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阿曼女性乳腺癌患者对症状的了解、就诊时间和寻求医疗帮助的障碍:一项横断面研究。

Knowledge of symptoms, time to presentation and barriers to medical help-seeking among Omani women diagnosed with breast cancer: a cross-sectional study.

机构信息

Family Medicine and Public Health, Sultan Qaboos University, Muscat, Oman

Oncology Unit, Department of Medicine, Sultan Qaboos University, Muscat, Oman.

出版信息

BMJ Open. 2021 Jan 21;11(1):e043976. doi: 10.1136/bmjopen-2020-043976.

Abstract

OBJECTIVE

To identify knowledge of breast cancer (BC) symptoms, time taken to consult a doctor and factors contributing to delays in medical help-seeking.

DESIGN

A cross-sectional study of Omani women diagnosed with BC.

SETTING

The two main teaching hospitals in Oman: Royal Hospital and Sultan Qaboos University Hospital.

PARTICIPANTS

Adult Omani women recently diagnosed with BC.

TOOLS

The Breast Module of the Cancer Awareness Measure and the International Cancer Benchmarking Partnership questionnaire were used to collect data.

RESULTS

A total of 300 women with BC participated (response rate: 91.0%). The mean age at diagnosis was 43.0±12.50 years and 33.5% were diagnosed at stage III or IV. Although most women (74.4%) recognised breast/armpit lumps to be a symptom of BC, less than half identified other symptoms, including breast/armpit pain (44.0%), changes in the position of the nipple (36.2%), redness (31.7%), fatigue (26.3%), weight loss (23.4%) and loss of appetite (20.8%). While most (91.6%) were aware that BC could be cured if detected early, only 66.4% sought medical help within a month of developing symptoms. Initial responses to symptoms included informing husbands (40.2%) or family members (36.5%). Barriers to seeking medical help included feeling scared (68.9%) and worried about what the doctor might find (62.8%). Highly educated women were more likely to recognise the following as BC symptoms: changes in nipple position (OR: 0.16, 95% CI 0.03 to 0.81), breast pain (OR: 0.10, 95% CI 0.01 to 0.86) and unexplained weight loss (OR: 0.18, 95% CI 0.04 to 0.88) (all p<0.05).

CONCLUSIONS

Although many Omani women with BC were aware of the importance of early diagnosis, most demonstrated inadequate knowledge of symptoms, did not prioritise seeking medical help and reported emotional barriers to help-seeking. More educational measures are needed to improve symptom recognition and address help-seeking barriers to minimise delays in diagnosis.

摘要

目的

识别乳腺癌(BC)症状知识、咨询医生的时间以及导致医疗求助延迟的因素。

设计

对阿曼被诊断患有 BC 的女性进行的横断面研究。

地点

阿曼的两家主要教学医院:皇家医院和苏丹卡布斯大学医院。

参与者

最近被诊断患有 BC 的阿曼成年女性。

工具

使用乳腺癌模块的癌症意识量表和国际癌症基准伙伴关系问卷收集数据。

结果

共有 300 名 BC 女性参与(应答率:91.0%)。诊断时的平均年龄为 43.0±12.50 岁,33.5%的患者处于 III 期或 IV 期。尽管大多数女性(74.4%)认识到乳房/腋窝肿块是 BC 的症状,但不到一半的女性能识别其他症状,包括乳房/腋窝疼痛(44.0%)、乳头位置改变(36.2%)、发红(31.7%)、疲劳(26.3%)、体重减轻(23.4%)和食欲不振(20.8%)。虽然大多数女性(91.6%)知道如果早期发现,BC 是可以治愈的,但只有 66.4%的女性在出现症状后一个月内寻求医疗帮助。对症状的初步反应包括告知丈夫(40.2%)或家庭成员(36.5%)。寻求医疗帮助的障碍包括感到害怕(68.9%)和担心医生会发现什么(62.8%)。受教育程度较高的女性更有可能将以下情况识别为 BC 症状:乳头位置改变(OR:0.16,95%CI 0.03 至 0.81)、乳房疼痛(OR:0.10,95%CI 0.01 至 0.86)和不明原因体重减轻(OR:0.18,95%CI 0.04 至 0.88)(均 p<0.05)。

结论

尽管许多阿曼 BC 女性都意识到早期诊断的重要性,但大多数女性对症状的认识不足,没有优先考虑寻求医疗帮助,并报告了寻求帮助的情绪障碍。需要采取更多的教育措施来提高对症状的识别,并解决寻求帮助的障碍,以尽量减少诊断延误。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e368/7825262/a212b3855c08/bmjopen-2020-043976f01.jpg

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