Abstract:

Objective To explore the health behavior changes in first-degree relatives（FDRs） of breast cancer（BC） survivors. Methods A multiple embedded case study was adopted，and a total of 21 FDRs of BC survivors were recruited by purpose sampling between January 2020 and July 2021. Data were collected through individual interviews，original documents，and observation. Then，thematic analysis was performed based on case study analysis strategies. Results Health behavior change types included “with intention and condition”，“no intention，with condition”，“with intention，no condition”，and “no intention and condition”. Meanwhile，there were 6 influencing factors，including personal restrictions，exposure，adverse circumstances，coping ability，endorsement from social network，and special events. Based on behavior change types and influence factors，6 hypotheses were drawn and a model of FDRs’ behavior changes for coping with BC risk was developed. Conclusion Healthcare professionals should design targeted interventions based on FDRs’ individual circumstances and help them tilt the model scale to the right by increasing facilitators，reducing barriers，strengthening special events，and improving coping ability，which will ultimately lead to the occurrence of protective behaviors and a reduced risk of BC.

Key words: Breast Neoplasms, Family History, First-Degree Relative, Health Behavior, Case Study, Nursing Care

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。

关键词: 乳腺肿瘤, 家族史, 一级亲属, 健康行为, 个案研究, 护理