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Peipins LA, Dasari S, Viox MH, Rodriguez JL. Information needs persist after genetic counseling and testing for BRCA1/2 and Lynch Syndrome. Breast Cancer Res Treat 2024; 208:19-27. [PMID: 39046629 DOI: 10.1007/s10549-024-07377-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 05/14/2024] [Indexed: 07/25/2024]
Abstract
PURPOSE Research has shown that cancer genetic risk is often not well understood by patients undergoing genetic testing and counseling. We describe the barriers to understanding genetic risk and the needs of high-risk persons and cancer survivors who have undergone genetic testing. METHODS Using data from an internet survey of adults living in the USA who responded 'yes' to having ever had a genetic test to determine cancer risk (N = 696), we conducted bivariate analyses and multivariable logistic regression models to evaluate associations between demographic, clinical, and communication-related variables by our key outcome of having vs. not having enough information about genetics and cancer to speak with family. Percentages for yes and no responses to queries about unmet informational needs were calculated. Patient satisfaction with counseling and percentage disclosure of genetic risk status to family were also calculated. RESULTS We found that a lack of resources provided by provider to inform family members and a lack of materials provided along with genetic test results were strongly associated with not having enough information about genetics and cancer (OR 4.54 95% CI 2.40-8.59 and OR 2.19 95% CI 1.16-4.14 respectively). Among participants undergoing genetic counseling, almost half reported needing more information on what genetic risk means for them and their family and how genetic testing results might impact future screening. CONCLUSION High levels of satisfaction with genetic counseling may not give a full picture of the patient-provider interaction and may miss potential unmet needs of the patient. Accessible resources and ongoing opportunities for updating family history information could reinforce knowledge about genetic risk.
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Affiliation(s)
- Lucy A Peipins
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
- Centers for Disease Control and Prevention, NCCDPHP/DCPC, 4770 Buford Hwy., NE, Mailstop S107-4, Chamblee, GA, USA.
| | | | | | - Juan L Rodriguez
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Ugurlu M, Aydin R, Sahan FU, Vural G. Ovarian cancer awareness of women in Turkey: A cross-sectional study. Public Health Nurs 2024; 41:535-542. [PMID: 38482964 DOI: 10.1111/phn.13306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 02/05/2024] [Accepted: 02/26/2024] [Indexed: 04/16/2024]
Abstract
PURPOSE Early diagnosis of ovarian cancer (OC) increases survival rates; however, due to low awareness levels, women may be diagnosed with OC at the advanced stage. The aim of this cross-sectional study is to reveal the OC awareness of Turkish women and affecting factors. METHODS Participants were invited to study via social media tools between February-June 2022. Data was collected with Personal Information Form and the "OC Awareness Scale" from 446 women. RESULTS 81% of the participants did not recall OC symptoms, 80.8% recognized OC risk factors. The most frequently recalled and recognized OC symptom is pelvic pain (19.8%; 55.8%, respectively). The most frequently recalled and recognized OC risk factors were smoking (43.1%, 67.9%, respectively) and family history (39%, 58.7%, respectively). 2% of the participants felt very confident in recognizing the signs, 72.9% would seek help within 1-2 days when they recognized the signs of OC. CONCLUSIONS The awareness of OC was higher among women who had advanced age, higher education, family history and were in menopause. Turkish women have low level of awareness and knowledge about OC symptoms and risk factors. There is an urgent need for an OC awareness campaign that takes into account the socio-demographic characteristics of women. The results of the study may also guide strategies to prevent OC.
