title: Understanding Breast Cancer Survivors' Beliefs and Concerns About Adjuvant Hormonal Therapy: Promoting Adherence.
abstract: Adjuvant hormonal therapy is recommended for women with hormone receptor (HR)-positive breast cancer. Though critical, many patients are non-adherent to this therapy. Few scales have been developed to specifically address beliefs about adjuvant hormonal therapy. This study explores the clarity and relevance of the Beliefs about Medicine Questionnaire (BMQ) in the context of adherence behaviors to hormonal therapy in Black and White breast cancer survivors. We recruited women diagnosed with HR-positive cancer from the Washington, DC, area. An interviewer administered a standardized survey and conducted a cognitive interview. Participants rated the BMQ across three areas: relevance, difficulty, and clarity. We coded whether the comments identified item level issues: limited applicability, unclear reference, unclear perspective, or wording or tone. In-depth interviews were conducted with women who prematurely discontinued hormone therapy. The sample (n = 30) was equally split between Black and White survivors. On average, women were 57.9 years old (SD = 9.0). Overall 77% rated scale as relevant. Cognitive interviews revealed areas of perceived limited acceptability such as the notion of becoming too dependent or the notion of becoming worse if not taking the medication. Women who discontinued hormonal therapy (n = 2) felt ambivalent towards hormonal therapy as they reported having both positive and negative beliefs about the medication. Our study findings suggest new areas for further research and instrument development to accurately measure self-reported beliefs about hormonal therapy by HR-positive breast cancer survivors.
authors.affiliation: Cancer Prevention and Control Program, Department of Oncology, Lombardi Comprehensive Cancer Center, 3300 Whitehaven St., NW Suite 4100, Washington, DC, 20007, USA. ahd28@georgetown.edu.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Hurtado-de-Mendoza
authors.affiliation: Cancer Prevention and Control Program, Department of Oncology, Lombardi Comprehensive Cancer Center, 3300 Whitehaven St., NW Suite 4100, Washington, DC, 20007, USA.
authors.forename: Roxanne E
authors.initials: RE
authors.lastname: Jensen
authors.affiliation: Department of Health Behavior and Policy, Virginia Commonwealth University, School of Medicine, 830 East Main Street, Richmond, VA, 23219, USA.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Jennings
authors.affiliation: Department of Health Behavior and Policy, Virginia Commonwealth University, School of Medicine, 830 East Main Street, Richmond, VA, 23219, USA.
authors.forename: Vanessa B
authors.initials: VB
authors.lastname: Sheppard
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology; D000073116:Cancer Survivors / Q000523:psychology*; D017024:Chemotherapy, Adjuvant; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy* / Q000523:psychology; D010361:Patients / Q000523:psychology*; D011788:Quality of Life; D011795:Surveys and Questionnaires
chemical_list: D018931:Antineoplastic Agents, Hormonal
keywords: Breast cancer; Cognitive interviews; Medication beliefs; Survivors