社区30—50岁女性乳腺X线检查意向及影响因素的调查分析

目的描述社区30～50岁女性参加乳腺X线检查的意向并探讨其影响因素。方法采取便利抽样法,使用自制问卷对某市2个社区300名30～50岁的女性进行调查。结果48．20％的调查对象有参加乳腺X线检查的意向;社区30—50岁女性乳腺X线检查知识、态度得分分别为（3．64±1．33）分和（22．934-392）分;文化程度、乳腺X线检查经验及他人对乳腺X线检查的建议是社区30～50岁女性乳腺X线检查意向的保护因素。结论社区30～50岁女性中有参加乳腺X线检查意向者较少,提示乳腺癌的预防工作亟待加强。     

Influence of traditional Chinese beliefs on cancer screening behaviour among Chinese-Australian women

AIM: This paper reports a study exploring how traditional Chinese life philosophy, including fatalism, influences understanding of the concepts of health and illness, and the impact of these concepts on cancer screening behaviour. BACKGROUND: The language of risk is central to contemporary Western understanding of health and illness. Women aged over 50 years are considered at risk of developing breast cancer and are highly recommended to undergo regular mammographic screening. However, screening rates among Chinese women are consistently lower than for most other groups. METHODS: In-depth interviews, in Cantonese, were conducted with a convenience sample of 20 Chinese-Australian women, and the data analysed thematically, using case summaries, coding and matrix tables. The data were collected in 2001. FINDINGS: The findings revealed that when dealing with cancer prevention, Chinese-Australian women are heavily influenced by cultural traditions related to the life-cycle and disease prevention. Informants believed that contracting disease, including cancer, is inevitable and that there is no way to prevent it. Fatalism appears to be a significant barrier to their participation in cancer screening services. CONCLUSION: Our findings suggest that the effects of breast cancer screening and other health promotion programmes, which are general and do not take account of cultural variations may be compromised when it comes to cultural minorities. In the case of older Chinese-Australian women, breast cancer screening promotion programmes may overcome acceptance of fatalistic philosophy if they emphasize increased risk following immigration.     

Overuse of mammography during the first round of an organized breast cancer screening programme

Objectives  We examined the frequency of mammography screening among women who had had a screening mammogram recently and therefore generally did not need to repeat the examination.
Methods  A population-based sample of 50- to 69-year-old women were surveyed immediately before and 8 months after they received an invitation to participate in the first round of screening of the newly organized mammography screening programme in Geneva, Switzerland. These women also received a booklet that included the recommendation to have screening mammograms at 2-year intervals.
Results  The baseline survey identified 660 women who had had a mammogram within the previous 12 months. Of these, 23.2% [95% confidence interval (CI), 20.0–26.6] had an opportunistic mammogram and 4.1% (95% CI, 2.7–5.9) had an organized mammogram during follow-up. Women who had had their last mammogram 6–12 months prior to baseline (vs. more recently), intended to have a mammogram within the next 6 months, wished to receive more information on mammography screening, and had a history of surgical breast biopsy were more likely to have an unnecessary screening mammogram (either organized or opportunistic) during follow-up. Compared with women who had an opportunistic mammogram, women who had an organized mammogram were more likely to be of lower socioeconomic status, to have made their own screening decision and to have anticipated the date of their next mammogram by no more than a few months.
Conclusions  Opportunistic mammography screening in excess of recommendation is common, and persists despite explicit advice about recommended screening frequency.     

Psychosocial consequences among women with false-positive results after mammography screening in Norway

Abstract

Background: Mammography screening may cause psychosocial harm for women experiencing a false-positive screening result. Previous studies suggest long-term consequences. The aim of the present study was to assess psychosocial consequences of false-positive findings on screening mammography within a six month follow-up.

Methods: A prospective matched cohort survey study using the questionnaire ‘Consequences of Screening for Breast Cancer’ (COS-BC), which was translated from Danish to Norwegian. Psychometric analyses investigated the measurement properties of the Norwegian version. Two screening clinics in Norway distributed the survey to 299 women with an abnormal mammogram and 541 women with a normal screen. Women received the questionnaire when receiving the screening result, and one and six months after screening.

Results: At six months, statistically significant differences appeared in two scales: existential values and breast examination. At six-month follow-up, women with false-positive results showed no statistically significant differences from women diagnosed with breast cancer in three outcomes: sense of dejection, anxiety, and keeping my mind off things.

