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1.
BMC Womens Health ; 19(1): 122, 2019 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640681

RESUMO

BACKGROUND: Incidence of breast cancer in the Kingdom of Saudi Arabia (KSA) has increased in recent years. Screening helps in early detection of cancer and early diagnosis and timely treatment of breast cancer lead to a better prognosis. Women in the healthcare profession can have a positive impact on the attitudes, beliefs, and practices of general public. Therefore, it is important that the healthcare workers themselves have adequate knowledge and positive attitudes. We conducted a study to assess the knowledge, attitudes, and practices related to breast cancer screening among female healthcare professionals. METHODS: A cross-sectional study was conducted on female health professional of KFMC (King Fahad Medical City). Data was collected using a pre-designed, tested, self-administered questionnaire. The questionnaire included specific sections to test the participants' knowledge, attitude, and practices related to cervical cancer and its screening. Data analysis was done using descriptive statistics. RESULTS: A total of 395 health care workers participated in this study. The mean age of the participants was 34.7 years. Participants included physicians (n = 63, 16.0%), nurses (n = 261, 66.1%), and allied health workers (n = 71, 18.0%). Only 6 (1.5%) participants had a good level of knowledge of breast cancer and 104 (26.8%) participants demonstrated a fair level of knowledge. Overall, 370 (93.7%), 339 (85.8%), and 368 (93.2%) participants had heard of breast self-examination, clinical breast examination, and mammography, respectively. A total of 295 (74.7%) participants reported practicing breast self-examination, 95 (24.1%) had undergone clinical breast examination, and 74 (18.7%) had ever undergone mammography. CONCLUSION: The knowledge, attitudes, and practices related to breast cancer screening were found to be lower than expected. Active steps are required to develop educational programs for the health care staff, which might empower them to spread the knowledge and positively influence the attitudes of female patients in the hospital.


Assuntos
Atitude do Pessoal de Saúde , Neoplasias da Mama/psicologia , Detecção Precoce de Câncer/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Adulto , Neoplasias da Mama/diagnóstico , Autoexame de Mama/psicologia , Estudos Transversais , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Mamografia/psicologia , Pessoa de Meia-Idade , Arábia Saudita , Inquéritos e Questionários , Neoplasias do Colo do Útero/psicologia , Saúde da Mulher
2.
BMC Womens Health ; 19(1): 116, 2019 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-31519195

RESUMO

BACKGROUND: Breast cancer is the most prevalent cancer in women, and in those with a positive family history, it is important to perform mammography. One of the probable barriers in doing mammography is fatalism. METHODS: This is a descriptive/cross-sectional study conducted on 400 women residing in Isfahan, Iran, randomly selected in 2017. Sampling was done randomly among the enrolled women in Health Integrity System. The data collection tool was a questionnaire regarding the demographic-fertility information and fatalism. The data analysis was done by SPSS software. A P-value < 0.05 was considered statistically significant. RESULTS: The results showed that the mean rate of fatalism was 59.5 ± 23.2 in women with the experience of mammography, and 65.9±18.7 in women without the experience. Moreover, the mean rate of fatalism was 73.1±15.2 in subjects with a family history of breast cancer, and 59.3 ± 22.5 in those no family history related to this condition. Accordingly, fatalism was statistically significant associated (P < 0.001) with a family history of breast cancer and experience of mammography. There was no significant relationship between demographic information and fatalism (P > 0.05). CONCLUSION: The results indicated that fatalism in women with no experience of mammography was higher than in those with a positive history. Regarding the necessity of mammography in women with a family history of breast cancer, the required interventions seem to be essential to changing the viewpoints of women regarding the importance and effect of mammography as a screening method for breast cancer.


Assuntos
Neoplasias da Mama/psicologia , Detecção Precoce de Câncer/psicologia , Predisposição Genética para Doença/psicologia , Mamografia/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adulto , Neoplasias da Mama/diagnóstico , Estudos Transversais , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Irã (Geográfico) , Mamografia/estatística & dados numéricos , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Inquéritos e Questionários
3.
Public Health ; 177: 135-142, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31563701

