scholarly journals The Treatment Decision-Making Process: Age Differences in a Sample of Women Recently Diagnosed With Nonrecurrent, Early-Stage Breast Cancer

1997 ◽  
Vol 37 (5) ◽  
pp. 598-608 ◽  
Author(s):  
A. C. Petrisek ◽  
L. L. Laliberte ◽  
S. M. Allen ◽  
V. Mor
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Age Differences ◽  
Early Stage ◽  
Treatment Decision ◽  
Early Stage Breast Cancer ◽  
Decision Making Process ◽  
Treatment Decision Making

“It’s important to me”: A qualitative analysis of shared decision-making and patient preferences in early-stage breast cancer patients.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 227-227
Author(s):  
Valerie Lawhon ◽  
Rebecca England ◽  
Audrey S. Wallace ◽  
Courtney Williams ◽  
Stacey A. Ingram ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Shared Decision Making ◽  
Patient Preferences ◽  
Early Stage ◽  
Treatment Decision ◽  
Treatment Decisions ◽  
Early Stage Breast Cancer ◽  
Shared Decision ◽  
Treatment Decision Making

227 Background: Shared decision-making (SDM) occurs when both patient and provider are involved in the treatment decision-making process. SDM allows patients to understand the pros and cons of different treatments while also helping them select the one that aligns with their care goals when multiple options are available. This qualitative study sought to understand different factors that influence early-stage breast cancer (EBC) patients’ approach in selecting treatment. Methods: This cross-sectional study included women with stage I-III EBC receiving treatment at the University of Alabama at Birmingham from 2017-2018. To understand SDM preferences, patients completed the Control Preferences Scale and a short demographic questionnaire. To understand patient’s values when choosing treatment, semi-structured interviews were conducted to capture patient preferences for making treatment decisions, including surgery, radiation, or systemic treatments. Interviews were audio-recorded, transcribed, and analyzed using NVivo. Two coders analyzed transcripts using a constant comparative method to identify major themes related to decision-making preferences. Results: Amongst the 33 women, the majority of patients (52%) desired shared responsibility in treatment decisions. 52% of patients were age 75+ and 48% of patients were age 65-74, with an average age of 74 (4.2 SD). 21% of patients were African American and 79% were Caucasian. Interviews revealed 19 recurrent treatment decision-making themes, including effectiveness, disease prognosis, physician and others’ opinions, side effects, logistics, personal responsibilites, ability to accomplish daily activities or larger goals, and spirituality. EBC patient preferences varied widely in regards to treatment decision-making. Conclusions: The variety of themes identified in the analysis indicate that there is a large amount of variability to what preferences are most crucial to patients. Providers should consider individual patient needs and desires rather than using a “one size fits all” approach when making treatment decisions. Findings from this study could aid in future SDM implementations.

Improving informed breast cancer systemic treatment decision-making.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 225-225
Author(s):  
Sarah T. Hawley ◽  
Larry An ◽  
Yun Li ◽  
Reshma Jagsi ◽  
Steven J. Katz
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Systemic Treatment ◽  
Early Stage ◽  
Controlled Trial ◽  
Treatment Decision ◽  
Early Stage Breast Cancer ◽  
Decision Quality ◽  
Decision Tool ◽  
Treatment Decision Making

