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Patient participation in treatment decision making and the psychological consequences of breast cancer surgery. 患者参与治疗决策和乳腺癌手术的心理后果。
Pub Date : 1998-01-01
A Moyer, P Salovey

Women in the early stages of breast cancer can be treated effectively with either modified radical mastectomy or tumor excision plus postoperative radiation therapy. Thus, breast cancer patients may be given a choice between these two modes of treatment. In some states, physician disclosure of such treatment alternatives for breast cancer is mandated by law. Despite the belief that patient participation in decision making is beneficial, the evidence is preliminary, although generally supportive. This study examined the extent to which patient participation in the choice of surgical options was related to psychological functioning, fear of cancer recurrence, and aspects of treatment satisfaction 3 and 13 months postoperatively. Few associations with degree of participation in treatment decision making or type of surgical treatment emerged after 3 months. After 13 months, however, women with greater levels of input into their treatment plan were more satisfied with their medical care, although they were not better off in terms of psychological functioning or fear of cancer recurrence. The positive effects of shared treatment decision making may be more closely related to aspects of longer term treatment satisfaction rather than a buffer against psychological distress resulting from breast cancer.

早期乳腺癌妇女可以通过改良根治性乳房切除术或肿瘤切除加术后放射治疗得到有效治疗。因此,乳腺癌患者可以在这两种治疗模式中做出选择。在一些州,法律规定医生必须披露乳腺癌的替代治疗方案。尽管相信患者参与决策是有益的,但证据是初步的,尽管通常是支持的。本研究考察了患者参与手术选择的程度与心理功能、对癌症复发的恐惧以及术后3个月和13个月的治疗满意度有关。3个月后,参与治疗决策的程度或手术治疗的类型很少出现关联。然而,13个月后,对治疗计划投入更多的妇女对她们的医疗护理更满意,尽管她们在心理功能或对癌症复发的恐惧方面并没有好转。共同治疗决策的积极作用可能与长期治疗满意度密切相关,而不是缓解乳腺癌引起的心理困扰。
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引用次数: 0
Provision of mental health services in women's health centers. 在妇女保健中心提供精神保健服务。
Pub Date : 1998-01-01
B Curbow, A J Khoury, C S Weisman

Women's health centers are often associated with a comprehensive model of health care that treats the "whole woman." Using data from a nationwide study of 467 women's health centers, we explored how the ideal of comprehensive care was implemented with respect to mental health services. Specifically, we examined the rates of screening and treatment for a subset of mental health and behavioral and social problems in women's health centers and the structural, staffing, philosophical, and patient factors associated with the provision of services. Across 12 services, the overall rates of provision ranged from 7.7% for screening for dementing disorders to 27.6% for smoking cessation counseling and treatment. In a series of logistic regressions, center type (primary care) and having a mental health staff person were consistently associated with service provision; other important variables were having a high percentage of women using the center as their usual source of care and having a belief in women-centered care. Findings indicate that the majority of women using women's health centers do not receive services in a comprehensive care environment that includes key mental health services.

妇女保健中心通常与治疗“整个女性”的综合保健模式联系在一起。利用来自全国467个妇女健康中心的研究数据,我们探讨了如何在心理健康服务方面实现全面护理的理想。具体来说,我们检查了妇女健康中心对心理健康、行为和社会问题子集的筛查和治疗率,以及与提供服务相关的结构、人员配置、理念和患者因素。在12项服务中,总体提供率从痴呆症筛查的7.7%到戒烟咨询和治疗的27.6%不等。在一系列的逻辑回归中,中心类型(初级保健)和拥有精神卫生工作人员始终与服务提供相关;其他重要的变量是,有很高比例的妇女使用该中心作为她们通常的护理来源,并相信以妇女为中心的护理。调查结果表明,大多数使用妇女保健中心的妇女没有在综合护理环境中获得服务,其中包括关键的心理健康服务。
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引用次数: 0
The promise of a multiple roles paradigm for women's health research. 妇女健康研究的多重角色范式的承诺。
Pub Date : 1998-01-01
R L Repetti
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引用次数: 0
The impact of work-family systems on women's psychological health: an introduction. 工作-家庭制度对妇女心理健康的影响:导论。
Pub Date : 1998-01-01
E M Ozer
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引用次数: 0
Change in job conditions and change in psychological distress within couples: a study of crossover effects. 夫妻工作条件的变化与心理困扰的变化:交叉效应研究。
Pub Date : 1998-01-01
R C Barnett, R T Brennan

In a random sample of 242 full-time employed men and women in dual-earner couples (N = 484), this study estimated the relations between (a) his experiences on the job over time and her distress over time and (b) her experiences on the job over time and his distress over time. In addition, we explored whether the crossover effects were due primarily to experiences with particular job conditions, and whether there were gender differences in the magnitude of these associations. The participants were interviewed 3 times over a 2-year period. After taking into account the relationship between each partner's own job conditions over time and her or his own psychological distress, there were significant associations between both the time-varying and the stable components of each partner's job conditions on the other partner's distress. The findings are discussed within the context of the need to expand the models used to study the job stress-illness relation to include longitudinal and within-couple crossover effects.

