Pearlman D N, Rakowski W, Clark M A, Ehrich B, Rimer B K, Goldstein M G, Woolverton H, Dube C E
Center for Gerontology and Health Care Research, Brown University, Providence, Rhode Island 02912, USA.
Cancer Epidemiol Biomarkers Prev. 1997 Jun;6(6):451-7.
The present study examines women's decision making about mammography over a 1-year period, using "decisional balance," a summary of women's positive and negative perceptions about mammography derived from the Transtheoretical Model (TTM). Data were from a survey of women ages 50-74 years who completed both the baseline and 1-year follow-up telephone surveys (n = 1144) for an intervention study to increase the use of mammography screening. A shift toward less favorable perceptions about mammography was related to being a smoker and not having a recent clinical breast examination and Pap test. Change in women's attitudes toward mammography was also related to four dimensions of a woman's information environment. Women who rated the opinions of a physician as somewhat or not important, those who reported that at least one family member or friend discouraged them from having a mammogram, and women who felt they lacked enough people in their social network with whom they could discuss health concerns were less likely to express favorable attitudes about mammography over 1 year. In contrast, women who consistently communicated the value of mammography to others expressed more favorable views of screening over the study period. Interventions designed to promote breast cancer screening must recognize that a woman not only reacts to mammography information provided by significant others in her social network but may proactively reach out to others as an advocate of breast cancer screening, thus reinforcing or changing others' opinions or behavior as well as her own.
本研究采用“决策权衡”方法，对女性在一年时间里关于乳腺X光检查的决策进行了考察。“决策权衡”是从跨理论模型（TTM）中得出的女性对乳腺X光检查的积极和消极看法的总结。数据来自一项针对50 - 74岁女性的调查，这些女性完成了干预研究的基线和一年随访电话调查（n = 1144），该干预研究旨在增加乳腺X光检查筛查的使用率。对乳腺X光检查的看法向不太有利的方向转变与吸烟、近期未进行临床乳房检查和巴氏试验有关。女性对乳腺X光检查态度的变化还与女性信息环境的四个维度有关。那些认为医生的意见有些重要或不重要的女性、那些报告至少有一名家庭成员或朋友不鼓励她们进行乳腺X光检查的女性，以及那些觉得自己社交网络中缺乏足够可以讨论健康问题的人的女性，在一年时间里对乳腺X光检查表达出积极态度的可能性较小。相比之下，那些持续向他人传达乳腺X光检查价值的女性在研究期间对筛查表达出更积极的看法。旨在促进乳腺癌筛查的干预措施必须认识到，女性不仅会对社交网络中重要他人提供的乳腺X光检查信息做出反应，还可能作为乳腺癌筛查的倡导者主动与他人接触，从而强化或改变他人的意见或行为以及她自己的意见或行为。
