A Causal Model of Breast Cancer Preventive Behaviors among Female Relatives of Thais with Breast Cancer

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Aphorn Khamkon
Kanaungnit Pongthavornkamol
Teradech Chai-Aroon
Karin Olson
Adune Ratanawichitrasin
Nantiya Watthayu


                 The purpose of this study was to test the Casual Model of Breast Cancer Preventive Behaviors among 200 first-degree female relatives of Thais with breast cancer. Development of our hypothesized Model was informed by the Health Belief Model and a literature review. A total of 200 relatives of patients receiving treatments at a tertiary care hospital in Bangkok were recruited using convenience sampling. Data collection used six self-administered questionnaires: The Demographic Data Form, Perceived Risk Questionnaire, Impact of Event Scale, Powe Fatalism Inventory, Perceived Self-efficacy Scale, and Health-Promoting Lifestyle Behavior Questionnaire. Descriptive statistics were used to describe the demographic characteristics of the participants, while path analysis was undertaken using AMOS. The results showed that the final Model fitted well with the empirical data of all variables, except the relative breast cancer index, and explained 52% and 49 % of the total variance in breast cancer screening and healthy lifestyles, respectively. Age and education had an indirect effect on these behaviors through breast cancer fatalism, perceived self-efficacy, and perceived risk while breast cancer specific distress had indirect effect only through perceived risk. Breast cancer fatalism had the lowest effect, whereas perceived risk and perceived self-efficacy had the strongest effect on both breast cancer screening and healthy lifestyle. Our findings suggest that nurses should conduct interventions to enhance perceived self-efficacy and perceived risk of breast cancer for motivating these high-risk women to perform regular breast cancer prevention behaviors. Further, longitudinal research to refine our Model with women with a family history of breast cancer is recommended.

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Khamkon A, Pongthavornkamol K, Chai-Aroon T, Olson K, Ratanawichitrasin A, Watthayu N. A Causal Model of Breast Cancer Preventive Behaviors among Female Relatives of Thais with Breast Cancer. PRIJNR [Internet]. 2014 Jan. 8 [cited 2022 Oct. 5];18(1):16-28. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/7401
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Author Biography

Adune Ratanawichitrasin, MD, Associate Professor, Division of Head-Neck and Breast Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand