Women with a family history of breast cancer are at increased risk for developing the disease. This study investigated the beliefs of women at high risk for breast cancer (one or more first-degree relatives with breast cancer) about their breast cancer risk and the impact of this information on their surveillance behaviors and psychological distress. The Health Belief Model and the Fear Arousing Communications Theory were used in this study. Two hundred and seventeen women, enrolled in a breast protection program, completed a questionnaire regarding health beliefs and behaviors, social support, and psychological distress. While 94% came in for regularly scheduled mammograms, only 69% came in for regular clinical breast examinations. A discriminant function analysis revealed that increased cancer anxiety decreased regular clinical examinations (coefficient = -.65). Only 40% performed breast self-examination monthly, 10% never performed breast self-examination, and 50% did not perform breast self-examination regularly. High breast self-examination performance prior to coming to the program was the best predictor of current breast self-examination, and high anxiety predicted poor adherence to monthly breast self-examination (multiple R = .61). More than 27% of the women at high risk were defined as having a level of psychological distress consistent with the need for counseling. Women reporting more barriers to screening, fewer social supports, and low social desirability had more psychological distress (multiple R = .75). Higher anxiety was directly related to poor attendance at a clinical breast examination and poor adherence to monthly breast self-examination.(ABSTRACT TRUNCATED AT 250 WORDS)

This paper reports on the initial efforts to validate a brief self‐report inventory, the Systems of Belief Inventory(SBI‐15R), for use in quality of life (QOL) and psychosocial research studying adjustment to illness. The SBI‐15R was designed to measure religious and spiritual beliefs and practices, and the social support derived from a community sharing those beliefs. The authors proposed this scale to address the need for greater exploration of spiritual and religious beliefs in QOL, stress and coping research. Phase I: Item generation. The research team identified four domains comprised of 35 items that make up spiritual and religious beliefs and practices. The instrument was piloted in a structured interview format on 12 hospitalized patients with varying sites of cancer. Phase II: Formation of SBI‐54. After these initial efforts, the research team increased the number of items to 54 and adopted a self‐report format. To assess patients' reactions to the questionnaire, the new version was piloted on 50 outpatients with malignant melanoma. Phase III: Initial validation. To begin establishing validation, 301 healthy individuals with no history of cancer or serious illness in the prior year were asked to complete the SBI‐54 and several other instruments. A principal components analysis with varimax rotation of the SBI‐54 identified two factors, in contrast to the four which were hypothesized, one measuring spiritual beliefs and practices, the other measuring social support related to the respondent'rsquo;s religious community. Phase IV: Item reduction of the SBI‐54. A shortened version of the SBI‐54 with 15 items, five from the items identifying factor I and ten from those identifying factor II, was developed to lessen patient burden. The new SBI‐15 correlated highly with the SBI‐54, and demonstrated convergent, divergent, and discriminant validity. Revision of SBI‐15. The investigators rephrased one statement in order to broaden the applicability of the SBI‐15 to patients other than those with a diagnosis of cancer, and to healthy individuals. Discussion. The SBI‐15R met tests of internal consistency, test‐retest reliability, and convergent, divergent, and discriminant validity in both physically healthy and physically ill individuals. The SBI‐15R may have value in measuring religious and spiritual beliefs as a potentially mediating variable in coping with life‐threatening illness, and in the measurement of QOL. © 1998 John Wiley & Sons, Ltd.

In conclusion, MBAT is associated with significant, sustained benefits across a diverse range of breast cancer patients, particularly those with high stress levels.