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Affiliation(s)
- Meltem Ugurlu
- Health Sciences Faculty of Gulhane, Midwifery Department, University of Health Sciences Turkey, Etlik, Keçiören, Ankara, Turkey
| | - Ruveyde Aydin
- Department of Gynecology and Obstetrics Nursing, Health Sciences Faculty, Ondokuz Mayıs University, Atakum, Turkey
| | - Fatma Uslu Sahan
- Department of Obstetrics and Gynecologic Nursing, Faculty of Nursing, Hacettepe University, Sıhhıye, Ankara, Turkey
| | - Gulsen Vural
- Department of Nursing, Faculty of Health Sciences, Atılım University, Ankara, Turkey
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Jane Ling MY, Ahmad N, Aizuddin AN. Risk perception of non-communicable diseases: A systematic review on its assessment and associated factors. PLoS One 2023; 18:e0286518. [PMID: 37262079 PMCID: PMC10234567 DOI: 10.1371/journal.pone.0286518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 05/17/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND The burden of non-communicable diseases (NCDs) is increasing. Risk perception of NCDs is an important factor towards the uptake of preventive health interventions. There are various questionnaires assessing risk perception of NCDs, but no internationally standardized questionnaire has been available. Identification of factors associated with risk perception of NCDs may facilitate the development of targeted interventions. This systematic review aims to identify available questionnaire assessing risk perception of NCDs and the factors associated with risk perception of NCDs. METHODS The reporting of this systematic review is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We carried out a literature search through three databases (Scopus, PubMed, Web of Science) and targeted original article published in English between 2012 and 2021. Quality appraisal of the eligible articles was conducted using the Mixed Methods Appraisal Tool. Findings were synthesized using content analysis. RESULTS A total of 86 studies were included. We found a variety of questionnaires assessing risk perception of NCDs, with many differences in their development, domains, items and validity. We also identified several personal, sociopsychological and structural factors associated with risk perception of NCDs. LIMITATIONS Most of the included studies were of cross-sectional design, and therefore the quality of evidence was considered low and exhibit a high risk of bias. The role of publication bias within this systematic review should be acknowledged as we did not include grey literature. Additionally, language bias must be considered as we only included English-language publications. CONCLUSION Further development and testing of available questionnaire is warranted to ensure their robustness and validity in measuring risk perception of NCDs. All the identified factors deserve further exploration in longitudinal and experimental studies.
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Affiliation(s)
- Miaw Yn Jane Ling
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Norfazilah Ahmad
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Azimatun Noor Aizuddin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
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Chen Y, Liu X. Determinants of Beijing Residents' Intentions to Take Protective Behaviors against Smog: An Application of the Health Belief Model. HEALTH COMMUNICATION 2023; 38:447-459. [PMID: 34294010 DOI: 10.1080/10410236.2021.1956036] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Severe smog, a form of air pollution, has become a threat to public health in Beijing, China. To examine Beijing residents' protective behavioral intentions against smog, we proposed a conceptual model, which applies the health belief model (HBM) and specifies the roles of three distal predictors: exposure to news, discussion, and worry. The proposed model was tested in the context of protective behavioral intentions (i.e., intention to wear facemask & intention to use air purifier). Data were collected from Beijing residents during the period from 2/27 to 3/7 in 2017. Structural-equation-modeling (SEM) analyses of valid cases (N = 523) found support for the health belief model regarding the positive effects of perceived threat, perceived benefit, and perceived self-efficacy on intention to wear facemask or intention to use air purifier. Perceived barrier has a negative effect on intention to use air purifier, but is not related to intention to wear facemask. Neither exposure nor discussion is related to perceived threat. The effect of worry on intention to wear facemaskor intention to use air purifier is mediated by perceived threat. This proposed mediating mechanism is superior to the reverse mechanism (that worry mediates perceived threat). Implications of findings were discussed.
