Abstract
A cancer diagnosis signals entry for many patients into the complex and often bewildering world of cancer care. Understanding the role women prefer and their level of satisfaction with the decision-making process at time of diagnosis will help to inform healthcare professionals how to better support breast cancer patients as they navigate the cancer journey. Logistic regression was used to identify significant factors influencing outcomes in role preferences and satisfaction. A complementary method, principal components analysis was used to explore patterns of co-association between outcomes and their influencing factors. Results showed women tended to adopt cancer decision-making roles similar to those used for general health decision-making. Overall, women preferred a collaborative/active role (40/38%) over a passive role (16%). Satisfaction rates were high with 88.1% of women being satisfied/very satisfied with their cancer treatment choice; 89.7% of women satisfied with their decision-making role and; 83.6% satisfied with the information provided to support their decision. Further research involving cohorts of women diagnosed with more advanced disease and for whom decisional regret may be greater, is needed to further explore the link between preferred decision-making role and satisfaction.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Balneaves LG, Long B (1999) An embedded decisional model of stress and coping: implications for exploring treatment decision making by women with breast cancer. J Adv Nurs 30(6):1321–1331
Blanchard CG, Labrecque MS, Ruckdeschel JC, Blanchard EB (1988) Information decision-making preferences of hospitalized adult cancer patients. Soc Sci Med 27(11):1139–1145
Braddock CH III, Edwards KA, Hasenberg NM, Laidley TL, Levinson W (1999) Informed decision making in outpatient practice: time to get back to basics. JAMA 282(24):2313–2320
Bruera E, Willey JS, Palmer JL, Rosales M (2002) Treatment decisions for breast carcinoma: patient preferences and physician perceptions. Cancer 94(7):2076–2080
Cassileth BR, Heiberger RM, March V, Sutton-Smith K (1980) Information seeking and participation preferences among cancer patients. Ann Intern Med 92(6):832–836
Deber RB, Kraetschmer N, Irvine J (1996) What role do patients wish to play in treatment decision making? Arch Intern Med 156:1414–1420
Degner LF, Sloan JA (1992) Decision-making during serious illness: what role do patients really want to play? J Clin Epidemiol 45(9):941–950
Degner LF, Kristjanson LJ, Bowman D, Sloan JA, Carriere KC, O’Neil J, Bilodeau B, Watson P, Mueller B (1997) Information needs and decisional preferences in women with breast cancer. JAMA 277(18):1485–1492
Fallowfield L (1997) Offering choice of surgical treatments to women with breast cancer. Patient Educ Couns 30(3):209–214
Hewitt M, Breen N, Devesa S (1999) Cancer prevalence and survivorship issues. Analyses of the 1992 National health Interview Survey. J Natl Cancer Inst 91:1480–1486
Johnson JD, Roberts CS, Cox CE, Rientgen DS, Levine JS, Parsons M (1996) Breast cancer patients’ personality style, age and treatment decision-making. J Surg Oncol 63(3):183–186
Keating NL, Guadagnoli E, Landrum MB, Borbas C, Weeks JC (2002) Treatment decision making in early-stage breast cancer: should surgeons match patients’ desired level of involvement? J Clin Oncol 20(6):1473–1479
Legendre P, Legendre L (1998) Numerical ecology. Amsterdam, Elsevier
Manly B (1986) Multivariate statistical methods: a primer. Chapman and Hall, New York
Mastaglia B, Kristjanson LJ (2001) Factors influencing women’s decisions for choice of surgery for Stage I and Stage II breast cancer in Western Australia. J Adv Nurs 35(6):836–847
Mellink WAM, Dulmen AM, Wiggens T, Spreeuwenberg PMM, Eggermont AMM, Bensing JM (2003) Cancer patients seeking a second surgical opinion: results of a study on motives, needs and expectations. J Clin Oncol 21:1492–1497
O’Connor AM (1995) Validation of a decisional conflict scale. Med Decis Making 15(1):25–30
Petrisek AC, Laliberte LL, Allen SM, Mor V (1997) The treatment decision-making process: age differences in a sample of women recently diagnosed with non-recurrent early stage breast cancer. Gerontologist 37(5):598–608
Sainio C, Eriksson E, Lauri S (2001) Patient participation in decision-making about care. Cancer Nurs 24(3):172–179
Scarth H, Cantin J, Levine M (2002) Clinical practice guidelines for the care and treatment of breast cancer: mastectomy or lumpectomy? The choice of operation for clinical stages I & II breast cancer (summary of the 2002 update). CMAJ 167(2):154–155
Schou I, Ekeberg O, Ruland CM, Karesen R (2002) Do women newly diagnosed with breast cancer and consulting surgeon asses decision-making equally? Breast 11(5):434–441
Siminoff LA, Fetting JH, Abeloff MD (1989) Doctor–patient communication about breast cancer adjuvant therapy. J Clin Oncol 7(9):1192–1200
Smith L (2002) A tutorial on principal components analysis
Acknowledgements
The authors would like to thank the Canadian Breast Cancer Foundation: Atlantic Chapter for funding support to undertake the study and the Surveillance and Epidemiology Unit, Cancer Care Nova Scotia for analytic and administrative support. Further, our sincere appreciation to all the Nova Scotia breast cancer patients and survivors who participated—without them this study would not have taken place.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sabo, B., St-Jacques, N. & Rayson, D. The decision-making experience among women diagnosed with stage I and II breast cancer. Breast Cancer Res Treat 102, 51–59 (2007). https://doi.org/10.1007/s10549-006-9309-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10549-006-9309-6