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首页> 外文学位 >Cultural concepts of cancer and mammography uptake and adherence: Lessons from the Haitian breast cancer study.
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Cultural concepts of cancer and mammography uptake and adherence: Lessons from the Haitian breast cancer study.

机译：癌症和乳腺摄影的文化概念以及摄取和依从性：海地乳腺癌研究的经验教训。

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摘要

Introduction. Most accounts of breast cancer burden inequalities emphasize (a) the cost benefit/cost utility of seeking care or (b) equity, including insurance status and other determinants of access. However, these factors do not fully explain racial/ethnic disparities. The purpose of this study was to explore the utility of an alternative explanatory framework---the 'cultural-explanatory model' of illness and health proposed by Kleinman (1978) in predicting appropriate mammography initiation (uptake) and timely continuous use (adherence). This study examines: (1) major themes, differences in cancer concepts between racial/ethnic groups and how these themes differed or paralleled professional concepts particularly the biomedical and (2) the marginal impact of self-reported knowledge on mammography uptake and adherence controlling for health insurance type, provider factors and other structural access barriers.; Design. A multi-ethnic group of 750 women from Eastern Massachusetts: Caucasian (143), Haitian (284), African-American (163) and Caribbean/Latina (160), comprised the sample. The main independent variables were (1) race/ethnicity and (2) measures of self-reported knowledge derived from qualitative analysis of open-ended questions addressing the nature of cancer, its causes, and potential cures. The covariate of interest was health insurance type. The dependent variables were multiple measures of appropriate mammography use, defined as: age at first mammogram (=40 years vs. over 40 years), annual or biennial mammography rate and number of mammograms per decade of life (5 or more). Racial/ethnic group differences in breast cancer knowledge were described using bivariate tests and multivariate logistic regression analyses that explored the main effects of knowledge measures and their interactions in explaining mammography use.; Findings. Important racial/ethnic differences were revealed in major themes about what is cancer, what can cause cancer, and what can cure cancer. Self-reported knowledge of cause remained a significant predictor of mammography adherence and uptake in a multivariate adjustment. In construct health insurance was only a significant predictor of uptake and not adherence.; Conclusion. The Cultural Explanatory Model can improve understanding of racial/ethnic patterns in mammography uptake and adherence. Future studies should explore other knowledge structures, other than the explanatory framework.
机译：介绍。大多数关于乳腺癌负担不平等的说明都强调（a）寻求护理的成本收益/成本效用，或者（b）公平，包括保险身份和其他获取途径的决定因素。但是，这些因素不能完全解释种族/族裔差异。这项研究的目的是探索一种替代性解释框架的作用-Kleinman（1978）提出的疾病和健康的“文化-解释性模型”，用于预测适当的乳房X线照相术（摄取）和及时连续使用（依从性） 。这项研究检查：（1）主要主题，种族/族裔群体之间癌症概念的差异以及这些主题如何与专业概念（尤其是生物医学）有所不同或平行，以及（2）自我报告的知识对乳房X线照片摄取和依从性控制的边际影响健康保险的类型，提供者因素和其他结构性获取障碍。设计。该样本由来自马萨诸塞州东部的750名妇女组成的多种族群体组成：高加索人（143），海地人（284），非裔美国人（163）和加勒比海地区（160）。主要的独立变量是（1）种族/民族和（2）自我报告知识的测度，这些测验是通过对涉及癌症性质，原因和潜在治疗方法的开放性问题的定性分析得出的。利息协变量是健康保险类型。因变量是适当使用乳腺X线摄影的多种测量方法，定义为：第一次乳腺X线摄影的年龄（<= 40岁vs. 40岁以上），每年或每两年一次的乳腺X线摄影率以及每十年的乳腺X线照片数量（5个或更多）。使用双变量检验和多元逻辑回归分析描述了乳腺癌知识中的种族/种族差异，这些知识探讨了知识量度的主要作用及其在解释乳腺X线照相术中的相互作用。发现。在主要主题中揭示了重要的种族/民族差异，即什么是癌症，什么可能导致癌症以及什么可以治愈癌症。自我报告的病因知识仍然是乳房X线照片依从性和摄取量的重要预测因素，可以进行多变量调整。在构造中，健康保险只是摄入量而不是依从性的重要预测指标。结论。文化解释模型可以增进对乳腺摄影摄取和依从性的种族/种族模式的了解。未来的研究应探索除解释性框架以外的其他知识结构。

著录项

  • 作者

    Mutale-Ruwe, Mathilda B.;

  • 作者单位

    Brandeis University, The Heller School for Social Policy and Management.;

  • 授予单位 Brandeis University, The Heller School for Social Policy and Management.;
  • 学科 Sociology Ethnic and Racial Studies.; Health Sciences Health Care Management.
  • 学位 Ph.D.
  • 年度 2006
  • 页码 180 p.
  • 总页数 180
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 民族学;预防医学、卫生学;
  • 关键词

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