Page 63 - 2022-28-中国全科医学

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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

乳腺癌是全球范围内女性常见的恶性肿瘤之一 ［1］ 。 析（LCA）是一种以个体为中心的研究方法，可根据条
2020 全球癌症统计报告指出，女性乳腺癌在全球癌症 目作答模式分析其潜在分类，从而关注个体的异质性，
发病率中已跃居第一，中国女性乳腺癌发病谱顺位有上 基于模型和拟合指标鉴别出具有相似特征的潜在亚群，
移趋势且在女性癌症死亡谱上位居第 4 位 ［2-3］ 。乳腺癌 以此来分析防治行为的多样分组特征 ［7］ 。因此，本研
不仅严重影响女性身心健康，同时也给患者及家庭带来 究基于 LCA 对社区女性乳腺癌的防治行为特征及影响
了沉重的经济负担 ［4］ 。相关研究表明，实施一级预防 因素进行分析，旨在为社区医护人员对不同类别人群进
与筛查是降低乳腺癌发病率和死亡率的有效方法 ［5］ ， 行有针对性的健康宣教提供借鉴，促使健康宣教效果达
也是防治行为的重要体现。行为是指判断与决策的过程， 到最大化，提高社区女性乳腺癌防治行为。
其本身是一种复杂的表现，行为不仅是态度的潜在表达， 1 对象与方法
也是导致最终结果的直接因素 ［6］ ，因此，通过提高防 1.1 研究对象 于 2019 年 11 月至 2020 年 8 月，采用
治行为改变社区女性的健康结局尤为重要。但由于个体 便利抽样的方法，选取银川市、中卫市的 5 个县（区）
存在行为异质性，如何做到提供针对性的干预措施，有 内 15 个乡镇 / 街道的社区女性作为此次调查对象。5 个
效提高女性乳腺癌的防治行为仍有待探索。潜在类别分 县（区）分别是兴庆区、西夏区、金凤区、沙坡头区、