Ann Fam Med. 2023 Jan 1;21(21 Suppl 1):3760. doi: 10.1370/afm.21.s1.3760.
Context: Breast cancer survivors have increased cardiovascular disease (CVD) risk compared to those without cancer history. CVD is the leading cause of death for breast cancer survivors. Objective: To assess current CVD risk counseling practices and risk perception in breast cancer survivors. Study design and analysis: Interviews conducted with breast cancer survivors. Analysis of categorical data by frequency and quantitative variables by mean and standard deviation. Inductive qualitative analysis performed using NVIVO. Setting: Academic Family Medicine Outpatient Practices Population studied: Breast cancer survivors with an identified primary care provider. Intervention/instrument: Interviews on CVD risk behaviors, risk perception, challenges with risk reduction, and previous history of risk counseling. Outcome measures: Self-reported history of CVD, risk perception, and risk behaviors. Results: The average age of participants (n=19) was 57 with 57% being white and 32% African American. Of interviewed women, 89.5% reported a personal history and 89.5% reported a family history of CVD. Only 52.6% had previously reported receipt of CVD counseling. Primary care providers most commonly provided the counseling (72.7%), however it was additionally provided by oncology (27.3%). Among breast cancer survivors, 31.6% perceived they were at increased CVD risk and 47.5% were unsure of their relative CVD risk compared to women their age. Factors affecting perceived CVD risk included family history, cancer treatments, cardiovascular diagnoses, and lifestyle factors. Video (78.9%) and text messaging (68.4%) were the most highly reported mechanisms through which breast cancer survivors requested to receive additional information and counseling on CVD risk and risk reduction. Commonly reported barriers to adopting risk reduction strategies (such as increasing physical activity) included time, resources, physical limitations, and competing responsibilities. Barriers specific to survivorship status include concerns for immune status during COVID, physical limitations associated with cancer treatment, and psychosocial aspects of cancer survivorship. Conclusions: These data suggest improving the frequency and content of CVD risk reduction counseling is needed. Strategies should identify the best methods for providing CVD counseling, and should address general barriers as well as unique challenges faced by cancer survivors.
与无癌症病史者相比，乳腺癌幸存者的心血管疾病（CVD）风险增加。CVD 是乳腺癌幸存者的主要死亡原因。目的：评估乳腺癌幸存者当前的 CVD 风险咨询实践和风险认知。研究设计和分析：对乳腺癌幸存者进行访谈。通过频率分析分类数据，通过平均值和标准差分析定量变量。使用 NVIVO 进行归纳定性分析。背景：学术家庭医学门诊实践 研究人群：有明确初级保健提供者的乳腺癌幸存者。干预/工具：关于 CVD 风险行为、风险认知、降低风险的挑战以及先前风险咨询史的访谈。结果测量：自我报告的 CVD 病史、风险认知和风险行为。结果：参与者（n=19）的平均年龄为 57 岁，其中 57%为白人，32%为非裔美国人。接受采访的女性中，89.5%报告有个人 CVD 病史，89.5%报告有家族 CVD 病史。只有 52.6%之前报告过接受 CVD 咨询。初级保健提供者最常提供咨询（72.7%），但肿瘤学也提供咨询（27.3%）。在乳腺癌幸存者中，31.6%认为自己 CVD 风险增加，47.5%不确定与同龄女性相比自己的相对 CVD 风险。影响 CVD 风险认知的因素包括家族史、癌症治疗、心血管诊断和生活方式因素。视频（78.9%）和短信（68.4%）是乳腺癌幸存者要求获得 CVD 风险和风险降低相关信息和咨询的报告率最高的两种方式。采用降低风险策略（如增加体力活动）的常见障碍包括时间、资源、身体限制和竞争责任。与生存状态相关的独特障碍包括 COVID 期间对免疫状态的担忧、癌症治疗相关的身体限制以及癌症生存的心理社会方面。结论：这些数据表明，需要提高 CVD 风险降低咨询的频率和内容。策略应确定提供 CVD 咨询的最佳方法，并应解决一般障碍以及癌症幸存者面临的独特挑战。
