中华护理杂志 ›› 2023, Vol. 58 ›› Issue (16): 1932-1939.DOI: 10.3761/j.issn.0254-1769.2023.16.002
收稿日期:
2022-12-08
出版日期:
2023-08-20
发布日期:
2023-08-14
通讯作者:
刘均娥,E-mail:liujune66@163.com作者简介:
陈少华:女,博士,讲师,E-mail:chenshaohua0312@163.com
基金资助:
CHEN Shaohua(), LIU Jun’e(), GUO Dongmei, SU Yali, LIU Yu
Received:
2022-12-08
Online:
2023-08-20
Published:
2023-08-14
摘要:
目的 探索乳腺癌患者一级亲属健康行为改变,为该人群的健康促进和疾病预防提供参考。 方法 采用个案研究法,于2020年1月—2021年7月选择21名在行为改变上存在较大差异的乳腺癌患者一级亲属为个案,基于访谈、文件和观察法收集资料,通过个案研究分析策略和主题分析法分析资料。 结果 乳腺癌患者一级亲属的健康行为改变包括“得心应手型”、“潜移默化型”、“有心无力型”、“依然故我型”4种类型,影响行为改变的因素包括个人限制、暴露因素、不利环境、应对能力、社会支持、关键事件6类。根据上述结果提出6个相关命题假设,构建了乳腺癌患者一级亲属健康行为改变模型。 结论 乳腺癌患者一级亲属的健康行为受较多因素影响,其健康行为改变模型提示医护人员为乳腺癌患者一级亲属提供支持时可从影响行为改变的因素着手,增强有利因素,减少不利因素,促进健康行为往“得心应手”和“潜移默化”方向改变,以降低乳腺癌患病风险。
陈少华, 刘均娥, 郭冬梅, 苏娅丽, 刘宇. 乳腺癌患者一级亲属健康行为改变模型构建的研究[J]. 中华护理杂志, 2023, 58(16): 1932-1939.
CHEN Shaohua, LIU Jun’e, GUO Dongmei, SU Yali, LIU Yu. Study on the theoretical framework of health behavior changes in first-degree relatives of breast cancer survivors[J]. Chinese Journal of Nursing, 2023, 58(16): 1932-1939.
图2 乳腺癌患者一级亲属行为改变影响因素的聚类分析
Figure 2 Cluster analysis of influencing factors of behavior change of health behavior changes in first-degree relatives of breast cancer survivors
表3 乳腺癌患者一级亲属行为改变的命题、关键变量以及变量间关系
Table 3 Propositions, key variables, and relationships between variables of health behavior changes in first-degree relatives of breast cancer survivors
[1] | Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3):209-249. |
[2] |
Global Burden of Disease Cancer Collaboration. Global,regional,and national cancer incidence,mortality,years of life lost,years lived with disability,and disability-adjusted life-years for 29 cancer groups,1990 to 2017:a systematic analysis for the global burden of disease study[J]. JAMA Oncol, 2019, 5(12):1749-1768.
DOI URL |
[3] |
Rudolph A, Chang-Claude J, Schmidt MK. Gene-environment interaction and risk of breast cancer[J]. Br J Cancer, 2016, 114(2):125-133.
DOI |
[4] |
Albright FS, Kohlmann W, Neumayer L, et al. Population-based relative risks for specific family history constellations of breast cancer[J]. Cancer Cause Control, 2019, 30(6):581-590.
DOI PMID |
[5] |
Brewer HR, Jones ME, Schoemaker MJ, et al. Family history and risk of breast cancer:an analysis accounting for family structure[J]. Breast Cancer Res Tr, 2017, 165(1):193-200.
DOI URL |
[6] |
Bevers TB, Ward JH, Arun BK, et al. Breast cancer risk reduction[J]. J Natl Compr Canc Netw, 2015, 13(7):880-915.
DOI URL |
[7] |
Lofterød T, Frydenberg H, Flote V, et al. Exploring the effects of lifestyle on breast cancer risk,age at diagnosis,and survival:the EBBA-Life study[J]. Breast Cancer Res Tr, 2020, 182(1):215-227.
DOI PMID |
[8] |
Bertoni N, de Souza MC, Crocamo S, et al. Is a family history of the breast cancer related to women's cancer prevention behaviors?[J]. Int J Behav Med, 2019, 26(1):85-90.
DOI PMID |
[9] |
Erdoğan E, Tuzcu A. Comparison of mammography behaviors,health beliefs,and fear levels of women with and without familial breast cancer history[J]. Women Health, 2020, 60(7):776-791.
DOI PMID |
[10] | Yin RK. Case study research:design and methods[M]. 5th ed. Thousand Oak, CA: Sage Publications, 2014. |
[11] |
Eisenhardt K. Building theories from case study research[J]. Acad Manage Rev, 1989, 14(4):532-550.
