DOI QR코드

DOI QR Code

Psychological Impact of Health Risk Appraisal of Korean Women at Different Levels of Breast Cancer Risk: Neglected Aspect of the Web-based Cancer Risk Assessment Tool

  • Kye, Su-Yeon (Cancer Information and Education Branch, National Cancer Center) ;
  • Park, Kee-Ho (Cancer Information and Education Branch, National Cancer Center) ;
  • Park, Hyeong-Geun (Cancer Information and Education Branch, National Cancer Center) ;
  • Kim, Myung-Hyun (Cancer Information and Education Branch, National Cancer Center)
  • Published : 2012.02.29

Abstract

Objective: Health risk appraisal is often utilized to modify individual's health behavior, especially concerning disease prevention, and web-based health risk appraisal services are being provided to the general public in Korea. However, little is known about the psychological effect of the health risk appraisal even though poorly communicated information by the web-based service may result in unintended adverse health outcomes. This study was conducted to explore the psychological effect of health risk appraisal using epidemiological risk factor profile. Methods: We conducted a randomized trial comparing risk factor list type health risk appraisal and risk score type health risk appraisal. We studied 60 women aged 30 years and older who had no cancer. Anxiety level was assessed using the Spielberger State-Trait Anxiety Inventory YZ. Results: The results of multivariate analysis showed that risk status was the independent predictors of increase of state anxiety after health risk appraisal intervention when age, education, health risk appraisal type, numeracy, state anxiety, trait anxiety, and health risk appraisal type by risk status interaction was adjusted. Women who had higher risk status had an odd of having increased anxiety that was about 5 times greater than women who had lower risk status. Conclusions: Our findings indicate that communicating the risk status by individual health risk appraisal service can induce psychological sequelae, especially in women having higher risk status. Hospitals, institutes, or medical schools that are operating or planning to operate the online health risk appraisal service should take side effects such as psychological sequelae into consideration.

Keywords

Risk assessment;breast cancer;risk communication;anxiety

Acknowledgement

Supported by : National Cancer Center

References

  1. Bowen DJ, Patenaude A F, Vernon SW (1999). Psychosocial issues in cancer genetics: from the laboratory to the public. Cancer Epidemiol Biomarkers Prev, 8, 326-8.
  2. Cella D, Hughes C, Peterman A, et al (2002). A brief assessment of concerns associated with genetic testing for cancer: the Multidimensional Impact of Cancer Risk Assessment (MICRA) questionnaire. Health Psychol, 21, 564-72. https://doi.org/10.1037/0278-6133.21.6.564
  3. Colditz GA, Atwood KA, Emmons K, et al (2000). Harvard report on cancer prevention volume 4: Harvard Cancer Risk Index. Risk Index Working Group, Harvard Center for Cancer Prevention. Cancer Causes Control, 11, 477- 88. https://doi.org/10.1023/A:1008984432272
  4. Croyle R, Smith K, Botkin J, et al (1997). Psychological responses to BRCA1 mutation testing: preliminary findings. Health Psychol, 16, 63-72. https://doi.org/10.1037/0278-6133.16.1.63
  5. Cull A, Anderson ED, Campbell S, et al (1999). The impact of genetic counselling about breast cancer risk on women's risk perceptions and levels of distress. Br J Cancer, 79, 501-8. https://doi.org/10.1038/sj.bjc.6690078
  6. Doerr BT, Hutchins EB (1981). Health risk appraisal: process, problems, and prospects for nursing practice and research. Nurs Res, 30, 299-306.
  7. Edwards A, Unigwe S, Elwyn G (2003). Effects of communicating individual risks in screening programmes: Cochrane systematic review. BMJ, 327, 703-9. https://doi.org/10.1136/bmj.327.7417.703
  8. Gail MH, Brinton LA, Byar DP, et al (1989). Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst, 81, 1879-86. https://doi.org/10.1093/jnci/81.24.1879
  9. Hahn D, Lee C, Chen K, et al (1999). The Korean adaptation of the State-Trait Depression Inventory: STDIK. Korean J Health Psychology, 3, 1-14.
  10. Lerman C, Croyle R (1994). Psychological issues in genetic testing for breast cancer susceptibility. Arch Intern Med, 154, 609-16. https://doi.org/10.1001/archinte.1994.00420060027003
  11. Lerman C, Lustbader E, Rimer B, et al (1995). Effects of individualized breast cancer risk counseling: a randomized trial. J Natl Cancer Inst, 87, 286. https://doi.org/10.1093/jnci/87.4.286
  12. Lerman C, Rimer BK, Engstrom PF (1991). Cancer risk notification: psychosocial and ethical implications. J Clin Oncol, 9, 1275-82. https://doi.org/10.1200/JCO.1991.9.7.1275
  13. Mahon SM, Casperson DS (1995). Hereditary cancer syndrome: Part 2.--Psychosocial issues, concerns, and screening--results of a qualitative study. Oncol Nurs Forum, 22, 775-82.
  14. Park K, Chang SJ, Kim HC, et al (2009). Big gap between risk perception for breast cancer and risk factors: nationwide survey in Korea. Patient Educ Couns, 76, 113-9. https://doi.org/10.1016/j.pec.2008.12.015
  15. Park K, Choi K, Kye S, et al (2010). Unwanted effects of risk notification for breast cancer regarding intention toward mammography utilization. Psychooncology, 19, 823-9.
  16. Ponder BA (1994). Setting up and running a familial cancer clinic. Br Med Bull, 50, 732-45. https://doi.org/10.1093/oxfordjournals.bmb.a072921
  17. Spielberger C, Luschene R (1970). Manual for the State-Trait Anxiety Interview(Self-Evaluation Questionnaire). Palo Alto: Consulting Psychologists Press.
  18. Thompson JA, Wiesner GL, Sellers TA, et al (1995). Genetic services for familial cancer patients: a survey of National Cancer Institute cancer centers. J Natl Cancer Inst, 87, 1446-55. https://doi.org/10.1093/jnci/87.19.1446
  19. Vogel VG, Yeomans A, Higginbotham E (1993). Clinical management of women at increased risk for breast cancer. Breast Cancer Res Treat, 28, 195-210. https://doi.org/10.1007/BF00666431
  20. Wagner EH, Beery WL, Schoenbach VJ, et al (1982). An assessment of health hazard/health risk appraisal. Am J Public Health, 72, 347-52. https://doi.org/10.2105/AJPH.72.4.347
  21. Waters EA, Sullivan HW, Nelson W, et al (2009). What is my cancer risk? How internet-based cancer risk assessment tools communicate individualized risk estimates to the public: content analysis. J Med Internet Res, 11, e33. https://doi.org/10.2196/jmir.1222
  22. Yeomans AC (1990). Hereditary cancer syndromes: implications for practice. Dimens Oncol Nurs, 4, 17-26.

Cited by

  1. Development of a risk assessment tool for projecting individualized probabilities of developing breast cancer for Chinese women vol.35, pp.11, 2014, https://doi.org/10.1007/s13277-014-1967-0