Life stress and risk of precancerous cervical lesions: a pretest directed by the life stress model

Oncol Nurs Forum. Jan-Feb 1997;24(1):63-70.

Abstract

Purpose/objectives: To present the results of a pilot study to pretest instruments designed to measure selected variables named in the Life Stress Model, a model of health outcomes. Additional aims were to determine the effect of completing personal risk assessments for precancerous squamous-cell intraepithelial lesions of the cervic (SIL) on receptivity to cervical cancer prevention information and to extend knowledge of stressful life events experienced by inner-city women attending high-risk health clinics.

Design: Cross-sectional.

Sample: 20 adult women attending high-risk prenatal or human immunodeficiency virus (HIV) outpatient clinics in one of two New York City hospitals. Most were recovering drugs abusers; half were diagnosed with HIV infections.

Methods: Data were collected by self-report using standard measures. Demographics, medical histories of immunosuppressive states, and investigator-developed screening inventories of behavioral and dietary risk factors associated with SIL also were administered.

Main research variables: Life event stressors, psychological state, social support, symptom distress, and SIL diagnosis.

Findings: Instruments met acceptable psychometric standards for internal consistency, but the standard measure of stressful life events did not capture the full range of stressors experienced by this group of patients: hovering relatives, abusive spouses, HIV diagnosis, changes in welfare benefits, the HIV status of the unborn, and mandatory foster care. Although unable to recall cancer histories of family members, about half of the women who completed study instruments were interested in receiving more information cervical cancer. Exploratory analyses suggest that women diagnosed with SIL experience more psychological distress and family disfunction than women without SIL.

Conclusions: Completing personal SIL risk assessments may stimulate patients' receptivity to cancer risk factor information. Health outcomes studies guided by the Life Stress Model may prove fruitful.

Implications for nursing practice: Cancer risk factor assessments may be an important method for promoting receptivity to cancer prevention information.

MeSH terms

  • Adult
  • Carcinoma, Squamous Cell / etiology
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / psychology*
  • Cervical Intraepithelial Neoplasia / etiology
  • Cervical Intraepithelial Neoplasia / pathology
  • Cervical Intraepithelial Neoplasia / psychology*
  • Clinical Nursing Research
  • Cross-Sectional Studies
  • Female
  • Humans
  • Life Style
  • Middle Aged
  • Models, Psychological
  • Neuropsychological Tests
  • Pilot Projects
  • Precancerous Conditions / etiology
  • Precancerous Conditions / pathology
  • Precancerous Conditions / psychology*
  • Risk Assessment
  • Risk Factors
  • Social Support
  • Stress, Psychological*
  • Uterine Cervical Neoplasms / etiology
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / psychology*
  • Vaginal Smears