225 Background: Decision making for adjuvant chemotherapy is increasingly complicated for women with a new diagnosis of early stage breast cancer. Few decision tools are designed to help support informed systemic treatment decision-making, by improving knowledge and decision quality. Methods: We conducted a randomized controlled trial (RCT) of a tailored, comprehensive (locoregional and systemic treatment) and interactive decision tool (iCanDecide), compared with static online information. 537 newly diagnosed, early stage breast cancer patients were enrolled from 22 surgical practices. Participants were surveyed 5 weeks (N = 496; RR 92%) and those eligible for systemic treatment (N = 358) again at 9 months (N = 307; RR 88%). The main outcome for this analysis was knowledge about systemic treatment using 4 true/false items, categorized into high (3- 4 correct) vs. low (0-2 correct). We also assessed subjective decision quality (SDQ) for chemotherapy on a 5-point scale and dichotomized into high (4-5) vs. low (1-3) We evaluated the distribution of participants in each arm, and assessed the association between the study arm and the outcomes using bivariate and multivariable approaches. Results: Of the 358 respondents, 201 did not receive or intend to have chemotherapy. Significantly more intervention than control patients had high knowledge about systemic treatment (52.9% vs. 39.9%, p = 0.012). Overall SDQ for chemotherapy was slightly higher in intervention than control subjects (mean 4.8 vs. 4.6, p = 0.08). However, among women who did not receive chemotherapy, significantly more intervention subjects reported high SDQ than controls (87.1% vs. 75.2%, p = 0.06). Values significantly related to chemotherapy use included avoiding side effects, continuing to work, and being most extensive possible. Conclusions: We found that the interactive decision tool contributed significantly to higher knowledge about systemic treatment among eligible patients. We further found the tool shows promise for improving subjective decision quality, particularly in patients who choose not to have chemotherapy. Further work to integrate tools into the oncology clinical setting is needed. Clinical trial information: NCT01840163.

Instrumental Relating and Treatment Decision Making Among Older Women With Early-Stage Breast Cancer

2011 ◽  
Vol 39 (1) ◽  
pp. E10-E19 ◽  
Author(s):  
Huibrie C. Pieters ◽  
MarySue V. Heilemann ◽  
Sally Maliski ◽  
Katrina Dornig ◽  
Jan Mentes
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Older Women ◽  
Early Stage ◽  
Treatment Decision ◽  
Early Stage Breast Cancer ◽  
Treatment Decision Making

Treatment Decision Making in Early-Stage Breast Cancer: Should Surgeons Match Patients’ Desired Level of Involvement?

2002 ◽  
Vol 20 (6) ◽  
pp. 1473-1479 ◽  
Author(s):  
Nancy L. Keating ◽  
Edward Guadagnoli ◽  
Mary Beth Landrum ◽  
Catherine Borbas ◽  
Jane C. Weeks
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Early Stage ◽  
Treatment Decision ◽  
Active Role ◽  
Breast Conserving Surgery ◽  
Treatment Choice ◽  
Early Stage Breast Cancer ◽  
Treatment Decision Making ◽  
Actual Role

PURPOSE: To describe desired and actual roles in treatment decision making among patients with early-stage breast cancer, identify how often patients’ actual roles matched their desired roles, and examine whether matching of actual and desired roles was associated with type of treatment received and satisfaction. PATIENTS AND METHODS: We surveyed 1,081 women (response, 70%) diagnosed with early-stage breast cancer in Massachusetts or Minnesota about their desired and actual roles in treatment decision making with their surgeon and used logistic regression to assess whether matching of actual to desired roles was associated with type of surgery and satisfaction. RESULTS: Most patients (64%) desired a collaborative role in decision making, but only 33% reported actually having such a collaborative role when they discussed treatments with their surgeons. Overall, 49% of women reported an actual role that matched the desired role they reported, 25% had a less active role than desired, and 26% had a more active role than desired. In adjusted analyses, patients whose reported actual role matched their desired role were no more likely than others to undergo breast-conserving surgery (P > .2), but these women were more satisfied with their treatment choice (83.5% very satisfied; reference) than those whose role was less active than desired (72.9% very satisfied; P = .02) or more active than desired (72.2% very satisfied; P = .005). CONCLUSION: Only approximately half of patients reported an actual role in decision making that matched the desired role they reported. These patients were more satisfied with their treatment choice than other patients, suggesting that women with early-stage breast cancer may benefit from surgeons’ efforts to identify their preferences for participation in decisions and tailor the decision-making process to them.

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