RESUMO

OBJECTIVES: Cross-sectional data from Alberta's Tomorrow Project (ATP) were used to assess the association between perceived susceptibility (PS) to developing cancer and mammography screening behaviour. STUDY DESIGN: Cross-sectional study. METHODS: ATP participants between 35 and 70 years of age who reported being free of chronic conditions were included in the study (n = 1803). PS was measured using three variables: participants' estimate of their personal PS of developing cancer, compared to others, on a 5-point Likert scale; participants' estimate of the percentage of people in their age group who would be diagnosed with cancer; and participants' estimate of their own chance (expressed as a percentage) of being diagnosed with cancer. Multivariable logistic regression models, adjusting for age, marital status, work status, education, family history, and place of residence, were used to explore the association of interest. RESULTS: PS of developing cancer was modestly yet significantly associated with mammography screening behaviour for two of the three PS variables. Specifically, the adjusted odds of mammography screening were 1.20 times greater for each one-unit increase in personal PS of developing cancer (95% confidence interval [CI] = 1.07-1.36 [P = 0.003]) and 1.01 times greater for each one-unit increase in both participants' estimate of the percentage of people who would develop cancer (95% CI = 1.00-1.01 [P = 0.05]) and participants' estimate of their own chance of developing cancer (95% CI = 1.00-1.01 [P = 0.02]). CONCLUSIONS: Understanding how certain factors, such as PS, are associated with screening behaviour is important to help address the underutilization of cancer screening.


Assuntos
Atitude Frente a Saúde , Neoplasias da Mama/psicologia , Detecção Precoce de Câncer/psicologia , Mamografia/psicologia , Adulto , Idoso , Alberta , Neoplasias da Mama/prevenção & controle , Estudos Transversais , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Humanos , Mamografia/estatística & dados numéricos , Pessoa de Meia-Idade , Medição de Risco , Inquéritos e Questionários
4.
Asian Pac J Cancer Prev ; 20(9): 2865-2873, 2019 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-31554389

RESUMO

Background: Early detection of breast cancer is essential in improving overall women's health. The researchers sought to develop a comprehensive measure that combined the basic components of the health belief model (HBM) with a focus on breast self-examination (BSE) and screening mammogram amongst women. Methods: Questionnaire items were developed following a review of relevant literature of HBM on BSE and screening mammogram. The sampling frame for the study was Malaysian women aged 35 to 70 years old, living in Kuantan, Pahang and able to read or write in Bahasa Malaysia or English. As such, 103 women were randomly selected to participate in the study. Tests of validity using exploratory factor analysis (EFA) and reliability were subsequently performed to determine the psychometric properties of the questionnaire. Results: The EFA revealed nine factors (self-efficacy of mammogram, perceived barriers of BSE and mammogram, perceived susceptibility of breast cancer, perceived severity of breast cancer, cues to action for mammogram screening, perceived benefits of BSE, health motivation, perceived benefits of mammogram and self-efficacy of BSE) containing 54 items that jointly accounted for 74.2% of the observed variance. All nine factors have good internal consistency with Cronbach's alpha ≥ 0.8. Fifty-four items remained in the final questionnaire after deleting 13 problematic items. The scale also showed good convergent and discriminant validity. Conclusion: The findings showed that the designed questionnaire was a valid and reliable instrument for the study involving women in Kuantan, Pahang. The instrument can help to assess women's beliefs on BSE adoption and mammogram screening in health care practice and research.


Assuntos
Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Autoexame de Mama/psicologia , Detecção Precoce de Câncer/psicologia , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Mamografia/psicologia , Adulto , Idoso , Neoplasias da Mama/psicologia , Cultura , Feminino , Seguimentos , Humanos , Malásia/epidemiologia , Pessoa de Meia-Idade , Motivação , Prognóstico , Psicometria , Inquéritos e Questionários , Saúde da Mulher
5.
Psychooncology ; 28(11): 2226-2232, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31461546

RESUMO

OBJECTIVE: Elevated anxiety and breast cancer worry can impede mammographic screening and early breast cancer detection. Genetic advances and risk models make personalized breast cancer risk assessment and communication feasible, but it is unknown whether such communication of risk affects anxiety and disease-specific worry. We studied the effect of a personalized breast cancer screening intervention on risk perception, anxiety, and breast cancer worry. METHODS: Women with a normal mammogram but elevated risk for breast cancer (N = 122) enrolled in the Athena Breast Health risk communication program were surveyed before and after receiving a letter conveying their breast cancer risk and a breast health genetic counselor consultation. We compared breast cancer risk estimation, anxiety, and breast cancer worry before and after risk communication and evaluated the relationship of anxiety and breast cancer worry to risk estimation accuracy. RESULTS: Women substantially overestimated their lifetime breast cancer risk, and risk communication somewhat mitigated this overestimation (49% pre-intervention, 42% post-intervention, 13% Gail model risk estimate, P < .001). Both general anxiety and breast cancer worry declined significantly after risk communication in women with high baseline anxiety. Baseline anxiety and breast cancer worry were essentially unrelated to risk estimation accuracy, but risk communication increased alignment of worry with accuracy of risk assessment. CONCLUSIONS: Personalized communication about breast cancer risk was associated with modestly improved risk estimation accuracy in women with relatively low anxiety and less anxiety and breast cancer worry in women with higher anxiety. We detected no negative consequences of informing women about elevated breast cancer risk.