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Affiliation(s)
- Yixin Chen
- Department of Communication Studies, Sam Houston State University
| | - Xinchuan Liu
- School of Journalism and Communication, Peking University
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5
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Women's awareness of ovarian cancer risk factors and symptoms in Western Iran in 2020-2021. BMC Womens Health 2022; 22:192. [PMID: 35614471 PMCID: PMC9131642 DOI: 10.1186/s12905-022-01779-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/20/2022] [Indexed: 11/10/2022] Open
Abstract
Objectives This study aimed to investigate awareness of women living in the western region of Iran about warning signs and risk factors for ovarian cancer. Methods This cross-sectional, descriptive-analytical study was conducted in Sanandaj and Kermanshah, Iran, 2020 and 2021. In this study, 1081 women aged 18–70 years were selected as the sample to fill out the electronic version of the Ovarian Cancer Awareness Measure (OCAM) to identify the significant variables of ovarian cancer warning signs and risk factors. The obtained data were statistically analyzed by descriptive statistics and ordinal logistic regression in SPSS 19. Results In this study, 60.9% of the participants had medium awareness of the subject. The results indicated that participants with higher educational attainment (P < 0.05) and those with a history of cancer (P < 0.001) showed higher knowledge of cancer. The lowest level of awareness of symptoms was associated with acute symptoms such as dysphagia (swallowing problems) most days, persistent bloating, a sense of abdominal fullness or heaviness, and frequent urination. Moreover, the lowest awareness of risk factors was related to the history of IVF treatments and the application of talcum powder to the genital area. Conclusion The study findings showed that women living in the western region of Iran have moderate awareness of ovarian cancer and insufficient knowledge of cancer warning signs; this suggests that it is necessary to train Iranian women to raise awareness of the signs and risk factors for ovarian cancer.
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Gallagher A, Waller J, Manchanda R, Jacobs I, Sanderson S. Women's Intentions to Engage in Risk-Reducing Behaviours after Receiving Personal Ovarian Cancer Risk Information: An Experimental Survey Study. Cancers (Basel) 2020; 12:cancers12123543. [PMID: 33260928 PMCID: PMC7760356 DOI: 10.3390/cancers12123543] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/11/2020] [Accepted: 11/24/2020] [Indexed: 12/02/2022] Open
Abstract
Simple Summary Risk stratification using genetic testing to identify women at increased risk of ovarian cancer may increase the number of patients to whom risk-reducing surgery (e.g., salpingo-oophorectomy) may be offered. However, little is known about public acceptability of such approaches. Our online experimental survey aimed to explore whether women aged 45–75 in the general population are willing to undergo ovarian cancer risk assessment, including genetic testing, and whether women’s potential acceptance of risk-reducing surgery differs depending on their estimated risk. We looked at whether psychological and cognitive factors mediated women’s decision-making. The majority of participants would be interested in having genetic testing. In response to our hypothetical scenarios, a substantial proportion of participants were open to the idea of surgery to reduce risk of ovarian cancer, even if their absolute lifetime risk is only increased from 2% to 5 or 10%. Abstract Risk stratification using genetic and/or other types of information could identify women at increased ovarian cancer risk. The aim of this study was to examine women’s potential reactions to ovarian cancer risk stratification. A total of 1017 women aged 45–75 years took part in an online experimental survey. Women were randomly assigned to one of three experimental conditions describing hypothetical personal results from ovarian cancer risk stratification, and asked to imagine they had received one of three results: (a) 5% lifetime risk due to single nucleotide polymorphisms (SNPs) and lifestyle factors; (b) 10% lifetime risk due to SNPs and lifestyle factors; (c) 10% lifetime risk due to a single rare mutation in a gene. Results: 83% of women indicated interest in having ovarian cancer risk assessment. After receiving their hypothetical risk estimates, 29% of women stated they would have risk-reducing surgery. Choosing risk-reducing surgery over other behavioural responses was associated with having higher surgery self-efficacy and perceived response-efficacy, but not with perceptions of disease threat, i.e., perceived risk or severity, or with experimental condition. A substantial proportion of women age 45–75 years may be open to the idea of surgery to reduce risk of ovarian cancer, even if their absolute lifetime risk is only increased to as little as 5 or 10%.
