了解社会经济地位较低男性早期发现前列腺癌的障碍

W. Dale, O. Sartor, T. Davis, C. Bennett
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引用次数: 15

摘要

目的:1998年,前列腺癌在美国造成180 000多例新病例和将近4万例死亡。在少数民族和社会经济地位较低的群体中,死亡率较高,这主要是因为癌症在发病时已处于晚期。了解早期发现前列腺癌的障碍可能有助于减少这些差异。材料和方法:与社会经济地位较低的个体进行32次焦点小组会议,讨论对体检、前列腺癌和保健信息来源的态度。根据使用健康信念模型分析的转录本,确定了早期发现的障碍。结果:大多数社会经济地位较低的男性对体检持消极态度,障碍包括时间、金钱成本、对前列腺检查的负面印象,以及缺乏对早期发现的信念。在少数接受过前列腺检查的男性中,他们通常是作为慢性疾病检查的一部分,或者是因为雇主要求进行例行检查。直肠检查被认为是非常消极的,因为担心身体疼痛,社交尴尬,和不确定的价值。大多数与会者表达了对前列腺癌的恐惧和宿命论。关于保健信息的来源,男子通常从媒体获得保健信息,电视是最常见的来源。在白人和非洲裔美国穷人组成的焦点小组之间,早期检测工作的障碍没有显著差异。结论:健康信念模型为评估社会经济地位较低的男性对前列腺癌早期发现的认知提供了一个框架。对身体检查的负面看法和对早期发现价值的怀疑是早期发现前列腺癌的主要障碍。需要针对这些障碍采取有针对性的战略,以提高社会经济地位较低的男性的早期检出率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Understanding Barriers to the Early Detection of Prostate Cancer Among Men of Lower Socioeconomic Status
Objectives: Prostate cancer accounted for more than 180,000 new cases and almost 40,000 deaths in the United States in 1998. Higher rates of mortality have been noted among racial minorities and lower socioeconomic status groups, primarily because of advanced stage of cancer at presentation. Understanding barriers toward early detection of prostate cancer may help diminish these variations. Materials and Methods: Thirty-two focus group sessions with individuals of lower socioeconomic status addressed attitudes toward physical examinations, prostate cancer, and sources of health-care information. Barriers to early detection were identified, based on transcripts that were analyzed using the Health Belief Model. Results: Most men of lower socioeconomic status viewed physical examinations negatively, with barriers including time, monetary costs, negative impressions of the prostate examination, and lack of belief in early detection. Among the minority of men who had had prostate examinations, they typically did so as part of examinations for chronic medical conditions or because of employer requirements for routine check-ups. The rectal examination was viewed very negatively because of concerns of physical pain, social embarrassment, and uncertain value. Fear and fatalism regarding prostate cancer were expressed by the majority of attendees. With respect to sources of health information, men typically received health-care information from the media, with television being the most common source. No significant differences in barriers to early detection efforts were observed between focus groups composed of white versus African American poor men. Conclusions: The Health Belief Model provides a framework for evaluating the perceptions of men of lower socioeconomic status toward the early detection of prostate cancer. Negative perceptions regarding physical examinations and skepticism about the value of early detection were major barriers to the early detection of prostate cancer. Targeted strategies directed at each of these barriers are needed to improve the rates of early detection in men of lower socioeconomic status.
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