Assuntos
Ansiedade , Neoplasias da Mama/psicologia , Predisposição Genética para Doença/psicologia , Mamografia/psicologia , Adulto , Neoplasias da Mama/genética , Comunicação , Detecção Precoce de Câncer , Feminino , Aconselhamento Genético , Comportamentos Relacionados com a Saúde , Humanos , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Inquéritos e Questionários
6.
Asian Pac J Cancer Prev ; 20(6): 1825-1831, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-31244306

RESUMO

Background: Breast cancer is the most common cancer in women worldwide. In south-east Asia, both the incidence and mortality rates of breast cancer are on the rise, and the latter is likely due to the limited access to large-scale community screening program in these resource-limited countries. Breast cancer awareness is an important tool which may, through increasing breast self-examination and the seeking of clinical examination, reduce breast cancer mortality. Investigating factors associated with breast cancer awareness of women is likely to help identify those at risk, and provide insights into developing effective health promotion interventions. Objective: To investigate factors associated with breast cancer awareness in Thai women. Methods: A cross-sectional sample of Thai women aged 20-64 years was collected during August to October, 2015 from two provinces of southern Thailand (Surat Thani and Songkla). A questionnaire including the Breast Cancer Awareness Scale along with demographic characteristics was administered and Proportional Odds Logistic regression was then used to investigate factors associated with breast cancer awareness. Results: In total, 660 Thai women participated in this study. Factors most often associated with the various breast cancer awareness domains were age and rurality. While rural women had poorer knowledge of breast cancer signs and symptoms, they also had lower levels of perceived barriers and considerably better breast cancer awareness behaviors. Conclusion: Despite lower knowledge of breast cancer risk factors and no evidence of better knowledge of signs and symptoms, we found rural Thai women had considerably better breast cancer awareness behavior. This may be due to these women's lower levels of perceived barriers to breast cancer screening services. Indeed this suggests, at least in Thai women, that interventions aimed at lowering perceived barriers rather than enhancing disease knowledge may be more successful in engaging women with breast cancer screening services and increasing breast self-examination.


Assuntos
Neoplasias da Mama/diagnóstico , Neoplasias da Mama/psicologia , Autoexame de Mama/estatística & dados numéricos , Detecção Precoce de Câncer/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Mamografia/estatística & dados numéricos , Adulto , Neoplasias da Mama/epidemiologia , Autoexame de Mama/psicologia , Estudos Transversais , Detecção Precoce de Câncer/psicologia , Feminino , Seguimentos , Humanos , Incidência , Mamografia/psicologia , Pessoa de Meia-Idade , Prognóstico , Inquéritos e Questionários , Tailândia/epidemiologia , Adulto Jovem
7.
Asian Pac J Cancer Prev ; 20(6): 1913-1920, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-31244318

RESUMO

Background: Breast cancer (BC) awareness is relatively poor among Malaysian women indicated by the presence of BC at a late stage and the low rate of mammography screening. Only a few theoretically based studies have been conducted on Malaysian women's participation in mammography. Therefore, the objective of this study is to use health belief model (HBM) and stage of change model (SCM) to determine the relationship between health beliefs on the behavioral adoption of mammography amongst women in Kuantan, Pahang. Methods: Five hundred and twenty women were randomly selected to complete the survey. Data were analyzed using multinomial logistic regression (MLR) to ascertain the multivariate relationships between health beliefs and stage of mammography behavioral adoption. Results: The MLR test indicates that there is no significant difference in perceived severity, benefits, motivator factors and cues to action between participants in the action stage and the maintenance stage. However, significant differences existed in perceived severity, susceptibility, motivator factors and self-efficacy between the pre-contemplation, relapse and contemplation stage to that of the referenced (maintenance) stage of mammography adoption. Conclusion: Women in the action stage are more likely to progress towards maintenance stage as they perceived breast cancer as a disease that leads to death and that mammogram screening is beneficial in detecting the disease at an early stage. However, women in the pre-contemplation, relapse and contemplation stage are found unlikely to move towards the maintenance stage as they perceived their risk of getting breast cancer is low.