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Affiliation(s)
- Ailish Gallagher
- Research Department of Behavioural Science and Health, University College London, Gower Street, London WC1E 6BT, UK;
| | - Jo Waller
- Cancer Prevention Group, School of Cancer & Pharmaceutical Sciences, King’s College London, Guy’s Hospital, Great Maze Pond, London SE1 9RT, UK;
| | - Ranjit Manchanda
- Wolfson Institute of Preventive Medicine, Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK;
- Department of Gynaecological Oncology, Barts Health NHS Trust, London EC1A 7BE, UK
| | - Ian Jacobs
- Department of Women’s Health, University of New South Wales, Australia, Level 1, Chancellery Building, Sydney 2052, Australia;
| | - Saskia Sanderson
- Research Department of Behavioural Science and Health, University College London, Gower Street, London WC1E 6BT, UK;
- Early Disease Detection Research Project UK (EDDRP UK), 2 Redman Place, London E20 1JQ, UK
- Correspondence:
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Minué-Lorenzo S, Fernández-Aguilar C, Martín-Martín JJ, Fernández-Ajuria A. [Effect of the use of heuristics on diagnostic error in Primary Care: Scoping review]. Aten Primaria 2020; 52:159-175. [PMID: 30711287 PMCID: PMC7063144 DOI: 10.1016/j.aprim.2018.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/12/2018] [Accepted: 11/03/2018] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To assess the use of representativeness, availability, overconfidence, anchoring and adjustment heuristics in clinical practice, specifically in Primary Care setting. DESIGN Panoramic review (scope review). DATA SOURCES OvidMedline, Scopus, PsycoINFO, Cochrane Library and PubMed databases. Each one of the selected studies was reviewed applying TIDIER criteria (Template for Description of the Intervention and Replication) to facilitate their understanding and replicability. SELECTION OF STUDIES A total of 48 studies were selected that analyzed availability heuristics (26), anchoring and adjustment (9), overconfidence (9) and representativeness (8). RESULTS From the 48 studies selected, 26 analyzed availability heuristics, 9 anchoring and adjustment, 9 overconfidence; and 8 representativeness. The study population included physicians (35.4%), patients (27%), trainees (20.8%), nurses (14.5%) and students (14.5%). The studies conducted in clinical practice setting were 17 (35.4%). In 33 of the 48 studies (68,7%) it was observed heuristic use in the population studied. Heuristics use on diagnostic process was found in 27 studies (54.1%); 5 of them (18%) were carried out in clinical practice setting. Of the 48 studies, 6 (12,5%) were performed in Primary Care, 3 of which studied diagnostic process: only one of them analyzed the use of heuristics in clinical practice setting, without demonstrating bias as consequence of the use of heuristic. CONCLUSION The evidence about heuristic use in diagnostic process on clinical practice setting is limited, especially in Primary Care.
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Affiliation(s)
- Sergio Minué-Lorenzo
- Integrated Health Services based on Primary Health Care WHO Collaborating Centre. Escuela Andaluza de Salud Pública, Granada, España.
