Modelo de crenças em saúde em familiares de pacientes com câncer colorretal / Health belief model in relatives of colorectal cancer patients

RESUMO

A compreensão dos comportamentos de saúde dos indivíduos a cerca do câncer colorretal (CCR) possibilita o estabelecimento de intervenções que podem aumentar a adesão dos indivíduos a programas de detecção precoce. Objetivou-se nesta tese descrever quatro conceitos do Modelo de Crenças em Saúde (MCS) - ... verificar a associação entre características sociodemográficas, a história familiar de câncer colorretal, com as variáveis do MCS e a preocupação com o câncer; traduzir e validaros questionários Champion's Health Belief Model Scale (CHBMS) e Lerman's Cancer Worry Scale (CWS). ... Participaram da pesquisa familiares de indivíduos com CCR com história familiar registrada no Registro de Câncer Colorretal Hereditário do Hospital A.C. Camargo. ... Observaram-se os seguintes resultados: o alfa de Cronbach da CHBMS variou entre 0,759 e 0,892. A CWS apresentou solução com um fator e alfa de Cronbach de 0,880. Foram entrevistados 125 indivíduos, 51,2% pertencentes a famílias com Síndrome de Lynch. A média da percepção de risco populacional para CCR foi 47,6% e a pessoal 53,9%. Os fatores preditores da percepção de susceptibilidade foram religião, óbito de familiares por câncer, número de familiares com CCR, e recebimento de informações sobre o risco de CCR. ... Foram variáveis preditoras da CWS idade média de diagnóstico de CCR na família, primos com CCR, a as escalas de susceptibilidade, gravidade e barreiras do CHBMS. Concluiu-se que a CHBMS e a CWS são escalas válidas e confiáveis para avaliação do MCS e da preocupação com o câncer; variáveis sociodemográficas e a história familiar de câncer contribuem para o MCS relacionado ao CCR.

ABSTRACT

In order to establish effective interventions to increase early detection programs´ compliance it is necessary to understand health beliefs related to colorectal cancer (CRC). This study aims included to describe four Health Belief Model (HBM) concepts ­ perception of susceptibility, severity, benefits and barriers and cancer worry in individuals with family history of CRC; to verify the association between demographic variables, cancer family history and the HBM variables and cancer worry; to translate and validate into Portuguese the Champion's Health Belief Model Scale (CHBMS) and the Lerman's Cancer Worry Scale (CWS). The CHBMS and the CWS have been translated into Portuguese through a committee technique and changes were suggested by a panel of judges. The participants of this study were relatives of CRC patients (proband) whose cancer family history was included at A.C. Camargo Hospital Hereditary Colorectal Cancer Registry. The proband acquiescence to the study was followed by an indication of their relatives. The approach of the relatives included explanation of the study, acceptance to participate and telephone interview. A questionnaire with sociodemographic characteristics, risk perception and colorectal screening history, and the CHBMS and the CWS was filled out. To validate the CHBMS and CWS, factor analysis and reliability analysis were used. To verify the association between variables, mean test and linear and logistic regression analysis was performed. The following results were observed Cronbach´s alpha of CHBMS scales varied from 0.759 to 0.892. The CWS had one factor solution with a Cronbach´s alpha of 0.880. A hundred and twenty-five individuals were interviewed, 51.2% of them belonged to Lynch Syndrome families. The mean populational risk perception was 47.6% and the personal risk perception was 53.9%. Characteristics that predicted higher perception of susceptibility were religion, death of family members, number of relatives with CRC, previous information regarding CRC risk. Variables that predicted perception of severity were educational level, religion, classification of risk, mean age of CRC diagnosis in family members, cousins with CRC and previous knowledge about colonoscopy procedure. Perception of susceptibility and having children predicted perception of benefits. Variables associated with perception of barriers were educational level, previous screening and perception of severity. Mean age of CRC diagnosis in family members, cousins with CRC, perception of susceptibility, perception of severity and barriers were the variables that predicted cancer worry. The CHMBS and CWS were valid reliable scales to evaluate the HBM and cancer worry in individuals at risk for CRC. Sociodemographic characteristics and family history were associated with HBM variables and cancer worry.