Assuntos
Neoplasias da Mama/diagnóstico , Neoplasias da Mama/psicologia , Detecção Precoce de Câncer/psicologia , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Mamografia/psicologia , Mamografia/estatística & dados numéricos , Adulto , Idoso , Atitude Frente a Saúde , Estudos Transversais , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Motivação , Aceitação pelo Paciente de Cuidados de Saúde , Percepção , Prognóstico , Inquéritos e Questionários
8.
BMC Womens Health ; 19(1): 74, 2019 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-31185959

RESUMO

BACKGROUND: This study examined factors influencing cultural beliefs associated with later-stage detection of breast cancer and determined what factors influence those cultural beliefs in Vietnamese women residing in a rural Vietnamese community. METHODS: A cross-sectional survey was conducted with 289 women aged 20-64 years from 12 villages using a self-administered structured questionnaire. Cultural beliefs were measured with a 13-item cultural beliefs scale consisting of four domains-characteristics of breast lumps, self-help techniques, faith-based beliefs, and futility of treatment. Data were collected in February 2017 and analyzed using chi-square tests, nonparametric tests, Fisher's exact tests, and multiple linear regression analyses with SPSS/WIN 24.0 statistical software. RESULTS: Although the total score was relatively low (3.4 out of 13), cultural beliefs that could contribute to later-stage breast cancer were identified. Younger women (ß = .15, p = .016) and women with a lower income (ß = .21, p < .001) held more erroneous cultural beliefs as compared to their counterparts. Most women believed they would not get breast cancer if they took care of themselves. More than one-third held cultural beliefs about breast lumps, thinking they would need to be painful and/or actively growing to be breast cancer. CONCLUSIONS: The results support the urgent need for education concerning breast cancer health promotion, including breast cancer assessment as well as guidance on evidence-based and up-to-date detection measures to change rural Vietnamese women's cultural beliefs.


Assuntos
Neoplasias da Mama/psicologia , Comportamentos Relacionados com a Saúde/etnologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Adulto , Estudos Transversais , Feminino , Educação em Saúde/métodos , Humanos , Mamografia/psicologia , Pessoa de Meia-Idade , Valores Sociais , Inquéritos e Questionários , Adulto Jovem
10.
Bull Cancer ; 106(7-8): 684-692, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31047637

RESUMO

French program of breast cancer screening is implemented since15 years and results are in adequation with international guidelines except for participation. To answer to recurrent controversies about breast cancer screening, publications from National Institute of French cancer registry confirm the positive impact of screening on decreasing mortality for participating women. The harms of mammography (and not from screening) need to be communicated to the invited women to help them to make decision about participation but also the risk of worse prognosis in case of symptomatic cancer. The future of screening will be different and works are in progress to find new ways to select women who will beneficiate for screening and whose cancer needs to be treated. Until then, the only way to screen for breast cancer stays the mammographic process as well as other technics in case of dense breast or in case of family history of breast cancer.


Assuntos
Atitude do Pessoal de Saúde , Neoplasias da Mama/prevenção & controle , Detecção Precoce de Câncer , Mamografia , Radiologistas/psicologia , Adulto , Idoso , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/epidemiologia , Tomada de Decisões , Dissidências e Disputas , Detecção Precoce de Câncer/psicologia , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , França/epidemiologia , Humanos , Imagem por Ressonância Magnética , Mamografia/efeitos adversos , Mamografia/métodos , Mamografia/psicologia , Mamografia/estatística & dados numéricos , Metanálise como Assunto , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Utilização de Procedimentos e Técnicas , Exposição à Radiação , Ultrassonografia Mamária
11.
Asian Pac J Cancer Prev ; 20(5): 1481-1485, 2019 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-31127912

RESUMO

Objective: This paper aims to report the relationship between perceptions of mammography and screening practices. Methods: This cross-sectional study was conducted between May and September 2017, involving 400 women of over 40 years old, who was referred to as urban health centers in Tehran, Iran. The subjects were selected by multi-stage cluster sampling. Women with inconsistent mammography perceptions and practices were identified the Pros and Cons of mammography behavior for perceptions and Transtheoretical model (TTM) stage of adoption for prior and intended screening practices. The research instrument included a self-administered questionnaire and data were analyzed using descriptive statistics and measures of central tendency, and the chi-square, T-tests, and correlation regression analysis. Results: The average age participant was 45.6±5.4. Consistent with the TTM and pros and cons of mammography, women in action tended to have more positive perceptions of mammography than women in pre-contemplation or contemplation (mean decisional balance: action= 16.8; SD, 1.4; contemplation=1.8; SD, 0.48; precontemplation= SD, 1.4;0.56; p<0.001). Conclusion: results of the current study indicate there are inconsistent mammography perceptions and practice among women in Iran, then we recommend that future intervention, consider setting factors in addition to standard perceptions focused counseling.


