中国全科医学 ›› 2022, Vol. 25 ›› Issue (28): 3515-3522.DOI: 10.12114/j.issn.1007-9572.2022.0477

所属专题: 女性健康最新文章合集

• 论著·人群健康研究 • 上一篇    下一篇

社区女性乳腺癌防治行为的潜在类别及其影响因素研究

马佳慧1, 刘国莲1,*(), 郑连花2, 白亚茹1, 买娟娟1, 姚文莲1   

  1. 1750004 宁夏回族自治区银川市,宁夏医科大学护理学院
    2364000 福建省龙岩市第一医院神经内科
  • 收稿日期:2022-07-01 修回日期:2022-07-30 出版日期:2022-10-05 发布日期:2022-08-18
  • 通讯作者: 刘国莲
  • 马佳慧,刘国莲,郑连花,等.社区女性乳腺癌防治行为的潜在类别及其影响因素研究[J].中国全科医学,2022,25(28):3515-3522,3530.[www.chinagp.net]
    作者贡献:马佳慧、刘国莲负责文章的设计;郑连花、白亚茹、买娟娟负责数据的收集与整理;马佳慧负责数据的分析及论文的撰写;马佳慧、刘国莲、姚文莲负责论文的质量控制及审校。
  • 基金资助:
    宁夏回族自治区重点研发计划项目(2019BEG03020)

Breast Cancer Prevention and Treatment Behaviors in Community-living Women: Latent Class Analysis and Influencing Factors

Jiahui MA1, Guolian LIU1,*(), Lianhua ZHENG2, Yaru BAI1, Juanjuan MAI1, Wenlian YAO1   

  1. 1School of Nursing, Ningxia Medical University, Yinchuan 750004, China
    2Neurology Department, Longyan First Hospital, Longyan 364000, China
  • Received:2022-07-01 Revised:2022-07-30 Published:2022-10-05 Online:2022-08-18
  • Contact: Guolian LIU
  • About author:
    MA J H, LIU G L, ZHENG L H, et al. Breast cancer prevention and treatment behaviors in community-living women: latent class analysis and influencing factors[J]. Chinese General Practice, 2022, 25 (28) : 3515-3522, 3530.

摘要: 背景 我国乳腺癌发病率整体呈上升趋势,严重威胁着女性的身心健康。提高女性乳腺癌防治行为是改变社区女性健康结局的重要手段,但个体行为存在异质性,如何有效提高其防治行为有待探索。 目的 了解社区女性乳腺癌防治行为的潜在类别及其影响因素,为社区女性乳腺癌防治提供针对性的干预措施。 方法 于2019年11月至2020年8月,采用便利抽样的方法,选取银川市、中卫市的5个县(区)内15个乡镇/街道的1 355例社区女性为调查对象。本研究所用调查问卷包括基本情况和"宁夏地区妇女'两癌’防治知信行现况调查问卷"中的乳腺癌防治行为部分。基于调查结果对社区女性乳腺癌防治行为进行潜在类别分析,进而采用多项Logistic回归分析影响社区女性乳腺癌防治行为类别的因素。 结果 共回收有效问卷1 327份(97.93%)。潜在类别分析结果显示,1 327例社区女性根据乳腺癌防治行为可分为防治行为积极组522例(39.34%)、高危行为-就医积极组449例(33.83%)、高危行为-就医消极组229例(17.26%)、防治行为一般组127例(9.57%)4个类别。社区女性乳腺癌防治行为总中位得分为9.00(7.00,11.00)分。其中防治行为积极组中位得分为11.00(11.00,12.00)分,高危行为-就医积极组中位得分为9.00(8.00,10.00)分,高危行为-就医消极组中位得分为6.00(5.00,6.00)分,防治行为一般组中位得分为8.00(6.00,9.00)分,四组比较,差异有统计学意义(H=1 008.493,P<0.001)。多项Logistic回归分析结果显示,防治行为积极组与防治行为一般组相比,所在市为中卫市、已生育者更容易归为防治行为积极组,医保类型为城乡居民基本医疗保险、商业保险、自费及其他,已接受过激素替代治疗者更容易归为防治行为一般组(P<0.05);高危行为-就医积极组与防治行为一般组相比,已生育者更容易归为高危行为-就医积极组,医保类型为城乡居民基本医疗保险及商业保险、已接受过激素替代治疗者更容易归为防治行为一般组(P<0.05);高危行为-就医消极组与防治一般组相比,文化程度为小学及以下、家庭人均月收入为1 000~2 999元者更容易归为高危行为-就医消极组,医保类型为城乡居民基本医疗保险者更容易归为防治行为一般组(P<0.05)。 结论 社区女性乳腺癌防治行为具有明显的分类特征,其防治行为处于中等水平,社区应重点关注高危行为-就医消极组人群,对防治行为积极组、高危行为-就医积极组以及防治行为一般组也应针对存在的问题进行相应的干预,提高宁夏社区女性乳腺癌防治行为。

