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心血管风险与早期乳腺癌幸存者的沟通。

Cardiovascular risk and communication among early stage breast cancer survivors.

机构信息

Department of Health Education and Behavioral Science, Rutgers, The State University, School of Public Health, Piscataway, NJ, United States; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States.

Rutgers School of Social Work, New Brunswick, NJ, United States.

出版信息

Patient Educ Couns. 2017 Jul;100(7):1360-1366. doi: 10.1016/j.pec.2017.02.010. Epub 2017 Feb 10.

Abstract

OBJECTIVE

African American (AA) women have disproportionately high rates of cardiovascular (CV) risk factors that, coupled with potentially cardiotoxic breast cancer (BC) therapies, place them at risk of adverse CV outcomes. The purpose of this study was to assess CV risk factors among white and AA BC survivors and perceptions of patient-provider CV-related communication and post-treatment information needs.

METHODS

Early-stage, English-speaking BC survivors were recruited through community-based survivorship organizations/clinics in New Jersey. Qualitative, semi-structured interviews and a brief survey of socio-demographics and comorbidities were conducted.

RESULTS

BC survivors reported high rates of CV risk factors. Most reported their health as good/excellent despite their cancer history and CV risk profile. Approximately half of overweight/obese BC survivors reported no weight-related conversation with their health care team and, among those who reported discussion, 36% indicated it was self-initiated and dismissed. More than half of BC survivors' reported a desire for lifestyle-related information and guidance.

CONCLUSION

BC survivors may not understand how their separate, yet cumulative, health issues can impact their CV risk.

PRACTICE IMPLICATIONS

Patient-provider communication on behavioral risk factor modification and CV risk is needed, particularly among at-risk subgroups such as AA and obese BC survivors, to improve BC and CV outcomes.

摘要

目的

非裔美国女性(AA)心血管(CV)风险因素的比例过高,再加上潜在的心脏毒性乳腺癌(BC)治疗方法,使她们面临不良 CV 结局的风险。本研究的目的是评估白人和 AA BC 幸存者的 CV 风险因素,以及他们对医患之间与 CV 相关的沟通和治疗后信息需求的看法。

方法

通过新泽西州的社区生存组织/诊所招募了早期、讲英语的 BC 幸存者。进行了定性、半结构化访谈以及社会人口统计学和合并症的简要调查。

结果

BC 幸存者报告了很高的 CV 风险因素。尽管他们有癌症病史和 CV 风险状况,但大多数人报告自己的健康状况良好/优秀。大约一半超重/肥胖的 BC 幸存者报告说,他们与医疗团队没有进行任何与体重相关的对话,而在那些报告有讨论的人中,有 36%表示这是他们自己发起的,并被忽略了。超过一半的 BC 幸存者表示希望获得与生活方式相关的信息和指导。

结论

BC 幸存者可能不了解他们各自的、但又累积的健康问题如何影响他们的 CV 风险。

实践意义

需要医患之间就行为风险因素改变和 CV 风险进行沟通,特别是在 AA 和肥胖 BC 幸存者等高危亚组中,以改善 BC 和 CV 结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bba/5568653/d212a7a92691/nihms853071f1.jpg

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