Assuntos
Mamografia/psicologia , Mamografia/estatística & dados numéricos , Programas de Rastreamento/psicologia , Programas de Rastreamento/estatística & dados numéricos , Adulto , Atitude Frente a Saúde , Estudos Transversais , Tomada de Decisões/fisiologia , Feminino , Comportamentos Relacionados com a Saúde/fisiologia , Humanos , Irã (Geográfico) , Pessoa de Meia-Idade , Percepção/fisiologia , Análise de Regressão , Inquéritos e Questionários/estatística & dados numéricos
12.
PLoS One ; 14(3): e0214057, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30913217

RESUMO

BACKGROUND: In Spain, women invited to breast screening are not usually informed about potential harms of screening. The objective of the InforMa study is to assess the effect of receiving information about the benefits and harms of breast screening on informed choice and other decision-making outcomes, in women approaching the age of invitation to mammography screening. METHODS: Two-stage randomised controlled trial. In the first stage, 40 elementary territorial units of the public healthcare system were selected and randomised to intervention or control. In the second stage, women aged 49-50 years were randomly selected. The target sample size was 400 women. Women in the intervention arm received a decision aid (DA) with detailed information on the benefits and harms of screening. Women in the control arm received a standard leaflet that did not mention harms and recommended accepting the invitation to participate in the Breast Cancer Screening Program (BCSP). The primary outcome was informed choice, defined as adequate knowledge and intentions consistent with attitudes. Secondary outcomes included decisional conflict, worry about breast cancer, time perspective, opinions about the DA or the leaflet, and participation in the BCSP. RESULTS: In the intervention group, 23.2% of 203 women made an informed choice compared to only 0.5% of 197 women in the control group (p < 0.001). Attitudes and intentions were similar in both study groups with a high frequency of women intending to be screened, 82.8% vs 82.2% (p = 0.893). Decisional conflict was significantly lower in the intervention group. No differences were observed in confidence in the decision, anxiety, and participation in BCSP. CONCLUSIONS: Women in Spain lack knowledge on the benefits and harms of breast screening. Providing quantitative information on benefits and harms has produced a considerable increase in knowledge and informed choice, with a high acceptance of the informative materials. TRIAL REGISTRATION: Trial identifier NCT03046004 at ClinicalTrials.gov registry. Registered on February 4 2017. Trial name: InforMa study.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Tomada de Decisões , Mamografia , Comportamento de Escolha , Técnicas de Apoio para a Decisão , Detecção Precoce de Câncer , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Mamografia/efeitos adversos , Mamografia/psicologia , Programas de Rastreamento , Pessoa de Meia-Idade , Participação do Paciente , Medição de Risco , Espanha
13.
PLoS One ; 14(3): e0213615, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30856210

RESUMO

INTRODUCTION: False-positive recall is an issue in national screening programmes. The aim of this study is to investigate the recall rate at first screen and to identify potential predictors of false-positive recall in a multi-ethnic Asian population-based breast cancer screening programme. METHODS: Women aged 50-64 years attending screening mammography for the first time (n = 25,318) were included in this study. The associations between potential predictors (sociodemographic, lifestyle and reproductive) and false-positive recall were evaluated using multivariable logistic regression models. RESULTS: The recall rate was 7.6% (n = 1,923), of which with 93.8% were false-positive. Factors independently associated with higher false-positive recall included Indian ethnicity (odds ratio [95% confidence interval]: 1.52 [1.25 to 1.84]), premenopause (1.23 [1.04 to 1.44]), nulliparity (1.85 [1.57 to 2.17]), recent breast symptoms (1.72 [1.31 to 2.23]) and history of breast lump excision (1.87 [1.53 to 2.26]). Factors associated with lower risk of false-positive recall included older age at screen (0.84 [0.73 to 0.97]) and use of oral contraceptives (0.87 [0.78 to 0.97]). After further adjustment of percent mammographic density, associations with older age at screening (0.97 [0.84 to 1.11]) and menopausal status (1.12 [0.95 to 1.32]) were attenuated and no longer significant. CONCLUSION: For every breast cancer identified, 15 women without cancer were subjected to further testing. Efforts to educate Asian women on what it means to be recalled will be useful in reducing unnecessary stress and anxiety.