| | - Carmen Fernández-Aguilar
- Integrated Health Services based on Primary Health Care WHO Collaborating Centre. Escuela Andaluza de Salud Pública, Granada, España
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Jatho A, Bikaitwoha ME, Mugisha NM. Socio-culturally mediated factors and lower level of education are the main influencers of functional cervical cancer literacy among women in Mayuge, Eastern Uganda. Ecancermedicalscience 2020; 14:1004. [PMID: 32104206 PMCID: PMC7039689 DOI: 10.3332/ecancer.2020.1004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Indexed: 11/17/2022] Open
Abstract
Background Health literacy (HL) is the degree of an individual’s knowledge and capacity to seek, understand and use health information to make decisions on one’s health, yet information on the functional level of cervical cancer literacy in Mayuge and Uganda as a whole is lacking. We, therefore, assessed the level of functional cervical cancer literacy among women aged 18–65 years in Mayuge district in five functional HL domains; prior knowledge, oral, print, numeracy and e-health. Understanding the factors associated with cervical cancer literacy is also pertinent to cervical health communication programming, however, no study has documented this in Uganda and particularly in Mayuge. Mayuge is a rural population based cancer registry and one of the sites for piloting cancer control interventions in Uganda. We also assessed the factors associated with cervical cancer literacy and awareness about currently available cervical cancer preventive services. Methods The study protocol was approved by the Uganda Cancer Institute research and ethic committee (UCI-REC). In August 2017, we assessed five HL domains; cervical cancer knowledge, print literacy, oral literacy using audio-clip, numeral literacy and perceived e-HL among 400 women at household levels. Correct response was scored 1 and incorrect response was scored 0 to generate the mean percentage score for each domain. The mean scores were classified as limited, basic and proficient bands based on the McCormack HL cut-offs scale for knowledge, print, oral and e-health and Weiss cut-offs in the newest vital signs (NVS) for numeracy. We used the cervical cancer literacy scores to explore the effect of selected study variables on cervical cancer literacy. We also conducted five focus group discussions (FGDs) based on the theoretical constructs of the PEN-3 model. Results The majority (96.8%) of the participants demonstrated a limited level of cervical cancer literacy with a mean score of 42%. Women who had completed a primary level of education or lower (OR = 3.91; p = 0.044) were more likely to have limited cervical cancer literacy. The qualitative data indicated that the women had limited cervical cancer literacy coupled with limited decisional, social and financial support from their male partners with overall low locus of control. Most (92.3%) of the women were not aware of the available cervical cancer services and had no intention to screen (52.5%). Conclusions The women in Mayuge in general have limited cervical cancer literacy except oral HL domain. Limited cervical cancer literacy was highest among women with lower level of education and overall literacy seemed to be influenced on the higher side by socio-cultural constructs characterised by limited decisional, social and personal resources among the women with overall low locus of control. The Mayuge women further demonstrated scant knowledge about the available health services in their district and low intention to screen. Multi-strategy cervical health empowerment programme is needed to improve cervical HL using orally disseminated messages.
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Affiliation(s)
- Alfred Jatho
- Uganda Cancer Institute, PO Box 3935, Kampala, Uganda.,Uganda Martyrs University, PO Box 5498, Kampala, Uganda.,Department of Cancer Control and Population Health, National Cancer Centre Graduate School of Cancer Science and Policy, Goyang, South Korea
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Campacci N, de Campos Reis Galvão H, Garcia LF, Ribeiro PC, Grasel RS, Goldim JR, Ashton-Prolla P, Palmero EI. Genetic cancer risk assessment: A screenshot of the psychosocial profile of women at risk for hereditary breast and ovarian cancer syndrome. Psychooncology 2020; 29:681-687. [PMID: 31984583 DOI: 10.1002/pon.5305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 11/21/2019] [Accepted: 11/21/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVE There is a lack of information describing Brazilian women at risk of hereditary breast and ovarian cancer syndrome (HBOC) who undergo genetic cancer risk assessment (GCRA). This study aims to characterize the psychosocial profile of women at risk for HBOC at their first GCRA to obtain an overview of their families' profiles and the challenges of the oncogenetics setting. METHODS This was a cross-sectional study in which interviews were conducted with 83 cancer-affected women at their first GRCA appointment after the pedigree draw. Tools to evaluate psychological outcomes were applied. The pedigree genogram and ecomap were constructed and analyzed with content analysis using the "life course perspective" theory. RESULTS Individuals perceived their breast/ovarian cancer risk to be equal to that of the general population, although they were highly concerned about developing cancer. No evidence of anxiety or depressive symptoms was identified. Participants used the coping strategy of searching for religiosity. The genograms and ecomaps resulted in five major themes: support and social support; attitudes, feelings and emotions; cancer causes; communication; and relationships with relatives. Individuals between 20-29 years of age and those with no family history of cancer tended not to communicate with relatives, which may indicate future problems in the GCRA process regarding genetic testing. CONCLUSIONS This study demonstrated that knowing the families who undergo the GCRA process can help professionals provide more individualized and thorough attention during GCRA and genetic testing, which results in better follow-up and prevention strategies.