关键词: 乳腺肿瘤, 潜在类别分析, 防治行为, 社区卫生服务, 影响因素分析

Abstract:

Background

The overall incidence of breast cancer in Chinese women is on the rise, seriously threatening their physical and mental health. Breast cancer prevention and treatment behaviors are critical to the outcomes of affected women in the community. However, these behaviors vary across individuals. And measures should be explored to improve the efficacy of such behaviors.

Objective

To perform a latent class analysis of breast cancer prevention and treatment behaviors among community-living women, and to explore the associated factors, providing evidence for individualized prevention and management of female breast cancer in the community.

Methods

A total of 1 355 community-living women were selected from in 15 towns/subdistricts of 5 counties/districts in Yinchuan and Zhongwei cities of Ningxia, China by use of convenience sampling method from November 2019 to August 2020. They were surveyed using a questionnaire consisting of baseline characteristics, and breast cancer prevention and treatment behaviors (relevant questions used are belonging to the part of breast cancer prevention and treatment in the Knowledge, Attitude and Practice of Breast and Cervical Cancer Prevention and Treatment Among Women in Ningxia) . The latent classes of breast cancer prevention and treatment behaviors were presented, and their influencing factors were identified by multivariable logistic regression analysis.

Results

The survey achieved a response rate of 97.93% (1 327/1 355) .By use of latent class analysis, breast cancer prevention and treatment behaviors of the respondents were classified into four latent classes, including positive prevention and treatment (n=522, 39.34%) , high-risk behaviors plus positive treatment (n=449, 33.83%) , high-risk behaviors plus negative treatment (n=229, 17.26%) , and general prevention and treatment (n=127, 9.57%) . The overall median score of breast cancer prevention and treatment behaviors was 9.00 (7.00, 11.00) points for all respondents. The median score of breast cancer prevention and treatment behaviors was 11.00 (11.00, 12.00) points for respondents with positive prevention and treatment behaviors, 9.00 (8.00, 10.00) points for those with high-risk behaviors plus positive treatment behaviors, 6.00 (5.00, 6.00) points for those with high-risk behaviors plus negative treatment behaviors, and 8.00 (6.00, 9.00) points for those with general prevention and treatment behaviors, with significant difference across the groups (H=1 008.493, P<0.001) . Multivariable Logistic regression analysis showed that, compared with general prevention and treatment behaviors, living in Zhongwei and having a history of childbirth were associated with increased possibility of being classified into positive prevention and treatment behaviors, having health insurance〔urban resident basic medical insurance (URBMI) , commercial health insurance, or other types〕, self-pay treatment, and a history of hormone replacement therapy were associated with increased possibility of being classified into general prevention and treatment behaviors (P<0.05) , having a history of childbirth were associated with increased possibility of being classified into high-risk behaviors plus positive treatment behaviors, having health insurance (URBMI or commercial health insurance) , as well as a history of hormone replacement therapy were associated with increased possibility of being classified into general prevention and treatment behaviors (P<0.05) , and primary education or below, household monthly income per person of 1 000-2 999 yuan were associated with increased possibility of being classified into high-risk behaviors plus negative treatment behaviors, and having URBMI were associated with increased possibility of being classified into general prevention and treatment behaviors (P<0.05) .

Conclusion

In general, breast cancer prevention and treatment behaviors in this group could be definitely classified, all being performed at a moderate level. To improve the level of breast cancer prevention and treatment behaviors of Ningxia's community-living women, focus should be on those who have high-risk behaviors and negatively seek for treatment. Moreover, the problems in positive breast cancer prevention and treatment behaviors in women with other three classes of behaviors should also be intervened and corrected to improve the outcomes of them.

Key words: Breast neoplasms, Latent class analysis, Prevention and treatment behavior, Community health services, Root cause analysis