DOI URL |
[12] | 王宁. 个案研究的代表性问题与抽样逻辑[J]. 甘肃社会科学, 2007(5):1-4. |
Wang N. Representative problem and sampling logic of case study[J]. Gansu Soc Sci, 2007(5):1-4. | |
[13] |
Bandura A. Social foundations of thought and action:a social cognitive theory[J]. J Appl Psychol, 1986, 12(1):169.
DOI URL |
[14] |
Ajzen I. The theory of planned behavior[J]. Organ Behav Hum Decis Process, 1991, 50:179-211.
DOI URL |
[15] |
Cummings KM, Jette AM, Rosenstock IM. Construct validation of the health belief model[J]. Health Educ Monogr, 1978, 6:394-405.
DOI PMID |
[16] |
Steven PD, Rogers RW. Protection motivation theory and preventive health:beyond the health belief model[J]. Health Educ Res, 1986, 3:153-161.
DOI URL |
[17] |
Prochaska JO, Velicer WF. The transtheoretical model of health behavior change[J]. Am J Health Promot, 1997, 12:38-48.
DOI PMID |
[18] | 陈向明, 朱晓阳, 赵旭东. 社会科学研究:方法评论[M]. 重庆: 重庆大学出版社, 2006:169-172. |
Chen XM, Zhu XY, Zhao XD. Social science research:methodo-logical review[M]. Chongqing: Chongqing University Press, 2006: 169-172. | |
[19] | Baun V, Clarke V. Using thematic analysis in psychology[J]. Qual Res Psychol, 2006,3,77-101. |
[20] | 陈晓萍, 徐淑英, 樊景立. 组织与管理研究的实证方法[M]. 北京: 北京大学出版社, 2008. |
Chen XP, Xu SY, Fan JL. Empirical methods in organization and management research[M]. Beijing: Peking University Press, 2008. | |
[21] |
Paalosalo-Harris K, Skirton H. Mixed method systematic review:the relationship between breast cancer risk perception and health-protective behaviour in women with family history of breast cancer[J]. J Adv Nurs, 2017, 73(4):760-774.
DOI PMID |
[22] |
Fattahi AM, Salehi-Abargouei A, Sotoudeh A, et al. Do subjec-tive norms predict the screening of cancer patients’ first-de-gree relatives?A systematic review and meta-analysis[J]. Asian Pac J Cancer Prev, 2020, 21(6):1521-1530.
DOI URL |
[23] |
Kırca N, Tuzcu A, Gözüm S. Breast cancer screening behaviors of first degree relatives of women receiving breast cancer treatment and the affecting factors[J]. Eur J Breast Health, 2018, 14(1):23-28.
DOI PMID |
[24] |
黄娜, 周英凤, 李丽, 等. 妊娠期糖尿病孕妇血糖管理行为改变动机的质性研究[J]. 中华护理杂志, 2022, 57(4):389-394.
DOI |
Huang N, Zhou YF, Li L, et al. A qualitative study on the motivation of blood glucose management behavior changes in pregnant women with gestational diabetes mellitus[J]. Chin J Nurs, 2022, 57(4):389-394.
DOI |
|
[25] |
Rabin C, Pinto B. Cancer-related beliefs and health behavior change among breast cancer survivors and their first-degree relatives[J]. Psycho-Oncology, 2006, 15:701-712.
DOI PMID |
[26] |
Mackenzie CR. ‘It is hard for mums to put themselves first’:how mothers diagnosed with breast cancer manage the sociological boundaries between paid work,family and caring for the self[J]. Soc Sci Med, 2014, 117:96-106.
DOI URL |
[27] |
Tahergorabi Z, Mohammadifard M, Salmani F, et al. Breast cancer screening behavior and its associated factors in female employees in South Khorasan[J]. J Educ Health Promot, 2021, 10:102.
DOI PMID |
[28] |
Damghanian M, Mahmoodzadeh H, Khakbazan Z, et al. Self-care behaviors in high-risk women for breast cancer:a randomized clinical trial using health belief model education[J]. J Educ Health Promot, 2020, 9:265.
DOI PMID |
[29] |
Fisher CL, Kastrinos A, Piemonte N, et al. Coping with breast cancer together:challenging topics for mothers and their adolescent-young adult(AYA) daughters[J]. J Psychosoc Oncol, 2021, 40(6),756-769.
DOI URL |
[30] |
Khorsandi B, Khakbazan Z, Mahmoodzadeh HA, et al. Self-efficacy of the first-degree relatives of patients with breast cancer in the prevention of cancer:using the health belief model[J]. J Cancer Educ, 2020, 35(5):977-982.
DOI PMID |
[31] |
宋鹏娟, 刘均娥, 陈少华, 等. 回归家庭干预对乳腺癌术后患者康复效果的影响[J]. 中华护理杂志, 2022, 57(2):133-139.