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Affiliation(s)
- Natalia Campacci
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
| | | | - Lucas F Garcia
- Programa de Pós-Graduação em Promoção da Saúde, Centro Universitário Cesumar, Maringá, Brazil
| | - Paula C Ribeiro
- Oncogenetics Department, Barretos Cancer Hospital, Barretos, Brazil
| | - Rebeca S Grasel
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
| | - José R Goldim
- Programa de Pós-Graduação em Genéticae Biologia Molecular (PPGBM), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Patrícia Ashton-Prolla
- Programa de Pós-Graduação em Genéticae Biologia Molecular (PPGBM), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Laboratório de Medicina Genômica, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.,Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Edenir I Palmero
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil.,Programa de Pós-Graduação em Genéticae Biologia Molecular (PPGBM), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Barretos School of Health Sciences, Dr. Paulo Prata - FACISB, Sao Paolo, Brazil
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Lee KS, Feltner FJ, Bailey AL, Lennie TA, Chung ML, Smalls BL, Schuman DL, Moser DK. The relationship between psychological states and health perception in individuals at risk for cardiovascular disease. Psychol Res Behav Manag 2019; 12:317-324. [PMID: 31191053 PMCID: PMC6520523 DOI: 10.2147/prbm.s198280] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/07/2019] [Indexed: 12/20/2022] Open
Abstract
Backgrounds: Perceptions of health are important to motivate people to change behaviors. Non-adherence to healthy behaviors that prevent cardiovascular disease may result from inadequate health perceptions. However, there are few studies investigating relationships between health perceptions and psychological states. Objective: To determine whether psychological states (ie, depressive symptoms and anxiety) are associated with the congruency between health perception and estimated risk for cardiovascular disease in adults with 2 or more cardiovascular disease risk factors. Methods: Community dwellers at risk for cardiovascular disease were asked to complete the Patient Health Questionnaire-9 and the anxiety subscale of the Brief Symptom Inventory to measure depressive symptoms and anxiety, respectively. Participants rated their perceived health from excellent to poor. The estimated cardiovascular disease risks were measured with the 10-year cardiovascular disease Framingham risk scores. Participants were grouped into three health perception groups based on congruency between levels of health perception and cardiovascular disease risk. Multivariate multinomial logistic regression was done to examine the association between psychological states and health perception groups. Results: Of 828 participants 54.7%, 12.0%, and 33.3% had congruent, pessimistically biased, and optimistically biased health perception, respectively. Depressive symptoms were significantly associated with pessimistic bias (adjusted odds ratio: 1.070, 95% confidence interval 1.010–1.133), but not anxiety. Optimistic bias was not associated with either depressive symptoms or anxiety. Conclusions: A mismatch between individual health perceptions and cardiovascular disease risks was associated with depressive symptoms. As health perception is affected by depressive symptoms, clinicians should assess depressive symptoms when exploring health perceptions and engaging individuals in decision-making about a healthy lifestyle.
