Thomas L R, Fox S A, Leake B G, Roetzheim R G
Abt Associates Inc. Cambridge, MA 02138-1168, USA.
Women Health. 1996;24(3):77-94. doi: 10.1300/j013v24n03_05.
Screening mammography is particularly effective in detecting breast cancer in elderly women. Yet, although half of all breast cancers are diagnosed in older women, statistics show that women aged 65 and over tend to underutilize screening mammography. Prior research has used the constructs of the Health Belief Model to explore attitudes and beliefs relative to breast cancer screening. Prior studies have also identified health beliefs and concerns relative to screening mammography and race/ethnicity as some of the patient-related predictors of screening mammography utilization among younger women. This study uses the theoretical framework of the Health Belief Model to explore the effects of these variables on utilization in a multiracial, multiethnic, random sample of 1011 women, aged 65 and over. Race/ethnicity, belief that mammograms detect cancer, ease the mind, and provide accurate results; concern over the radiation, pain, and cost associated with receiving a mammogram; and other independent variables were tested as predictors of screening mammography utilization. Regression analysis identified that the belief that having a mammogram eases recipients minds was the most significant predictor of screening mammography utilization. None of the other health beliefs or health concerns were significant predictors. Race/ethnicity had no direct effects on utilization nor was it a confounder in the relationship between health beliefs, concerns and utilization. These results indicate that, along with emphasizing the importance of mammograms in early detection of breast cancer, stressing the reassurance that mammography brings recipients may be an effective health education strategy for elderly women of different racial/ethnic backgrounds.
乳腺钼靶筛查在检测老年女性乳腺癌方面特别有效。然而,尽管所有乳腺癌中有一半是在老年女性中被诊断出来的,但统计数据显示,65岁及以上的女性往往未充分利用乳腺钼靶筛查。先前的研究已经运用健康信念模型的概念来探索与乳腺癌筛查相关的态度和信念。先前的研究还确定了与乳腺钼靶筛查以及种族/民族相关的健康信念和担忧,这些是年轻女性中乳腺钼靶筛查利用率的一些患者相关预测因素。本研究使用健康信念模型的理论框架,在一个由1011名65岁及以上的女性组成的多种族、多民族随机样本中,探索这些变量对利用率的影响。种族/民族、认为钼靶检查能检测癌症、让人安心并提供准确结果的信念;对接受钼靶检查所涉及的辐射、疼痛和费用的担忧;以及其他自变量被作为乳腺钼靶筛查利用率的预测因素进行测试。回归分析表明,认为进行钼靶检查能让受检者安心这一信念是乳腺钼靶筛查利用率最显著的预测因素。其他健康信念或健康担忧均不是显著的预测因素。种族/民族对利用率没有直接影响,在健康信念、担忧与利用率之间的关系中也不是一个混杂因素。这些结果表明,除了强调钼靶检查在早期发现乳腺癌方面的重要性之外,强调钼靶检查给受检者带来的安心感可能是针对不同种族/民族背景老年女性的一种有效的健康教育策略。