DOI |
Song PJ, Liu JE, Chen SH, et al. Effect of return-to-family intervention on rehabilitation efficacy of breast cancer patients[J]. Chin J Nurs, 2022, 57(2):133-139.
DOI |
|
[32] |
张薇, 金颖, 徐萍, 等. 多理论模型在健康管理领域应用的研究进展[J]. 中华护理杂志, 2022, 57(15):1893-1898.
DOI |
Zhang W, Jin Y, Xu P, et al. Research progress on the application of Multi-Theory Model for health behavior change in health management[J]. Chin J Nurs, 2022, 57(15):1893-1898.
DOI |
[1] | 顾婕, 马倩云, 高旭, 李惠珍, 孟晓红, 谢双怡, 樊帆, 周意, 曹洁. 前列腺癌术后尿失禁患者康复护理方案的构建及应用[J]. 中华护理杂志, 2023, 58(9): 1029-1036. |
[2] | 薛瑾, 王清, 蒋玲, 程念开, 黄琴, 倪兴梅, 顾肖, 陈怡雷, 夏莲子. ICU患者谵妄管理临床决策支持系统的构建与应用研究[J]. 中华护理杂志, 2023, 58(9): 1037-1042. |
[3] | 方园, 周英凤, 李丽, 邢年路, 陈姝宇, 王娜, 阴传敏. 妊娠期糖尿病非药物管理决策支持系统的构建及应用[J]. 中华护理杂志, 2023, 58(9): 1043-1049. |
[4] | 夏艳玲, 潘文彦, 赵洋洋, 陈志炜, 蔡诗凝, 唐颖嘉, 金喆. 虚拟现实技术在ICU患者早期活动中的应用研究[J]. 中华护理杂志, 2023, 58(9): 1050-1055. |
[5] | 雒晓燕, 崔仁善, 许秀梅, 崔苗苗, 郭玲茹, 周丹. 基于“互联网+”的护理干预对癌症患者疼痛影响的Meta分析[J]. 中华护理杂志, 2023, 58(9): 1056-1062. |
[6] | 徐雪芬, 王红燕, 郭萍萍, 王宇璐, 冯素文. 人工智能在慢性病患者健康管理中的应用进展[J]. 中华护理杂志, 2023, 58(9): 1063-1067. |
[7] | 刘洋, 黄浠婷, 蒋智丽, 王智乾, 陶国芳, 邢美园, 黄丽华. 基于说服系统构建慢性病患者自我管理信息系统的范围综述[J]. 中华护理杂志, 2023, 58(9): 1068-1075. |
[8] | 倪秀梅, 徐凤玲, 陈浩, 宫娟, 章翀, 王翠, 李宝芹, 胡少华. 基于肺部超声的气道廓清方案在ICU机械通气患者中的应用[J]. 中华护理杂志, 2023, 58(9): 1076-1081. |
[9] | 相爽, 王宾, 苗华, 韩荆, 姜京京, 郑文, 严研, 王晓, 公威, 艾辉, 阙斌, 聂绍平, 张立新. 急性冠脉综合征住院患者跌倒风险评估及影响因素分析[J]. 中华护理杂志, 2023, 58(9): 1082-1087. |
[10] | 黄珂瑶, 丁思妍, 周海琴, 蔡英华. 肺移植患者衰弱变化轨迹及影响因素研究[J]. 中华护理杂志, 2023, 58(9): 1088-1095. |
[11] | 黄浩, 焦雨晨, 嵇艳. 三级综合医院急诊科护士置信职业行为指标的构建与验证[J]. 中华护理杂志, 2023, 58(9): 1096-1103. |
[12] | 陈芳, 江智霞, 杨明静, 罗倩, 张霞. 贵州省ICU护理人员对机械通气患者口渴认知及干预行为的调查研究[J]. 中华护理杂志, 2023, 58(9): 1104-1111. |
[13] | 张琦, 陈丽艳, 李媛媛, 张爱华, 杨丽娟. 非创伤性下肢截肢患者生活体验质性研究的Meta整合[J]. 中华护理杂志, 2023, 58(9): 1112-1119. |
[14] | 王利秀, 李建芳, 程红霞, 罗彦, 杨冰香, 刘茜. 造血干细胞移植并发移植物抗宿主病患者皮肤护理的最佳证据总结[J]. 中华护理杂志, 2023, 58(9): 1120-1126. |
[15] | 张若林, 楼妍, 吴婉英, 王春兰, 傅丽英, 周瑶, 洪美容, 徐毓露, 冯欣悦. 癌症患者照顾者角色过渡体验质性研究的Meta整合[J]. 中华护理杂志, 2023, 58(9): 1127-1134. |
阅读次数 | ||||||
全文 |
|
|||||
摘要 |
|
|||||