癌症宿命论与教育之间的关系。
The relationship between cancer fatalism and education.
机构信息
Saint Louis University, Saint Louis, MO, USA.
Washington University School of Medicine, Saint Louis, MO, USA.
出版信息
Cancer Causes Control. 2021 Feb;32(2):109-118. doi: 10.1007/s10552-020-01363-4. Epub 2020 Nov 5.
PURPOSE
Fatalism is defined by feelings of pessimism, hopelessness, and powerlessness regarding cancer outcomes. Early researchers reported associations between race and cancer fatalism. Yet current evidence suggests that social determinants of health are better predictors of cancer fatalism than race. Therefore, the aim of this study was to examine the association between age, race, education, and cancer fatalism.
METHODS
Three hundred ninety (n = 390) women who attended a screening mammogram at the Joanne Knight Breast Health Center at Siteman Cancer Center at Washington University School of Medicine (St. Louis, MO) completed the Powe Fatalism Inventory (PFI), a 15-item self-report instrument used to operationalize cancer fatalism. We used Pearson's correlation, independent samples t-tests, one-way ANOVA with post hoc tests, and linear regression to analyze the relationships between PFI total scores and age, race, and education.
RESULTS
There were no differences between the mean PFI scores for Non-Hispanic Whites (1.89, SD 0.55) and African Americans (2.02, SD 0.76, p = 0.092, 95% CI 0.27 to 0.02). We found significant differences between the mean PFI scores across levels of education. Women who attained a high school degree or less (n = 72) reported higher PFI scores (2.24, SD 0.77) than women who attended some college or post-high school vocational training (n = 111; 1.95, SD 0.61) and women with a college or postgraduate degree (n = 206; 1.83, SD 0.57). When PFI score was regressed onto age, race, and education, only education significantly explained fatalism (B = -0.19, p < 0.001).
CONCLUSIONS
In this study, cancer fatalism did not differ between Non-Hispanic White and African American women attending a screening mammogram. However, lower educational levels were associated with higher cancer fatalism. The previously observed associations between race and cancer fatalism may be explained by racial disparities in social determinants of health, such as education. Importantly, study findings indicate that the people with the greatest need for cancer fatalism interventions are those with lower educational levels.
目的
宿命论是指对癌症结果感到悲观、绝望和无力。早期研究人员报告了种族与癌症宿命论之间的关联。然而，目前的证据表明，健康的社会决定因素比种族更能预测癌症宿命论。因此，本研究旨在探讨年龄、种族、教育程度与癌症宿命论之间的关系。
方法
390 名（n=390）在华盛顿大学医学院 Siteman 癌症中心的 Joanne Knight 乳房健康中心接受乳房 X 光筛查的女性完成了 Powe 宿命论量表（PFI），这是一种 15 项自我报告工具，用于操作癌症宿命论。我们使用 Pearson 相关、独立样本 t 检验、单向方差分析和事后检验以及线性回归来分析 PFI 总分与年龄、种族和教育程度之间的关系。
结果
非西班牙裔白人和非洲裔美国人的平均 PFI 评分（非西班牙裔白人 1.89，SD 0.55；非洲裔美国人 2.02，SD 0.76，p=0.092，95%CI 0.27 至 0.02）之间没有差异。我们发现教育程度不同的人群的平均 PFI 评分存在显著差异。完成高中学历或以下学业的女性（n=72）报告的 PFI 评分较高（2.24，SD 0.77），高于接受过一些大学或高中职业培训的女性（n=111；1.95，SD 0.61）和具有大学或研究生学历的女性（n=206；1.83，SD 0.57）。当 PFI 评分回归到年龄、种族和教育程度时，只有教育程度显著解释了宿命论（B=-0.19，p<0.001）。
结论
在这项研究中，参加乳房 X 光筛查的非西班牙裔白人和非洲裔美国女性之间的癌症宿命论没有差异。然而，较低的教育水平与较高的癌症宿命论相关。先前观察到的种族与癌症宿命论之间的关联可能可以通过健康的社会决定因素（如教育）的种族差异来解释。重要的是，研究结果表明，最需要进行癌症宿命论干预的人群是教育程度较低的人群。
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