在242对双职工家庭的全职男女随机样本中(N = 484),本研究估计了(a)他的工作经历与她的痛苦之间的关系(b)她的工作经历与他的痛苦之间的关系。此外,我们还探讨了交叉效应是否主要是由于特定工作条件的经历,以及这些关联的程度是否存在性别差异。参与者在两年的时间里接受了三次采访。在考虑到每个伴侣自己的工作条件与她或他自己的心理痛苦之间的关系后,每个伴侣的工作条件的时变和稳定成分对另一个伴侣的痛苦都有显著的关联。研究结果在需要扩展用于研究工作压力-疾病关系的模型以包括纵向和夫妻内交叉效应的背景下进行了讨论。
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引用次数: 0
Ten-year prediction of women's drinking behavior in a nationally representative sample. 全国代表性样本中妇女饮酒行为的十年预测。
Pub Date : 1998-01-01
R W Wilsnack, S C Wilsnack, A F Kristjanson, T B Harris

This study evaluates how well women's personal and social characteristics predict their drinking behavior over a 10-year period, using data from a national representative sample of 696 U.S. women interviewed in 1981 and 1991. Interviews obtained data on drinking behavior, personality characteristics, childhood and recent experiences, and perceptions of the social environment. Analyses using paired comparisons, correlations, and linear and logistic regression found that women's alcohol use and its adverse consequences in 1991 were predicted by age, 1981 drinking behavior, and many other aspects of their lives measured 10 years before. Heavier and riskier drinking patterns were associated in particular with adverse childhood experiences, missing interpersonal ties, and expected self-expressive benefits of drinking. However, no variables predicted all patterns of drinking behavior, and specific predictors of different drinking patterns showed little overlap. We conclude that many aspects of women's lives, and particularly their interpersonal relationships, have long-term influences on their drinking behavior, but different patterns of drinking behavior have different antecedents.

这项研究利用1981年和1991年对696名美国女性的全国代表性样本的数据,评估了女性的个人和社会特征在10年期间预测她们饮酒行为的能力。访谈获得了有关饮酒行为、个性特征、童年和近期经历以及对社会环境的感知的数据。使用配对比较、相关性、线性和逻辑回归的分析发现,1991年女性饮酒及其不良后果可以通过年龄、1981年饮酒行为和10年前测量的许多其他生活方面来预测。更严重和更危险的饮酒模式尤其与不良的童年经历、人际关系缺失以及饮酒对自我表达的预期益处有关。然而,没有变量可以预测所有的饮酒行为模式,不同饮酒模式的特定预测指标几乎没有重叠。我们得出的结论是,女性生活的许多方面,尤其是她们的人际关系,对她们的饮酒行为有长期影响,但不同的饮酒行为模式有不同的前因。
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引用次数: 0
The effect of alternative work arrangements on women's well-being: a demand-control model. 替代工作安排对妇女福利的影响:需求控制模式。
Pub Date : 1998-01-01
E K Kelloway, B H Gottlieb

The growth of women's participation in the labor force and evidence of the conflict they experience between job and family demands have spurred many employers to introduce alternative work arrangements such as flextime, job sharing, and telecommuting. Drawing on data gained from a sample of women (N = 998) in two large Canadian organizations, this study evaluates two mediational models of the impact of alternative work arrangements on women's stress and family role competence. Specifically, it tests and finds support for the hypotheses that (a) work arrangements involving scheduling flexibility (telecommuting and flextime) promote these aspects of women's well-being by increasing their perceived control over their time, and (b) arrangements involving reduced hours of employment (part-time employment and job sharing) promote well-being by reducing perceived job overload. Discussion of these findings centers on their implications for employed women, their employers, and future research.

越来越多的女性加入劳动力大军,而且有证据表明她们在工作和家庭需求之间存在冲突,这促使许多雇主引入其他工作安排,如弹性工作时间、工作分担和远程办公。根据加拿大两家大型组织的女性样本(N = 998)的数据,本研究评估了替代工作安排对女性压力和家庭角色能力影响的两种中介模型。具体而言,它检验并支持以下假设:(a)涉及日程安排灵活性(远程办公和弹性工作时间)的工作安排通过增加她们对时间的感知控制来促进妇女福祉的这些方面,以及(b)涉及减少就业时间(兼职就业和工作分担)的安排通过减少感知的工作超负荷来促进福祉。对这些发现的讨论集中在它们对就业女性、雇主和未来研究的影响上。
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引用次数: 0
Substance use and social outcomes among participants in perinatal alcohol and drug treatment. 围产期酒精和药物治疗参与者的物质使用和社会结果
Pub Date : 1998-01-01
G Berkowitz, C Brindis, S Peterson

In recent years comprehensive, woman-centered alcohol and other drug (AOD) treatment programs for pregnant and parenting women have increased in number, despite a scarcity of information about their effectiveness. In response, an evaluation study was undertaken to document the behavioral and social outcome among a sample of women enrolled in AOD treatment through a California network of perinatal treatment services. A sample of 591 women were interviewed shortly before leaving treatment about their pretreatment and current treatment experiences, and 460 of them completed a follow-up interview 6 months later. Areas of positive change observed included reductions in AOD use, maintenance of some kind of treatment contact after discharge from the perinatal treatment program, reductions in criminal activity, and reductions in social problems. These findings suggest that comprehensive programs are effective at promoting recovery and positive social changes for pregnant and parenting women and their children.

