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Physical condition, nutritional status, fatigue, and quality of life in oncological out-patients
(2017)
Our aim was to provide data regarding uptake of gynecological early detection measures and performance of breast self-examinations among migrant women in Germany. Cross-sectional self-reported data were collected using paper-and-pencil questionnaires. Descriptive analyses, Chi square-tests, and logistic regression were applied. Results were adjusted for educational level. Of 5387 women, 89.9% were autochthonous, 4.1% German resettlers, 2.8% Turkish, 3.1% other migrants. Participation rates regarding cancer screening differed significantly, with the lowest proportion in Turkish migrants (65.0%), resettlers (67.8%), other migrants (68.2%) and autochthonous population (78.2%). No differences in performance of breast self-examinations were detected. When adjusted for education, results indicated only slight changes in the odds to participate in screening irregularly or not at all. Results support existing evidence by showing lower participation rates in cancer screening among migrant women, but there were no differences regarding breast self-examinations. Migrant women form a potential high-risk group for late-stage diagnosis of cervical or breast cancer.
Background:
The population-based mammography screening program (MSP) is aimed to reduce breast cancer mortality, to detect breast cancer at an early stage, and to allow for less invasive treatment. However, it also has
some potential harms, such as overdiagnosis and overtreatment. Therefore, it is necessary that women receive sufficient and balanced information to enable informed decision-making. We examined knowledge about benefits and harms of the MSP in Germany among first-time invitees of different socio-demographic backgrounds.
Methods:
This observational study assessed knowledge about benefits and harms of the MSP among women who were invited to the MSP for the first time by six multiple choice items, using a postal survey. We investigated (i)
single items of knowledge, (ii) the distribution of sufficient knowledge stratified by education, migration status and
invitation, and (iii) possible determinants of sufficient knowledge by analyzing Odds Ratios (ORs) using bivariate and multivariate logistic regression.
Results:
In total, 5397 women included in the analyses. 46.1% of the study population had sufficient knowledge about benefits and harms of the MSP. However, women with low educational level and migration background had
higher proportions of insufficient knowledge and used most frequently the option “don’t know”. Women had the most difficulties answering the numeric question and the question about the target group correctly. Results from the logistic regression showed that the odds of having sufficient knowledge were higher among well-educated women (OR 3.84, 95%CI 3.24–4.55), among women who already received the MSP invitation (OR 1.38, 95%CI 1.20–1.59) and lowest among Turkish women (OR 0.14, 95%CI 0.07–0.25).
Conclusions:
Women with low education and migration background need adapted information regarding benefits and harms of the MSP and are important target groups for further developing the information material about
mammography screening to reduce disparities in knowledge and enable informed decision-making.
Die positive Wirkung eines gesunden Lebensstils auf die ganz-
heitliche Verfassung und Lebensqualität für Krebspatient*innen
(Cancer Survivors) ist wissenschaftlich belegt. Gemäß den Na-
tional Comprehensive Cancer Network (NCCN) Guidelines for
Survivorship ist Unterstützung in diesem Bereich ausdrücklich
gefordert. Bei hohem Unterstützungsbedarf für die Entwick-
lung und Umsetzung eines gesunden Lebensstils gibt es jedoch,
vor allem in ländlichen Regionen, einen Mangel an spezialisier-
ten Angeboten für Krebspatient*innen. Nach Erfassung der
Bedürfnisse war es unser Ziel, eine leicht zugängliche, multi-
mediale Patienteninformation auf der Basis des sozial-kogniti-
ven Prozessmodells des Gesundheitsverhaltens (Health Action
Process Approach – HAPA), zu konzipieren. Die Anhebung der
Gesundheitskompetenz steht u. a. als Basis für informierte Ent-
scheidungen, und ist damit eine wichtige Ressource für die
Krebsnachsorge. Weiterführende Erhebungen zur Akzeptanz,
Nutzung und Auswirkung der Patienteninformation hinsichtlich
einer angestrebten, längerfristigen Änderung des Gesundheits-
verhaltens sind empfohlen.