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健康信念模型在解释为什么有症状的伊朗女性不愿早期寻求乳腺癌筛查方面的作用:一项定性研究。

The Role of the Health Belief Model in Explaining Why Symptomatic Iranian Women Hesitate to Seek Early Screening for Breast Cancer: a Qualitative Study.

机构信息

Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Cancer Educ. 2023 Oct;38(5):1577-1583. doi: 10.1007/s13187-023-02302-y. Epub 2023 Apr 28.

Abstract

Early detection of breast cancer (BC) is important to increase the likelihood of treatment and improve the quality of life and survival. The study explored why symptomatic women linger to seek early screening for BC diagnosis based on the health belief model (HBM). In this qualitative study, 20 participants were selected using the purposive sampling method (9 health professionals and 11 female patients BC). Data were collected using in-depth, semi-structured interviews in 2019. Transcribed interview data were analyzed using the directed content analysis informed by HBM. According to the participants' experiences, although most patients comprehended the extent of the disease, they did not see themselves at risk of BC. Some were not adequately aware of the benefits of early diagnosis and did not have the self-efficacy required for early presentation. The main barriers to the early presentation included lack of awareness, financial problems, embarrassment over the clinical examination, and inadequate access to specialized centers. According to HBM, while designing and implementing educational programs, it is recommended to focus on reinforcing perceived susceptibility, perceived benefits, and perceived self-efficacy, providing access to facilities, and removing possible barriers and cultural issues to encourage women for timely referral for BC screening.

摘要

早期发现乳腺癌(BC)对于提高治疗的可能性、改善生活质量和生存率非常重要。本研究基于健康信念模型(HBM)探讨了为什么有症状的女性会迟迟寻求早期 BC 诊断筛查。在这项定性研究中,我们使用目的抽样法选择了 20 名参与者(9 名卫生专业人员和 11 名女性 BC 患者)。2019 年,我们使用深入的半结构化访谈收集数据。转录的访谈数据使用 HBM 指导的定向内容分析进行分析。根据参与者的经验,尽管大多数患者了解疾病的严重程度,但他们并未认为自己有患 BC 的风险。有些患者对早期诊断的益处认识不足,也缺乏早期就诊所需的自我效能感。早期就诊的主要障碍包括缺乏意识、经济问题、对临床检查的尴尬、以及无法获得专门中心的服务。根据 HBM,在设计和实施教育计划时,建议重点强化感知易感性、感知益处和感知自我效能感,提供设施服务,并消除可能的障碍和文化问题,以鼓励女性及时进行 BC 筛查。

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