理影响应被视为乳腺癌筛查的一种不良效应。

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