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Affiliation(s)
- Kyoung Suk Lee
- College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, South Korea
| | - Frances J Feltner
- University of Kentucky, Family and Community Medicine, Lexington, KY, USA
| | - Alison L Bailey
- University of Tennessee COM Chattanooga, Erlanger Health System, Chattanooga, TN, USA
| | - Terry A Lennie
- College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Misook L Chung
- College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Brittany L Smalls
- College of Medicine Center for Health Service Research, University of Kentucky, Lexington, KY, USA
| | - Donna L Schuman
- University of Kentucky, College of Social Work, Lexington, KY, USA
| | - Debra K Moser
- College of Nursing, University of Kentucky, Lexington, KY, USA
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White MC, Soman A, Weinberg CR, Rodriguez JL, Sabatino SA, Peipins LA, DeRoo L, Nichols HB, Hodgson ME, Sandler DP. Factors associated with breast MRI use among women with a family history of breast cancer. Breast J 2018; 24:764-771. [PMID: 29781100 DOI: 10.1111/tbj.13063] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 10/04/2017] [Accepted: 10/04/2017] [Indexed: 11/29/2022]
Abstract
Although annual breast magnetic resonance imaging (MRI) is recommended for women at high risk for breast cancer as an adjunct to screening mammography, breast MRI use remains low. We examined factors associated with breast MRI use in a cohort of women with a family history of breast cancer but no personal cancer history. Study participants came from the Sister Study cohort, a nationwide, prospective study of women with at least 1 sister who had been diagnosed with breast cancer but who themselves had not ever had breast cancer (n = 17 894). Participants were surveyed on breast cancer beliefs, cancer worry, breast MRI use, provider communication, and genetic counseling and testing. Logistic regression was used to assess factors associated with having a breast MRI overall and for those at high risk. Breast MRI was reported by 16.1% and was more common among younger women and those with higher incomes. After adjustment for demographics, ever use of breast MRI was associated with actual and perceived risk. Odds ratios (OR) were 12.29 (95% CI, 8.85-17.06), 2.48 (95% CI, 2.27-2.71), and 2.50 (95% CI, 2.09-2.99) for positive BRCA1/2 test, lifetime breast cancer risk ≥ 20%, and being told by a health care provider of higher risk, respectively. Women who believed they had much higher risk than others or had higher level of worry were twice as likely to have had breast MRI; OR = 2.23 (95% CI, 1.82-2.75) and OR = 1.76 (95% CI, 1.52-2.04). Patterns were similar among women at high risk. Breast cancer risk, provider communication, and personal beliefs were determinants of breast MRI use. To support shared decisions about the use of breast MRI, women could benefit from improved understanding of the chances of getting breast cancer and increased quality of provider communications.
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Affiliation(s)
- Mary C White
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Epidemiology and Applied Research Branch, Atlanta, GA, USA
| | - Ashwini Soman
- Information Systems, Northrop Grumman Corporation, Atlanta, GA, USA
| | - Clarice R Weinberg
- Biostatistics Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Juan L Rodriguez
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Epidemiology and Applied Research Branch, Atlanta, GA, USA
| | - Susan A Sabatino
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Epidemiology and Applied Research Branch, Atlanta, GA, USA
| | - Lucy A Peipins
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Epidemiology and Applied Research Branch, Atlanta, GA, USA
| | - Lisa DeRoo
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Hazel B Nichols
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | | | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
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Taber JM, Klein WMP, Suls JM, Ferrer RA. Lay Awareness of the Relationship between Age and Cancer Risk. Ann Behav Med 2017; 51:214-225. [PMID: 27752991 DOI: 10.1007/s12160-016-9845-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Cross-sectional studies suggest many people are unaware that cancer risk increases with age, but this misbelief has rarely been studied prospectively, nor are its moderators known. PURPOSE To assess whether people recognize that cancer risk increases with age and whether beliefs differ according to gender, education, smoking status, and family history of cancer. METHODS First, items from the cross-sectional Health Information National Trends Survey (n = 2069) were analyzed to examine the association of age and perceived cancer risk. Second, the prospective National Survey of Midlife Development in the United States (n = 3896) was used to assess whether perceived cancer risk changes over a decade. Third, beliefs about the age at which cancer occurs were analyzed using the US Awareness and Beliefs about Cancer survey (n = 1080). As a comparator, perceived risk of heart disease was also examined. RESULTS Cross-sectionally, older age was associated with lower perceived cancer risk but higher perceived heart disease risk. Prospectively, perceived cancer risk remained stable, whereas perceived heart attack risk increased. Seventy percent of participants reported a belief that cancer is equally likely to affect people of any age. Across three surveys, women and former smokers/smokers who recently quit tended to misunderstand the relationship between age and cancer risk and also expressed relatively higher perceived cancer risk overall. CONCLUSIONS Data from three national surveys indicated that people are unaware that age is a risk factor for cancer. Moreover, those who were least aware perceived the highest risk of cancer regardless of age.
