Analysis on Cognitive and Behavioral Factors Associated with the Stage of Change on Breast Cancer Screening Behavior among Women in a Community

일부 중년여성의 유방암 수검행동 변화단계와 인지-행동적 요인간의 관련성 분석

  • Kim Young-Bok (Department of Hospital Service Administration, College of Health Science, Seonam University)
  • Published : 2006.06.01

Abstract

Objectives: Recent studies have shown that tailoring to women's individual beliefs and stage of cancer screening adoption increase the probability that cancer screening will ensue. To identify variables associated with cancer screening behavior, many studies for cancer screening have used the Transtheoretical Model(TTM). This study was carried out to identity the cognitive and behavioral factors associated with breast cancer screening by stages of change among women, forties aged. Methods: Building on the TTM constructs, we collected the data to test the association with cognitive and behavioral factors for breast cancer screening by stage of change among women, forties aged (N=232), using the self-reported questionnaire. The stages of change were grouped according to screening participation and intention for breast cancer as precontemplation, contemplation, preparation, action, and maintenance. We found out the association between breast cancer screening and cognitive and behavioral factors, and testified the difference between stages of change by chi-square test, one-way ANOVA, and multiple comparison analysis(Duncan test). Results: Analyses of 232 women showed that participation on mammography was 68.1% within lifetime and 46.1% within last 2 years, and we found out the association with breast cancer screening participation, intention and cognitive-behavioral factors. The stages of change based on participation and intention were different from the decisional balance, the screening attitude, and the self-efficacy(p<0.01). The decisional balance was differ from stages of change because the difference on opinions about pros(positives) and cons(negative) were likely to significant by stages of change(p<0.05, p<0.01). Conclusion: To increase the screening rate for breast cancer, it should be developed the tailored message and recommend guideline. And the tailored message should be designed to increase the pros of breast cancer screening(mammography) and to decrease the cons, and considered the woman's stage of adoption.

Keywords

References

  1. 곽민선, 박은철, 방진영, 성나영, 이지영, 최귀선. 암검진 수검에 영향을 주는 요인. 예방의학회지 2005;38(4):473-481
  2. 보건복지부, 중앙암등록본부. 우리나라 암 발생 통계 요약집 (1999-2001). 2005
  3. 보건복지부. 2001년도 국민건강 영양조사 2002
  4. 보건복지부. 2004년도 국가 암 관리사업 안내. 2004
  5. 보건복지부 .2005년도 국가 암 관리사업 안내. 2005
  6. 성나영, 박은철, 신해림, 최귀선. 국가 암 조기검진 사업 참여에 영향을 미치는 인구사회학적 요인. 예방의학회지 2005;38(1):93-100
  7. 이명순. 예방책 채택과정 (Percaution Adoption Process Model) 모형을 활용한 일반시민들의 암 검진 행태 조사. 가정의학회지 2006;27:49-58
  8. 이혜진, 이선희, 정상혁, 신해림, 오대규. 단계적 행위변화모형을 이용한 자궁경부암 검진행위 관련요인 분석-국가 조기 암검진 대상자들을 중심으로-. 예방의학회지 2005;38(1):82-92
  9. 정인숙, 김윤진, 이장엽, 전진호. 암 조기검진 수검에 대한 자가보고의 타당도와 신뢰도 평가, 가정의학회지 2006;27:302-312
  10. Champion V, Foster JL, Menon U. Tailoring intervention for health behavior change in breast cancer screening. Cancer Practice 1997;5(5):283-288
  11. Champion V, Maraj M, Hui S, Perkings AJ, Tierney W, Menon U, Skinner CS. Comparison of tailored interventions to increase mammography screening in nonadherent older women. Preventive Medicine 2003;36:150-158 https://doi.org/10.1016/S0091-7435(02)00038-5
  12. Crane LA, Leakey TA, Rimer BK, et al. Effectiveness of a telephone outcall intervention to promote screening mammography among low income women. Preventive Medicine 1998;27:S39-S49
  13. Glanz K, Rimer BK, Lewis FM. Health behavior and health education: theory, research, and practice (3rd ed). San Francisco: Jossey-Bass. 2002
  14. Kelaher M, Gillespie AG, Allotey P, Manderson L, Potts H, Sheldrake M, Young M. 'The transtheoretical model and culturally diverse communities in Queensland'. Austrian Ethnic Health 1999;4(4):259-276 https://doi.org/10.1080/13557859998047
  15. Park YJ, Chang SK, Kang HC. Assessing decisional balance toward mammogracphy screening in Korea women. J Korean Acad Nurs 2001;31(7):1174-1180 https://doi.org/10.4040/jkan.2001.31.7.1174
  16. Prochaska JO, Velicer WF, Rossi JS, Goldstein MG, Marcus BH, Rakowski W, et al. Stages of change and decisional balance for 12 problem behaviors. Health Psychology 1994;12:39-46
  17. Rakowski W, Clark MA, Pearlman DN, Ehrich B, Rimer BK, Godstein MG, Cube CE, Woolverton H 'Integrating pros and cons for mammography and pap testing: extending the construct of decision balance to two behaviors'. Preventive Medicine 1997;26:664-673 https://doi.org/10.1006/pmed.1997.0188
  18. Rakowski W, Ehrich B, Goldstein MG, Rimer BK, et al. 'Increasing mammography among women aged 40-74 by use of a stage-matched tailored intervention'. Preventive Medicine 1998;27:748-756 https://doi.org/10.1006/pmed.1998.0354
  19. Rakowski W, Fulton JP, Feldman JP. 'Women's decision making about mammography: a replication of the relationship between stages of adoption and decisional balance'. Health Psychology 1993;12(3):200-214 https://doi.org/10.1037/0278-6133.12.3.200
  20. Stoddard AM, Rimer BK, Lane D, Fox SA, et al. Underusers of mammogram screening: stage of adoption in five U.S. subpopulations. Preventive Medicine 1998;27:478-487 https://doi.org/10.1006/pmed.1998.0310
  21. Thompson B, Coronado GD, Solomon CC, McClerran DF, Neuhouser ML, Feng Z. 'Cancer prevention behavior and socioeconomic status among hispanics and non-hispanic whites in a rural population in the united states' Cancer Causes Control 2002;13(8):719-728 https://doi.org/10.1023/A:1020280427712
  22. Velicer WF, Prochaska JO, Fava JL, Rossi JS, Redding CA, Laforge RG, Robbins ML. 'Using the Transtheoretical Model for population-based approaches to health promotion and disease prevention. Homeostasis in Health and Disease 2000;40:174-195
  23. WHO. National cancer control programmes: polices and managerial guidelines(2nd ed). Geneva: WHO. 2002