Hubbell F A, Chavez L R, Mishra S I, Valdez R B
Center for Health Policy and Research, University of California, Irvine, USA.
West J Med. 1996 May;164(5):405-9.
To improve breast cancer control among Latinas, it is important to understand culturally based beliefs that many influence the way women view this disease. We did a telephone survey of randomly selected Latinas and non-Hispanic white (Anglo) women in Orange County, California, to explore such beliefs using questions from previous national surveys and an ethnographic study of breast cancer. Respondents included 803 Latinas and 422 Anglo women. Latinas were more likely than Anglo women to believe that factors such as breast trauma (71% versus 39%) and breast fondling (27% versus 6%) increased the risk of breast cancer, less likely to know that symptoms such as breast lumps (89% versus 98%) and bloody breast discharge (69% versus 88%) could indicate breast cancer, and more likely to believe that mammograms were necessary only to evaluate breast lumps (35% versus 11%) (P < .01 for each). After adjusting for age, education, employment status, insurance status, and income, logistic regression analysis confirmed that Latino ethnicity and acculturation levels were significant predictors of these beliefs. We conclude that Latinas' beliefs about cancer differ in important ways from those of Anglo women and that these beliefs may reflect the moral framework within which Latinas interpret diseases. These findings are important for the development of culturally sensitive breast cancer control programs and for practicing physicians.
为改善拉丁裔女性的乳腺癌防治状况,了解诸多影响女性看待这种疾病方式的基于文化的观念很重要。我们对加利福尼亚州奥兰治县随机抽取的拉丁裔女性和非西班牙裔白人(盎格鲁)女性进行了电话调查,使用先前全国性调查的问题以及一项乳腺癌人种志研究来探究此类观念。受访者包括803名拉丁裔女性和422名盎格鲁女性。拉丁裔女性比盎格鲁女性更有可能认为诸如乳房创伤(71%对39%)和乳房抚摸(27%对6%)等因素会增加患乳腺癌的风险,更不太可能知道诸如乳房肿块(89%对98%)和乳头溢液(69%对88%)等症状可能表明患有乳腺癌,并且更有可能认为乳房X光检查仅用于评估乳房肿块(35%对11%)(每项P <.01)。在对年龄、教育程度、就业状况、保险状况和收入进行调整后,逻辑回归分析证实拉丁裔种族和文化适应水平是这些观念的重要预测因素。我们得出结论,拉丁裔女性对癌症的观念在重要方面与盎格鲁女性不同,并且这些观念可能反映了拉丁裔女性解释疾病的道德框架。这些发现对于制定具有文化敏感性的乳腺癌防治计划以及执业医生而言很重要。