Conclusion: Our results indicate that the psychosocial consequences from having false-positive screening mammography results diminish after six months. The results support previous research describing breast-specific outcomes. However, our results indicate that Norwegian women are less frightened than other Scandinavian mammography screening participants.     

Breast and cervical cancer screening among Korean American elderly women

The purpose of this study was to estimate the prevalence and correlates of breast and cervical cancer screening tests among Korean American elderly women. This study examined the effects of individual socio-demographic background, acculturation level (e.g., proportion of life spent in the US, spoken English proficiency), health status and access to health care on uptake of mammography and Pap smear tests in the past 2 years. Subjects were 130 Korean American women aged 60 and older living in the Greater Metropolitan Baltimore Area. A cross-sectional face-to-face interview was conducted. The 2-year prevalence was only 35% for mammography and 29% for Pap smear tests. In multiple logistic regression analysis, educational attainment, government support, multiple chronic conditions, and routine checkups were associated with having mammography. Age, acculturation and insurance were associated with having a Pap test. Taking advantage of the positive influence of identified covariates may increase the effectiveness of cancer control interventions among Korean American elderly women.     

Predictors of mammography uptake in Korean women aged 40 years and over

Title. Predictors of mammography uptake in Korean women aged 40 years and over Aim. This paper is a report of a study performed to identify the predictors of mammography uptake for Korean women according to the stage of change, as determined by the transtheoretical model. Background. Although breast cancer is the most common female cancer in South Korea, its early detection rate here is low when compared with other developed countries. The transtheoretical model can be used to facilitate health promotion based on individual health behaviour and to devise stage‐tailored interventions. Method. The participants were a convenience sample of 920 women aged ≥40 years between December 2005 and February 2006. A cross‐sectional design was used in which participants completed a questionnaire that consisted of measures of the transtheoretical model. To provide a standard of measure, the variables were converted from raw scores to standard scores and then to T scores (mean = 50, sd = 10). Logistic regression analysis was then used to estimate predictors of the stage of maintenance of mammography uptake. Findings. The most frequent stage of mammography uptake was ‘contemplation’. Predictors of mammography uptake included decisional balance, commitment to regular screening and avoiding contact with the healthcare system. Commitment to regular screening and breast self‐examination were strongly related to mammography maintenance. Conclusion. The results of this study can be used for the development of theory‐based and empirically supported mammography uptake intervention strategies and programmes directed towards women aged ≥40 years.     

Disability and mammography screening: intangible barriers to participation

Purpose.?The aim of this study was to investigate intangible or non-physical barriers to participation of women with disability in mammography screening.

Method.?Women with disability were recruited via specific advocacy and support organisations in New South Wales, Australia. Interviews were conducted which focused on issues relating to participants' experience with breast screening services.

Results.?A total of 75 women with varying degrees of disability agreed to participate. Three key intangible barriers were identified related to the women's expectations to be informed, to be involved and to be treated with respect. Details of the content, type, timing of appropriately presented information as well as who should provide it were emphasised. Barriers to active involvement to manage their disability and take control over their experience were identified. The women also indicated the specific treatment they received from screening staff which negatively impacted on their experience.

Conclusions.?This study has provided important and clinically significant detail of intangible barriers to participation in screening mammography experienced by women with physical disability. These study outcomes suggest ways in which the satisfaction with the mammogram experience can be increased for these women and contribute to increased participation in mammography screening.     

Older women and exercise: theory of planned behavior beliefs

Despite well-documented benefits of exercise, aging women remain largely sedentary. Further understanding of beliefs associated with exercise could result in more-effective public health interventions to increase exercise in this vulnerable population. This study examined the relationships between theory of planned behavior constructs and exercise behavior and exercise intention in older women. Constructs from the theory of planned behavior (behavioral beliefs, perceived control beliefs, and normative beliefs) were examined in a sample of 225 women aged 65 and older. Exercise was measured with the Baecke Physical Activity Scale. All women were interviewed, to prevent literacy and vision problems from hampering participation. Significant predictors of exercise behavior were perceived control beliefs and behavioral beliefs. Significant predictors of exercise intentions were perceived control beliefs, behavioral beliefs, and normative beliefs. Specific belief items predicting exercise behavior were that exercise is good for health and that exercise is difficult because of tiredness, as well as the lack of commitment and time. These findings provide partial support for the application of the theory of planned behavior to exercise in older women. The findings suggest that interventions should focus on increasing women's confidence that they can overcome barriers to exercise.     