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Affiliation(s)
- Jennifer M Taber
- Behavioral Research Program, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA
| | - William M P Klein
- Behavioral Research Program, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA.
| | - Jerry M Suls
- Behavioral Research Program, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA
| | - Rebecca A Ferrer
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA
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Scheideler JK, Taber JM, Ferrer RA, Grenen EG, Klein WMP. Heart disease versus cancer: understanding perceptions of population prevalence and personal risk. J Behav Med 2017; 40:839-845. [PMID: 28577198 DOI: 10.1007/s10865-017-9860-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 05/22/2017] [Indexed: 11/30/2022]
Abstract
Although the gap is narrowing, Americans are more likely to be diagnosed with and die from heart disease than cancer, and yet many believe cancer is more common and their personal risk of cancer is higher than their heart disease risk. Using nationally representative 2013 Health Information National Trends Survey data, we assessed such beliefs and examined sociodemographic and psychological factors and health behaviors associated with these beliefs. 42.8% of participants rated cancer as more common and 78.5% rated their own cancer risk as equal to or exceeding their heart disease risk. These misperceptions were only modestly correlated. Beliefs about relative population risk were associated with various psychological factors, whereas beliefs about relative personal risk were not. Both beliefs were inconsistently associated with health behaviors. Accuracy in beliefs about cancer and heart disease relative risk and prevalence is low and future research should explore antecedents and consequences of these beliefs.
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Affiliation(s)
- Jennifer K Scheideler
- National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA.
| | - Jennifer M Taber
- Department of Psychological Sciences, Kent State University, 144 Kent Hall, Kent, OH, 44242, USA
| | - Rebecca A Ferrer
- National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA
| | | | - William M P Klein
- National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA
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Chen Y, Yang Q. How do cancer risk perception, benefit perception of quitting, and cancer worry influence quitting intention among current smokers: A study using the 2013 HINTS. JOURNAL OF SUBSTANCE USE 2017. [DOI: 10.1080/14659891.2016.1271033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Yixin Chen
- Department of Communication Studies, Sam Houston State University, Hunstville, TX, USA
| | - Qinghua Yang
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
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Choi E, Lee YY, Suh M, Park B, Jun JK, Kim Y, Choi KS. Associations of perceived risk and cancer worry for colorectal cancer with screening behaviour. J Health Psychol 2016; 23:840-852. [PMID: 27872387 DOI: 10.1177/1359105316679721] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We investigated the associations of perceived risk and cancer worry with colorectal cancer screening by the faecal occult blood test, colonoscopy or both. This study was based on the 2013 Korean National Cancer Screening Survey, including 2154 randomly selected, cancer-free and over 50-year-old adults. Individuals with higher cancer worry were 1.53 times more likely to undergo colorectal cancer screening, influenced by emotional reaction; individuals with greater perceived risk were 1.61 times more, affected by subjective awareness. However, cancer worry was only associated with the faecal occult blood test. Better understanding of cancer worry and perceived risk on screening behaviours may help to increase colorectal cancer screening rates.
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Affiliation(s)
- Eunji Choi
- 1 Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea
| | - Yoon Young Lee
- 2 National Cancer Control Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - Mina Suh
- 2 National Cancer Control Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - Boyoung Park
- 1 Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea
| | - Jae Kwan Jun
- 2 National Cancer Control Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - Yeol Kim
- 2 National Cancer Control Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - Kui Son Choi
- 1 Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea
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Eismann S, Vetter L, Keller M, Bruckner T, Golatta M, Hennings A, Domschke C, Dikow N, Sohn C, Heil J, Schott S. Long-term experiences with genetic consultation in people with hereditary breast and ovarian cancer. Arch Gynecol Obstet 2016; 294:1011-1018. [DOI: 10.1007/s00404-016-4133-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 06/02/2016] [Indexed: 12/30/2022]
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