E Anderson Emily, Tejada Silvia, B Warnecke Richard, Hoskins Kent
Narrat Inq Bioeth. 2018;8(1):53-66. doi: 10.1353/nib.2018.0023.
Individual risk assessment (IRA) for breast cancer may increase adherence to risk-appropriate screening and prevention measures. However, knowledge gaps exist regarding how best to communicate IRA results and support women at increased risk in future health care decisions, in part because patients conceptualize and make meaning of risk differently from the medical community. Better understanding the views of low-income women of color identified as being at increased risk for breast cancer can inform efforts to conduct IRA in an ethical and respectful manner. We conducted in-depth interviews with 13 low-income African American and Latina women who receive care at a federally qualified health center (FQHC) and had recently learned of their increased risk for breast cancer. These interviews explored their experience of the IRA process, their interpretation of what being at increased risk means, and their reactions to provider recommendations. Eight key themes were identified. We conclude with recommendations for the implementation of IRA for breast cancer in underserved primary care settings.
乳腺癌的个体风险评估(IRA)可能会提高对风险适配筛查和预防措施的依从性。然而,在如何最好地传达IRA结果以及在未来医疗保健决策中支持高风险女性方面存在知识差距,部分原因是患者对风险的概念化和理解方式与医学界不同。更好地了解被确定为乳腺癌高风险的低收入有色人种女性的观点,可以为以符合伦理和尊重的方式开展IRA的努力提供信息。我们对13名在联邦合格健康中心(FQHC)接受治疗且最近得知自己患乳腺癌风险增加的低收入非裔美国人和拉丁裔女性进行了深入访谈。这些访谈探讨了她们在IRA过程中的经历、对高风险意味着什么的理解以及对医生建议的反应。确定了八个关键主题。我们最后提出了在服务不足的初级保健环境中实施乳腺癌IRA的建议。