近年来,尽管缺乏有关其有效性的信息,但针对孕妇和育儿妇女的以妇女为中心的综合性酒精和其他药物(AOD)治疗方案的数量有所增加。作为回应,通过加利福尼亚围产期治疗服务网络,开展了一项评估研究,记录了参加AOD治疗的妇女样本的行为和社会结果。591名妇女在离开治疗前不久接受了采访,了解了她们的治疗前处理和目前的治疗经历,其中460人在6个月后完成了随访采访。观察到的积极变化领域包括减少使用AOD,从围产期治疗项目出院后保持某种治疗联系,减少犯罪活动,减少社会问题。这些发现表明,综合方案在促进孕妇和育儿妇女及其子女的康复和积极的社会变化方面是有效的。
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引用次数: 0
Naive beliefs about breast cancer risk. 对乳腺癌风险的天真看法。
Pub Date : 1998-01-01
K D McCaul, S M O'Donnell

We examined the beliefs women have about their risk of breast cancer. Participants were 86 women, ages 18 to 90, with and without a family history of breast cancer. They were interviewed individually about their risk and their beliefs about risk factors for breast cancer. The results showed that participants form their risk estimates primarily from the absence or presence of a family history of breast cancer. When asked to compare their risk with the risk of others, only participants without a family history viewed their chances of getting breast cancer as lower than the chances of others. On an absolute risk measure, all participants overestimated their risk. Different risk measures can lead to different conclusions about how women perceive their risk. In addition, the nearly exclusive focus of women on family history may create difficulties for genetic counselors providing information about breast cancer risk.

我们调查了女性对自己患乳腺癌风险的看法。参与者是86名女性,年龄在18岁到90岁之间,有或没有乳腺癌家族史。他们接受了单独的采访,了解他们患乳腺癌的风险以及他们对乳腺癌风险因素的看法。结果显示,参与者的风险估计主要来自于没有或存在乳腺癌家族史。当被要求将自己患乳腺癌的风险与其他人进行比较时,只有没有家族史的参与者认为自己患乳腺癌的几率比其他人低。在绝对风险测量中,所有参与者都高估了他们的风险。不同的风险测量方法可以得出关于女性如何感知自身风险的不同结论。此外,女性几乎只关注家族史,这可能会给遗传咨询师提供有关乳腺癌风险的信息带来困难。
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引用次数: 0
Sexual functioning and intimacy in African American and white breast cancer survivors: a descriptive study. 非裔美国人和白人乳腺癌幸存者的性功能和亲密关系:一项描述性研究。
Pub Date : 1998-01-01
G E Wyatt, K A Desmond, P A Ganz, J H Rowland, K Ashing-Giwa, B E Meyerowitz

This study examines ethnic differences in sexual socialization and attitudes, sexual history and current practices, and the effects of treatment in 147 African American and White breast cancer survivors. Sex-related research in younger healthy populations has shown that cultural values associated with ethnicity influence sexual functioning, but small numbers of African American participants in previous research in breast cancer survivors has limited what we know about that population. In this study, there were few differences between the 2 ethnic groups in a predominantly well-educated, high-income, highly functional sample. However, African American women were significantly less likely to be comfortable with and to practice oral sex, self-touching, and masturbatory behaviors. White women were more likely to report that breast cancer had a negative impact on their sex lives. These differences in sexual repertoire and functioning should be noted by health care practitioners treating the sexual sequelae of breast cancer treatment.

本研究考察了147名非裔美国人和白人乳腺癌幸存者在性社会化和性态度、性史和当前行为以及治疗效果方面的种族差异。对年轻健康人群的性相关研究表明,与种族相关的文化价值观会影响性功能,但在之前对乳腺癌幸存者的研究中,少数非裔美国人参与者限制了我们对该人群的了解。在这项研究中,在主要受过良好教育、高收入、高功能的样本中,两个种族之间的差异很小。然而,非裔美国女性对口交、自我触摸和手淫行为的适应程度明显较低。白人女性更有可能报告说,乳腺癌对她们的性生活有负面影响。在治疗乳腺癌治疗后的性后遗症时,卫生保健从业人员应注意到这些性行为和功能上的差异。
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引用次数: 0
期刊
Women's health (Hillsdale, N.J.)
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