title: Factors associated with breast cancer-specific distress in younger women participating in a family history mammography screening programme.
abstract: This multi-centre study examined factors associated with breast cancer-specific distress in 2321 women under 50 who are on a mammographic screening programme on account of their family history. Women were recruited from 21 UK centres, and completed a questionnaire one month before their screening appointment. The transactional theory of stress, appraisal, and coping provided the theoretical framework for the study. Factors measured included screening history, family history, perceived risk, cognitive appraisals, coping, optimism, and cancer worry. The findings indicate that the majority of women appraise their family history as being relevant and somewhat threatening to personal well-being, but something they can deal with emotionally. Acceptance was the most commonly used coping strategy. Hierarchical regression analysis identified that the factors most significantly associated with distress were an appraisal of high relevance and threat, increased risk perception, low dispositional optimism, and the use of both avoidant and task-orientated coping strategies. Women with children and those with relatives who have died from breast cancer were also more distressed. To conclude, most women appraised their situation positively but there is a potential profile of risk factors which may help clinicians identify those women who need extra psychological support as they progress through screening.
authors.affiliation: Institute of Medical and Social Care Research, Ardudwy, Normal Site, University of Wales, Bangor, Gwynedd LL57 2PX, UK. b.j.henderson@bangor.ac.uk
authors.forename: B J
authors.initials: BJ
authors.lastname: Henderson
authors.forename: S
authors.initials: S
authors.lastname: Tyndel
authors.forename: K
authors.initials: K
authors.lastname: Brain
authors.forename: A
authors.initials: A
authors.lastname: Clements
authors.forename: C
authors.initials: C
authors.lastname: Bankhead
authors.forename: J
authors.initials: J
authors.lastname: Austoker
authors.forename: E
authors.initials: E
authors.lastname: Watson
authors.forename: Stephen
authors.initials: S
authors.lastname: Duffy
authors.forename: Gareth
authors.initials: G
authors.lastname: Evans
authors.forename: Hilary
authors.initials: H
authors.lastname: Fielder
authors.forename: Jonathon
authors.initials: J
authors.lastname: Gray
authors.forename: James
authors.initials: J
authors.lastname: Mackay
authors.forename: Douglas
authors.initials: D
authors.lastname: Macmillan
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005260:Female; D015438:Health Behavior; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D016730:Program Development