Assuntos
Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/psicologia , Mamografia/métodos , Mamografia/psicologia , Grupo com Ancestrais do Continente Asiático , Biópsia , Densidade da Mama , Neoplasias da Mama/diagnóstico , Reações Falso-Positivas , Feminino , Humanos , Estilo de Vida , Programas de Rastreamento/métodos , Menopausa , Pessoa de Meia-Idade , Análise Multivariada , Educação de Pacientes como Assunto , Pré-Menopausa , Reprodução , Singapura , Classe Social
14.
Artigo em Inglês | MEDLINE | ID: mdl-30781792

RESUMO

Obesity in Australia is rising rapidly, and is a major public health concern. Obesity increases the risk of breast cancer and worsens associated outcomes, yet breast screening participation rates in Australia are suboptimal and can be lower in higher risk, obese women. This study qualitatively explored barriers to breast screening participation in obese women in Australia. In-depth interviews (n = 29), were conducted with obese women (body mass index ≥ 30) and key health providers. A disconnect between providers' and women's perceptions was found. For women, low knowledge around a heightened need to screen existed, they also reported limited desire to prioritize personal health needs, reluctance to screen due to poor body image and prior negative mammographic experiences due to issues with weight. Providers perceived few issues in screening obese women beyond equipment limitations, and health and safety issues. Overall, weight was a taboo topic among our interviewees, indicating that a lack of discourse around this issue may be putting obese women at increased risk of breast cancer morbidity and mortality. Consideration of breast screening policy in obese women is warranted. Targeted health promotion on increased breast cancer risk in obese women is required as is a need to address body image issues and encourage screening participation.


Assuntos
Pessoal de Saúde/psicologia , Programas de Rastreamento/psicologia , Obesidade/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Relações Profissional-Paciente , Idoso , Austrália/epidemiologia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/prevenção & controle , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Mamografia/psicologia , Pessoa de Meia-Idade , Obesidade/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Pesquisa Qualitativa , Risco
15.
Asian Pac J Cancer Prev ; 20(2): 469-478, 2019 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-30803209

RESUMO

Objective: Evaluate the beliefs about the risk factors for breast cancer in a population of women from the western Amazon and determine the factors associated with the higher belief scores presented by this population. Methods: A population-based cross-sectional study included 478 women aged >40 years residing in Rio Branco, Acre, Brazil. An American Cancer Society questionnaire was applied to assess the knowledge, attitudes, and beliefs about breast cancer. Results: The main beliefs about the risk factors for breast cancer were breast trauma (95%), use of underwire bra (58.5%), and a high number of sexual partners (55.5%). Women from younger age groups presented higher belief scores (Bcoefficient: ­0.04, 95% CI: ­0.07; ­0.01) than those of women from older age groups. A strong association was noted between high knowledge scores of risk factors and signs/symptoms of the disease and high belief scores in the study group (Bcoefficient:0.33;95%CI:0.28;0.38). Conclusion: The results indicate the existence of important beliefs related to the risk factors for breast cancer. Women from younger age groups, women who have seen a gynecologist in the past 2 years, and women who had more knowledge about the risk factors and signs and symptoms of breast cancer had higher belief scores.


Assuntos
Neoplasias da Mama/psicologia , Autoexame de Mama/psicologia , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Mamografia/psicologia , Adulto , Idoso , Brasil/epidemiologia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Prognóstico , Inquéritos e Questionários
16.
BMC Public Health ; 19(1): 189, 2019 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-30760275

RESUMO

BACKGROUND: A range of barriers influence women's uptake to a first breast screening invitation. Few studies however, have examined factors associated with second screening uptake. This study follows Maltese women to explore predictors and behaviours to re-attendance, and to determine if uptake of first invitation to the Maltese Breast Screening Programme (MBSP) is a significant predictor of second screening uptake. METHODS: A prospective study was conducted to determine factors associated with re-attendance for 100 women invited to the second MBSP round. Records of women's second attendance to the MBSP were extracted in January 2016 from the MBSP database. Data were analyzed using chi-square tests, Independent Samples t-test, Mann Whitney test, Shapiro Wilk test and logistic regression. RESULTS: There were no significant associations for sociodemographic or health status variables with second screening uptake (p > 0.05), except breast condition (Fisher's exact test, p = 0.046). Non-attendees at second screening were most unsure of screening frequency recommendations (χ2 = 9.580, p = 0.048). Attendees were more likely to perceive their susceptibility to breast cancer (p = 0.041), believed breast cancer to be life changing (p = 0.011) and considered cues to action to aid attendance (p = 0.028). Non-attendees were in stronger agreement on mammography pain (p = 0.008) and were less likely to consider cues to action (15.4% non-attendees vs 1.4% attendees) (p = 0.017 respectively). 'Perceived barriers', 'breast cancer identity', 'causes' and 'consequences' were found to be significant predictors of second screening uptake, with 'perceived barriers' being the strongest. The inclusion of illness perception items improved the regression model's accuracy in predicting non-attendance to the second screening round (84.6% vs 30.8%). First screening uptake was found to be a significant predictor of subsequent uptake (OR = 0.102; 95% CI = 0.037, 0.283; p = 0.000). CONCLUSIONS: Interventions to increase uptake should target first invitees since attending for the first time is a strong predictor of uptake to the second cycle. Further research is required given the small sample. Particular attention should be paid to women who did not respond to their first invite or are unsure or reluctant participants initially.


