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遗传性乳腺癌BRCA基因突变男性携带者在医疗决策中的性别内差异

Within-Gender Differences in Medical Decision Making Among Male Carriers of the BRCA Genetic Mutation for Hereditary Breast Cancer.

作者信息

Hesse-Biber Sharlene, An Chen

机构信息

1 Boston College, Chestnut Hill, MA, USA.

出版信息

Am J Mens Health. 2017 Sep;11(5):1444-1459. doi: 10.1177/1557988315610806. Epub 2015 Oct 14.

DOI:10.1177/1557988315610806
PMID:26468160
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5675203/
Abstract

An intersectional approach was used to understand sex/gender differences in men's health decisions with regard to hereditary breast cancer (BRCA). A sequential explanatory mixed method design was employed consisting of an online survey with a convenience sample of 101 men who tested positive for the breast cancer mutation following up with an in-depth interview with a subsample of 26 males who participated in the survey. The survey results revealed that 70.3% ( n = 45) considered "Family Risk" as the primary reason for getting BRCA tested; 21.9% ( n = 14) considered "Medical Considerations," and 7.8% ( n = 5) considered "Social Support" as their primary reason. Male participants who were 50 years old or younger or who did not have children were more likely to consider medical reasons as the primary reason to get tested. In terms of self-concept, younger men were more stigmatized than their older counterparts; married men felt a greater loss of control with regard to their BRCA-positive mutation diagnosis than single men; and professional men as a whole felt more vulnerable to the negative influences of the disease than those who had already retired. Regression analysis results indicated that negative self-concept was strongly related to sampled males' BRCA involvement 6 months after testing. Applying an intersectional approach to health care, decision-making outcomes among BRCA-positive mutation males provides an important lens for ascertaining the within-sex/gender demographic and psychosocial factors that affect the diversity of men's pretesting and posttesting medical decisions.

摘要

采用交叉性方法来理解男性在遗传性乳腺癌(BRCA)健康决策方面的性别差异。研究采用了顺序解释性混合方法设计,包括对101名乳腺癌基因突变检测呈阳性的男性进行便利抽样的在线调查,并对参与调查的26名男性子样本进行深入访谈。调查结果显示,70.3%(n = 45)认为“家族风险”是进行BRCA检测的主要原因;21.9%(n = 14)认为是“医疗考虑”,7.8%(n = 5)认为“社会支持”是主要原因。50岁及以下或没有孩子的男性参与者更有可能将医疗原因视为检测的主要原因。在自我概念方面,年轻男性比年长男性更容易受到污名化;已婚男性在BRCA阳性突变诊断方面比单身男性感到更大的失控感;总体而言,职业男性比已退休男性更容易受到疾病负面影响。回归分析结果表明,消极的自我概念与抽样男性检测后6个月的BRCA参与度密切相关。将交叉性方法应用于医疗保健,BRCA阳性突变男性的决策结果为确定影响男性检测前和检测后医疗决策多样性的性别内部人口统计学和心理社会因素提供了一个重要视角。

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