Coping with appraised threat of breast cancer: Primary prevention coping behaviors utilized by women at increased risk
Diane R Lancaster, RN, PhD
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Breast cancer affects nearly one in nine women and is a leading cause of cancer related deaths among this group. Yet, little is known about how high risk women deal with this health threat. Conceptualized within the Neuman Systems model, the purpose of this study was to examine how women with family histories of breast cancer appraise and cope with their breast cancer risk. Using a descriptive correlational design, a convenience sample of 209 women responded to a mailed questionnaire. Instrument content and construct validity was established and alpha reliabilities ranged from.70 to.93. Ninety percent of the sample perceived their degree of breast cancer risk to be moderate or high. However, women with high and low degrees of appraised threat had low actual breast cancer risk scores, whereas women with moderate degrees of appraised threat tended to have higher actual breast cancer risk scores. Thus, a curvilinear relationship was present and lends partial support to the hypothesized relationship between these variables. The most common and effective coping modes used by at least 50% of the sample were confrontive, optimistic, and early detection behaviors. Over 75% of the sample rated evasive, emotive, palliative, and fatalistic modes of coping as behaviors they did not use and which were ineffective in dealing with this health threat. A significant moderate correlation (r =.41, p $<$.001) was found between a subject's appraised degree of breast cancer risk and the number of general coping behaviors used. Therefore, the higher the degree of threat appraised, the more coping behaviors used. Multiple regression analyses demonstrated that actual and appraised breast cancer risk accounted for only small percentages of variance in coping behaviors. Canonical correlation analyses revealed five different patterns of appraisal and resultant types of coping. The type of coping behaviors used varied with how the breast cancer threat was perceived, thereby supporting the hypothesized relationship between these variables. The knowledge generated from this study can help nurses to assist women at increased risk to maintain optimal levels of health. And, it is an important step in testing a middle range theory derived from the Neuman model.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 9215110; ProQuest document ID: 304003798. The author still retains copyright.
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