Assuntos
Atitude Frente a Saúde , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/psicologia , Detecção Precoce de Câncer/tendências , Mamografia/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Idoso , Neoplasias da Mama/prevenção & controle , Bases de Dados Factuais , Feminino , Previsões , Humanos , Modelos Logísticos , Malta , Mamografia/tendências , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Estudos Prospectivos
17.
Acta Oncol ; 58(5): 763-768, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30747014

RESUMO

Background: Persistent breast pain (PBP) is prevalent among breast cancer survivors and has powerful negative psychological consequences. The present study provided a first test of the hypothesis that: (a) pain catastrophizing, (b) heightened perceived risk of cancer, and (c) worry that pain indicates cancer may be independent mediating links between breast cancer survivors' experiences of PBP and heightened emotional distress. Methodology: We assessed levels of PBP and psychological factors in breast cancer survivors (Survivor Group: n = 417; Stages I-IIIA; White = 88.7%; Age M = 59.4 years) at their first surveillance mammogram post-surgery (6-15 months). A comparison group of women without histories of breast surgery or cancer (Non-cancer Group: n = 587; White = 78.7%; Age M = 57.4 years) was similarly assessed at the time of a routine screening mammogram. All women completed measures of breast pain, pain catastrophizing, perceived breast cancer risk, and worry that breast pain indicates cancer, as well as measures of emotional distress (symptoms of anxiety, symptoms of depression, and mammography-specific distress). Analyses included race, age, BMI, education, and menopausal status as covariates, with significance set at 0.05. Results: As expected, PBP prevalence was significantly higher in the Survivor Group than in the Non-cancer Group (50.6% vs. 17.5%). PBP+ survivors also had significantly higher levels of emotional distress, pain catastrophizing, mammography-specific distress, and worry that breast pain indicates cancer, compared to PBP- survivors. Structural equation modeling results were significant for all hypothesized mediational pathways. Interestingly, comparisons of PBP+ to PBP- women in the Non-cancer Group showed similar results. Conclusion: These findings suggest the importance of (a) pain catastrophizing, (b) perceived breast cancer risk and, (c) worry that breast pain may indicate cancer, as potential targets for interventions aimed at reducing the negative psychological impact of PBP in post-surgery breast cancer survivors, as well as in unaffected women with PBP due to unknown reasons.


Assuntos
Neoplasias da Mama/cirurgia , Sobreviventes de Câncer/psicologia , Catastrofização/epidemiologia , Mastodinia/epidemiologia , Mastodinia/etiologia , Adaptação Psicológica , Neoplasias da Mama/patologia , Neoplasias da Mama/psicologia , Catastrofização/psicologia , Estudos Transversais , Depressão , Feminino , Humanos , Mamografia/psicologia , Mastodinia/psicologia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/psicologia , Estresse Psicológico
18.
South Med J ; 112(1): 1-7, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30608622

RESUMO

OBJECTIVES: Black women are at increased risk of being called back for additional studies after a screening mammogram. With focus group input, we developed a brochure to improve awareness of the frequency of abnormal results. This study explored the brochure's acceptability and effect on understanding risk and breast cancer fears among black mammography patients at an urban safety-net breast imaging center in Miami, Florida. METHODS: A randomized controlled trial of the brochure (plus the standard result notification letter) versus usual care (standard notification letter alone). Black English-speaking women with an incomplete mammography result were randomized to the intervention or control group. Consenting participants completed a telephone questionnaire. Outcomes included awareness of result, anxiety level, and brochure acceptability. The χ2 or Fisher exact test was used and a univariate logistic regression was performed for intervention and control odds ratios. RESULTS: A total of 106 women were randomly selected to receive the brochure plus the letter or the letter alone. One chose to opt out; a minimum of three attempts were made to reach each of the remaining 105 women by telephone. Verbal communication was established with 59 of the randomized women, and 51 of those women agreed to participate in a survey to evaluate the brochure. There was no significant difference between the surveyed groups in knowledge of the result and follow-up plan. Surveyed intervention subjects were more likely to agree that "it is very common for women to have to follow up after a mammogram" (odds ratio [OR] 25.91, P = 0.029) and less likely to agree with the statement "getting a follow-up mammogram is scary" (OR 0.24, P = 0.021). Most intervention subjects said the pamphlet helped them understand their result "a lot" (79%, 19) and viewed it as "extremely" or "mostly" clear (96%, 23). Intervention subjects also voiced greater awareness of a telephone number they could call for more information about cancer (OR 11.38, P = 0.029). CONCLUSIONS: A culturally tailored brochure explaining the frequency of abnormal mammograms was well received by women at a large safety-net health system. Pilot testing suggests that it may improve patient perception of risk and awareness of informational resources. This strategy should be considered to enhance result communication.


