IntroductionBreast cancer has now b

Introduction
Breast cancer has now become the most
common cancer and a leading cause of death among
Thai women.1
Although the etiology of breast cancer
remains unknown, one of the risks for this is a family
history of the disease.2 The risk of women with family
history of breast cancer (FHBC) developing this
condition is two to four times higher than those
women without a family history.3 Furthermore,a study in Thailand found that approximately 3.5%
of all cases and 1.6 % of control patients reported
a history of breast cancer in mothers or sisters which
was consistent with studies conducted in the developed
world.4 Although breast cancer is currently incurable,
there is evidence that survival rate can be improved if
breast cancer is detected early.2
Besides, the healthy
lifestyles such as maintaining healthy weight, staying
physically active throughout life, stopping alcohol
consumption, and maintaining a healthy diet can
substantially reduce one’s lifetime risk of developing
cancer.5
Literature related to breast cancer preventive
behaviors (BCPB) reveals that women with a FHBC
who perceive themselves to be at high risk for the
disease are more likely to engage in appropriate
screening behaviors and physical activity than those
without such a family history.6, 7 In addition, women
who perceive self-efficacy in relation to BCPB are
more likely to perform these behaviors than those
who do not perceive self-efficacy,8 and as well cultural
factors also may have an influence. Furthermore,
previous studies have found breast cancer-specific
distress to be more likely to occur in women with
FHBC than those without this.9
Older women with
high education attainments are more likely to engage
in such behaviors than younger women with lower
education attainments.10 Moreover, factors involved
in the relative breast cancer index, such as age at onset,
time at cancer diagnosis, the number and type of
relatives with breast cancer have been found to affect
BCPB.11
Although evidence has shown the great benefits
of regular breast cancer screening and increasing
healthier lifestyles, regular screening is underused among
high-risk women including women with a FHBC.12
In Thailand, studies reporting women with family
history of breast cancer who practice regular breast
self-examination (BSE) are rather low at approximately
21%.13,14 Many women are unaware of the associations
between healthy lifestyle behaviors and breast cancer
risks.15 According to previous studies demonstrating
the relationships among those factors and BCPB,
how those factors work to affect such behaviors has
not been clearly delineated. Thus, this study was designed
to test a causal model of factors influencing BCPB to
guide nursing interventions focusing on breast cancer
screening and healthy lifestyle behaviors.
Conceptual Framework and Literature
Review
The conceptual framework of this study was
based on the Health Belief Model (HBM) and literature
related to BCPB among women with a FHBC. HBM
has been one theory frequently used to explain cancer
prevention behaviors. According to the HBM, individuals
are more likely to take action toward preventing or
detecting ill health if they: (1) feel susceptible to
a specific condition; (2) perceive the severity of
that condition and (3) believe their actions will be
beneficial with few barriers.16 The HBM and recent
modifications of this theorize that five factors are
related to the performance of a surveillance behavior,
namely; perceived seriousness of the disease, perceived
susceptibility to the disease, perceived benefits of
engaging in the surveillance behavior, perceived
barriers to engaging in the behavior and confidence in
correctly performing the surveillance behavior to
maximize its utility.17
The literature on the relationship and factors
influencing BCPB shows that women with a family
history are at least aware of their increased risk.18
Women assigned a high relative risk for breast cancer
often seek information to alleviate risk through screening
and breast cancer preventive behaviors.19 The findings
of one qualitative study provided evidence that breast
cancer risk was perceived to be greatly influenced by
family history.20 Women with high risks for developing
breast cancer are more likely to perceive their risk for
developing the disease and more motivated to participate in breast cancer screening programs.6,21
and to engage in regular physical activity.7
Moreover,
women who report confidence in their ability to
perform BSE are more likely to practice this regularly.
Consistently, a study by Quach22 revealed that perceived
self-efficacy predicted health behaviors. Another
factor influencing BCPB among female relatives of
breast cancer patients is fatalism, a complex phenomenon
with potentially far-reaching implications for health
behaviors. Cancer fatalism has been identified as a
barrier to partic

ผลลัพธ์ (ไทย) 1:

IntroductionBreast cancer has now become the mostcommon cancer and a leading cause of death amongThai women.1 Although the etiology of breast cancerremains unknown, one of the risks for this is a familyhistory of the disease.2 The risk of women with familyhistory of breast cancer (FHBC) developing thiscondition is two to four times higher than thosewomen without a family history.3 Furthermore,a study in Thailand found that approximately 3.5%of all cases and 1.6 % of control patients reporteda history of breast cancer in mothers or sisters whichwas consistent with studies conducted in the developedworld.4 Although breast cancer is currently incurable,there is evidence that survival rate can be improved ifbreast cancer is detected early.2 Besides, the healthylifestyles such as maintaining healthy weight, stayingphysically active throughout life, stopping alcoholconsumption, and maintaining a healthy diet cansubstantially reduce one’s lifetime risk of developingcancer.5Literature related to breast cancer preventivebehaviors (BCPB) reveals that women with a FHBCwho perceive themselves to be at high risk for thedisease are more likely to engage in appropriatescreening behaviors and physical activity than thosewithout such a family history.6, 7 In addition, womenwho perceive self-efficacy in relation to BCPB aremore likely to perform these behaviors than thosewho do not perceive self-efficacy,8 and as well culturalfactors also may have an influence. Furthermore,previous studies have found breast cancer-specificdistress to be more likely to occur in women withFHBC than those without this.9 Older women withhigh education attainments are more likely to engagein such behaviors than younger women with lowereducation attainments.10 Moreover, factors involvedin the relative breast cancer index, such as age at onset,time at cancer diagnosis, the number and type ofrelatives with breast cancer have been found to affectBCPB.11Although evidence has shown the great benefitsof regular breast cancer screening and increasinghealthier lifestyles, regular screening is underused amonghigh-risk women including women with a FHBC.12In Thailand, studies reporting women with familyhistory of breast cancer who practice regular breastself-examination (BSE) are rather low at approximately21%.13,14 Many women are unaware of the associationsbetween healthy lifestyle behaviors and breast cancerrisks.15 According to previous studies demonstratingthe relationships among those factors and BCPB,how those factors work to affect such behaviors hasnot been clearly delineated. Thus, this study was designedto test a causal model of factors influencing BCPB toguide nursing interventions focusing on breast cancerscreening and healthy lifestyle behaviors.Conceptual Framework and LiteratureReviewThe conceptual framework of this study wasbased on the Health Belief Model (HBM) and literaturerelated to BCPB among women with a FHBC. HBMhas been one theory frequently used to explain cancerprevention behaviors. According to the HBM, individualsare more likely to take action toward preventing ordetecting ill health if they: (1) feel susceptible toa specific condition; (2) perceive the severity ofthat condition and (3) believe their actions will bebeneficial with few barriers.16 The HBM and recentmodifications of this theorize that five factors arerelated to the performance of a surveillance behavior,namely; perceived seriousness of the disease, perceivedsusceptibility to the disease, perceived benefits ofengaging in the surveillance behavior, perceivedbarriers to engaging in the behavior and confidence incorrectly performing the surveillance behavior tomaximize its utility.17The literature on the relationship and factorsinfluencing BCPB shows that women with a familyhistory are at least aware of their increased risk.18Women assigned a high relative risk for breast canceroften seek information to alleviate risk through screeningand breast cancer preventive behaviors.19 The findingsof one qualitative study provided evidence that breastcancer risk was perceived to be greatly influenced byfamily history.20 Women with high risks for developingbreast cancer are more likely to perceive their risk fordeveloping the disease and more motivated to participate in breast cancer screening programs.6,21และ เข้าร่วมใน activity.7 ทางกายภาพปกติ นอกจากนี้ผู้หญิงที่รายงานความมั่นใจในความสามารถในการทำ BSE มีแนวโน้มที่จะฝึกเป็นประจำอย่างสม่ำเสมอ การศึกษา Quach22 โดยเปิดเผยที่รับรู้ประสิทธิภาพในตนเองคาดการณ์พฤติกรรมสุขภาพ อื่นปัจจัยที่มีอิทธิพลต่อ BCPB ในหมู่ญาติพี่น้องหญิงของผู้ป่วยมะเร็งเต้านมเป็นปรากฏการณ์ที่ซับซ้อน คร่วมมีผลกระทบอาจจุใจสำหรับสุขภาพพฤติกรรมการ พบมะเร็งคร่วมเป็นการให้ความระมัดระวัง