Chinese Breast Cancer Screening Beliefs Questionnaire: development and psychometric testing with Chinese-Australian women

Title.  Chinese Breast Cancer Screening Beliefs Questionnaire: development andpsychometric testing with Chinese-Australian women.
Aim.  This paper is a report of the development and psychometric testing of the Chinese Breast Cancer Screening Beliefs Questionnaire, a culturally sensitive questionnaire for measuring Chinese-Australian women's beliefs, knowledge and attitudes towards breast cancer and breast screening practices.
Background.  Breast cancer is the leading cause of cancer morbidity among Chinese-Australian women. They are, however, 50% less likely to participate in all types of breast examination. A valid and reliable instrument to explore the breast cancer beliefs is essential for the development of interventions to promote breast cancer screening practices.
Method.  Items for the questionnaire were drawn from a literature review and in-depth interviews. A panel of professional experts and lay women evaluated face and content validity. The instrument was translated from English to Chinese using back-translation. In 2008, a total of 292 Chinese-Australian women aged 22–78 years who were resident of Australia were included in testing the instrument. Multi-trait analysis and Cronbach's alpha were used to assess internal consistency reliability and exploratory factor analysis assessed construct validity.
Results.  The final 13-item questionnaire had satisfactory validity and internal consistency. Cronbach's alpha for the total scale was 0·76, and for the three subscales ranged from 0·70 to 0·79. Exploratory factor analysis showed that the scale reduced to three factors.
Conclusion.  Preliminary data suggest that the Chinese Breast Cancer Screening Beliefs Questionnaire is a valid, reliable and culturally sensitive instrument for the measurement of Chinese-Australian women's beliefs, knowledge and attitudes about breast cancer and breast cancer screening.     

Health‐related quality of life,anxiety and depression related to mammography screening in Norway

Aim and objectives. To measure health‐related quality of life, anxiety and depression ahead of mammography screening and to assess any differences in health‐related quality of life compared to reference population. Background. The study of health‐related quality of life among attendees prior to mammography screening has received little attention, and increased knowledge is needed to better understand the overall health benefits of participation. Design. A two‐group cross‐sectional comparative study was performed. Methods. The samples comprised 4,249 attendees to mammography screening and a comparison group of 943 women. We used the SF‐36 Health Survey to assess health‐related quality of life. Linear regression was used to study any differences between the groups with adjustment for age, level of education, occupation, having children and smoking status. Other normative data were also used. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Results. Attendees scored statistically significant higher on the SF‐36 than the comparison group but were in line with normative data. Attendees had anxiety mean 4 · 1 and depression mean 2 · 6. Conclusions. The majority of the attendees have a high health‐related quality of life, low anxiety and depression ahead of screening. Anxiety and depression were less than shown in normative data from Norway. Despite a high health‐related quality of life, low anxiety and depression among the majority, healthcare workers should pay special attention to the few women who are anxious and depressed, and have a lower health‐related quality of life. Omitted from mammography screening may be women who are unemployed, have lower socioeconomic status, are anxious and are depressed. Further research should be performed with non‐attendees and subgroups to improve the screening programme. Relevance to clinical practice. It is important to identify which patients have the greatest need for support and caring in an organised mammography screening and who may be overlooked.     

Breast cancer worry in further examination of mammography screening – a systematic review

Aims: In this systematic review, we explored which factors are associated with breast cancer (BC) worry in further examination (FE) of mammography screening and for how long women experience BC worry associated with FE. Methods: Medline, Cochrane, Cinahl and the International Network of Agencies for Health Technology Assessment databases were used in the search. In addition to this, reference lists of the selected articles were inspected. The subject headings and keywords searched included breast screening, mammography screening, BC worry, distress or anxiety, additional test, further examination and recall. These were used separately and in combination. The databases gave 598 references. From the selected titles, 83 abstracts were read; from these, 23 publications were selected for full‐text review. On the basis of full texts, 15 articles were chosen. Findings: There were very few studies about the associations between FE and BC worry. In those found, the amount of measured variables was limited. BC worry in FE of breast screening was associated with several sociodemographic and psychosocial factors of recalled women, as well as those related to the FE process. About half of the recalled women were quite or very anxious in the prediagnostic phase. Conclusions: The review gave implications for interventions in the FE process of mammography screening. These interventions should predominantly be made in the preclinical phase and should differ according to the type of recall visit and characteristics of recalled women. In communicating the diagnosis to the women, the time from the examination process to diagnosis should be as short as possible, and in addition to physicians being present, other health care professionals should also be there to ensure the necessary emotional and practical support a woman needs in such a situation.