Low-income women with early-stage breast cancer: physician and patient decision-making styles

2001 ◽  
Vol 10 (2) ◽  
pp. 137-146 ◽  
Author(s):  
Kristine L.S.P. McVea ◽  
William C. Minier ◽  
Jodi E. Johnson Palensky
2012 ◽  
Vol 30 (4) ◽  
pp. 258-267 ◽  
Author(s):  
Stephanie B. Wheeler ◽  
Yang Wu ◽  
Anne-Marie Meyer ◽  
William R. Carpenter ◽  
Lisa C. Richardson ◽  
...  

Author(s):  
Meghan S. Karuturi ◽  
Sharon H. Giordano ◽  
Diana S. Hoover ◽  
Robert J. Volk ◽  
Ashley J. Housten

2019 ◽  
Author(s):  
Mary Anne FitzPatrick ◽  
Alexandra Claudia Hess ◽  
Lynn Sudbury-Riley ◽  
Peter Johannes Schulz

BACKGROUND Although previous research shows broad differences in the impact of online health information on patient-practitioner decision making, specific research is required to identify and conceptualize patient decision-making styles related to the use of online health information and to differentiate segments according to the influence of online information on patient decision making and interactions with health professionals. OBJECTIVE This study aimed to investigate patients’ decision making in relation to online health information and interactions with health care practitioners. We also aimed to present a typology of patients based on significant differences in their decision making. METHODS We applied a large-scale cross-sectional research design using a survey. Data, generated using a questionnaire that was administered by companies specializing in providing online panels, were collected from random samples of baby boomers in the United Kingdom, the United States, and New Zealand. The total sample comprised 996 baby boomers born between 1946 and 1964, who had used the internet in the previous 6 months to search for and share health-related information. Data were analyzed using hierarchical cluster analysis and confirmatory factor analysis, as well as one-way analysis of variance, chi-square tests, and paired sample <italic>t</italic> tests. RESULTS Analyses identified 3 key decision-making styles that served as the base for 4 unique and stable segments of patients with distinctive decision-making styles: the Collaborators (229/996, 23.0%), the Autonomous-Collaborators (385/996, 38.7%), the Assertive-Collaborators (111/996, 11.1%), and the Passives (271/996, 27.2%). Profiles were further developed for these segments according to key differences in the online health information behavior, demographics, and interactional behaviors of patients. The typology demonstrates that collaborative decision making is dominant among patients either in its pure form or in combination with autonomous or assertive decision making. In other words, most patients (725/996, 72.8%) show significant collaboration in their decision making with health care professionals. However, at times, patients in the combination Autonomous-Collaborative segment prefer to exercise individual autonomy in their decision making, and those in the combination Assertive-Collaborative segment prefer to be assertive with health professionals. Finally, this study shows that a substantial number of patients adopt a distinctly passive decision-making style (271/996, 27.2%). CONCLUSIONS The patient typology provides a framework for distinguishing practice-relevant and addressable segments with important implications for health care practitioners, including better-targeted communication programs for patients and more successful outcomes for health care services in the long term.


Cancer ◽  
2019 ◽  
Vol 125 (10) ◽  
pp. 1709-1716 ◽  
Author(s):  
Christine M. Veenstra ◽  
Lauren P. Wallner ◽  
Paul H. Abrahamse ◽  
Nancy K. Janz ◽  
Steven J. Katz ◽  
...  

2018 ◽  
Vol 44 (6) ◽  
pp. 901
Author(s):  
Lorna Cook ◽  
Peter Bennett ◽  
Manish Kothari ◽  
Mikaela Nordblad ◽  
Elizabeth Clayton ◽  
...  

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 108-108
Author(s):  
Andrea Marie Covelli ◽  
Nancy N. Baxter ◽  
Margaret Fitch ◽  
Frances Catriona Wright

108 Background: Rates of both unilateral (UM) and contralateral prophylactic mastectomy (CPM) for early stage breast cancer (ESBC) have been increasing since 2003. More extensive surgery is not a benign procedure without the risk of complications. Studies suggest that the increase is due to women choosing UM and CPM; we do not know what factors are influencing the choice for more extensive surgery. Methods: We conducted a qualitative study using grounded theory to identify factors for the choice of mastectomy. Purposive sampling was used to identify women across the Toronto Area (Ontario, Canada), who were suitable candidates for breast conserving surgery (BCS) but underwent UM or CPM. Data were collected through semi-structured interviews. Constant comparative analysis identified key concepts and themes. Results: Data saturation was achieved after 29 in-person interviews. 12 interviewees were treated at academic cancer centers, 6 at an academic non-cancer center and 11 at community centers. 15 women underwent UM; 14 underwent UM+CPM. Median age was 55. ‘Taking control of cancer’ was the dominant theme. Fear of breast cancerwas expressed at diagnosisand remains throughout decision making. Fear translates into the overestimated risk of local recurrenceand contralateral cancer. Despite discussion of the equivalence of BCS and UM, patients chose UM due to fear of recurrence and misperceived survival advantage. Similarly, patients chose CPM to eliminate the risk of contralateral cancer and misperceived survival advantage. Women were actively trying to Control Outcomes, as more surgery was seen as greater control. Conclusions: Women seeking UM and CPM for treatment of their early stage breast cancer manage their fear of cancer by undergoing more extensive surgery which in turn drives mastectomy rates. It is important to understand this process so that we may improve our ability to discuss issues of importance to women and facilitate informed decision-making.


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