Assuntos
Afro-Americanos , Neoplasias da Mama/diagnóstico por imagem , Compreensão , Mamografia , Folhetos , Adulto , Idoso , Ansiedade/psicologia , Detecção Precoce de Câncer/psicologia , Feminino , Florida , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Hospitais Públicos , Humanos , Modelos Logísticos , Mamografia/psicologia , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Projetos Piloto , Inquéritos e Questionários
19.
Curr Probl Diagn Radiol ; 48(1): 40-44, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29273558

RESUMO

BACKGROUND: Breast cancer has the highest incidence of cancers in women in the United States. Previous research has shown that screening mammography contributes to reduced breast cancer mortality. This study aimed to clarify why late screening might occur in an at-risk population. MATERIALS AND METHODS: This study was a prospective cross-sectional study including 758 patients presenting to our radiology department for routine screening mammography who completed a 30-question survey regarding personal characteristics and mammography history. Univariate and multivariate logistic regression were performed to determine whether survey responses correlated with late screening. RESULTS: Of the 758 patients, 184 (24%) were noncompliant with screening mammography guidelines. Risk factors for late screening included younger age (P = 0.001), white race/ethnicity (P = 0.03), self-reported lack of financial means or health insurance (P = 0.005), lack of satisfaction with a previous mammogram experience (P = 0.001), inadequate mammography education by a physician (P = 0.001), and lack of awareness/comprehension of screening mammography guidelines (P = 0.002). CONCLUSION: Many factors contribute to late screening mammography. Although some are outside physician control, others can be influenced: patient education regarding screening mammography guidelines, and patient satisfaction with the mammography experience. This study highlights the importance of communication with and education of patients.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/psicologia , Mamografia/psicologia , Cooperação do Paciente , Estudos Transversais , Detecção Precoce de Câncer , Feminino , Humanos , Programas de Rastreamento , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Satisfação do Paciente , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários
20.
J Am Coll Radiol ; 16(2): 164-169, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30219346

RESUMO

OBJECTIVES: Studies have shown that having a baseline mammogram, the first screening mammogram, available for comparison at the time of interpreting a subsequent mammogram significantly decreases the potential of a false-positive examination. Our aim was to evaluate knowledge of and perception about the significance of baseline mammograms in those women undergoing screening mammography. MATERIALS AND METHODS: A cross-sectional prospective survey study was conducted in women without a history of breast cancer presenting for their screening mammogram. Respondents were surveyed anonymously between March and April 2017. The questionnaire was developed by primary care providers and radiologists and pretested for readability and clarity. RESULTS: In all, 401 women (87% white, 93% educated beyond high school) completed surveys in which 77% of women reported having yearly mammograms, 31% reported having a history of an abnormal mammogram, and 45% had not heard the term baseline mammogram. Of those who had heard the term, the most commonly reported source was their primary care provider (31%). Although 74% chose the correct definition of a baseline mammogram, 67% did not think that a baseline mammogram was important for decreasing associated cost, time, and discomfort due to the number of mammograms incorrectly read as abnormal. CONCLUSION: In a group of educated women who routinely get mammograms, almost one-half had not heard the term baseline mammogram. Furthermore, most women did not think baseline mammography was important for decreasing associated cost, time, and discomfort due to mammograms incorrectly read as abnormal. This study suggests that efforts to improve women's understanding of baseline mammograms and their importance are warranted, with greatest opportunity for health care providers and radiologists.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Mamografia/psicologia , Programas de Rastreamento/psicologia , Idoso , Estudos Transversais , Detecção Precoce de Câncer , Escolaridade , Reações Falso-Positivas , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Inquéritos e Questionários , Estados Unidos
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