scholarly journals Relationship Between Decision Conflict and Decision Regret Among Postoperative Breast Cancer Patients in China: The Regulating Role of Decision-Making Preparation

Author(s):  
Yan Wang ◽  
Qingyue Zhang ◽  
Jianmei Pang ◽  
Liyuan Shi ◽  
Xiaoyuan Wang ◽  
...  

Abstract Objective: Different surgical methods have different risks and benefits. The Chinese breast cancer(BC) patients’ decision-making of surgical treatment become a critical research question. Patients are often offered several options before surgery, and decision preparation play an important role in decision process. However some patients regret the original decision afterward. To understand the current situation, this study explore mainly explores the status of decision regret among newly diagnosed BC patients,and tests the relationship between decision conflicts, decision-making preparation, and decision regrets. Methods: A cross-sectional survey was conducted. Totally 320 postoperative BC patients were studied using a self-made general data scale, Decision Regret Scale, Decision Conflict Scale, and Preparation for Decision Making Scale. Basic descriptive analyses, Pearson’s correlation analyses and regression analyses were performed. Results: The average score of decision regret among BC patients after surgery was 34.28. Decision regret was positively associated with decision conflict (r=0.853, p<0.01), and negatively associated decision preparation (r=-0.404, p<0.01). Decision-making preparation plays a regulatory role for the emergence of decision conflicts and regrets. The correlation between decision conflicts and decision regrets increases with the increase of decision-making preparation. Conclusion: The adverse effects of decision conflicts on decision regrets gradually increase with the increase of decision-making preparation. Results indicate that reducing decision preparation can be expected to improve the level of decision regret among Chinese BC patients.Thus, Clinical staffs should encourage patients to actively participate in decision-making, provide specialized information support, and improve the level of decision regret among Chinese BCpatients after surgery.

2021 ◽  
Author(s):  
Yan Wang ◽  
Qingyue Zhang ◽  
Jianmei Pang ◽  
Liyuan Shi ◽  
Xiaoyuan Wang ◽  
...  

Abstract Objective: Different surgical methods have different risks and benefits.Chinese breast cancer(BC) patients’ decision-making of surgical treatment becomes a critical research question. Patients are often offered several options before surgery, and decision preparation plays an important role in the decision process. However some patients regret the original decision afterward. To understand the current situation, this study explore mainly explores the status of decision regret among postoperative breast cancer patients,and tests the relationship between decision conflicts, decision-making preparation, and decision regret. Methods: A cross-sectional survey was carried out. Totally 320 postoperative BC patients were studied using a self-made general data scale, Decision Regret Scale, Decision Conflict Scale, and Preparation for Decision Making Scale. Basic descriptive analyses, Pearson’s correlation analyses and regression analyses were performed. Results: The average score of decision regret among BC patients after surgery was 34.28. Decision regret was positively associated with decision conflict (r=0.853, p<0.01), and negatively associated decision preparation (r=-0.404, p<0.01). Decision-making preparation plays a regulatory role for the emergence of decision conflicts and regrets. The correlation between decision conflicts and decision regret increases with the increase in decision-making preparation. Conclusion: The adverse effects of decision conflicts on decision regret gradually increase with the increase in decision-making preparation. Results indicate that reducing decision preparation can be expected to improve the level of decision regret among Chinese postoperative BC patients.Thus, Clinical staffs should encourage patients to take an active part in decision-making, provide specialized information support, and improve the level of decision regret among Chinese BC patients after surgery.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Sook Young Jeon ◽  
Kyoung-Eun Kim ◽  
Eun-Kyu Kim ◽  
Hyunhee Han ◽  
Han-Byoel Lee ◽  
...  

Purpose. We examined the incidence of emotional distress in women with newly diagnosed breast cancer to determine whether the degree of emotional distress affected their choice of breast-conserving surgery (BCS) or mastectomy and evaluated how the patient’s preferred role in decision-making influenced her choice of surgical method. Methods. This prospective study included 85 patients newly diagnosed with in situ or invasive breast cancer eligible for BCS. Their degree of depression/anxiety and attitude toward the decision-making process were measured using the Hospital Anxiety and Depression Scale (HADS) and Control Preference Scale (CPS), respectively. After receiving information on both surgical methods, the patients indicated their preferred surgical method and completed the CPS at their initial and second visits before surgery. Results. After the diagnosis of breast cancer, 75.3% of patients showed abnormal or borderline HADS scores for depression and 41.2% for anxiety. Patients with borderline or abnormal degrees of depression were more likely to have coexisting abnormal degrees of anxiety ( p < 0.001 ). However, the presence of depression or anxiety was not associated with patients’ surgical choices ( p = 0.394 and 0.530, respectively). Patients who preferred a more active role in the decision-making process were more likely to choose mastectomy over BCS, while those who were passive or collaborative chose BCS more frequently ( p = 0.001 ). Conclusion. Although many patients with newly diagnosed breast cancer experience depression and anxiety before surgery, these do not affect the choice of surgical method; however, their attitudes toward the decision-making process do.


Breast Care ◽  
2020 ◽  
pp. 1-7
Author(s):  
Julia Dick ◽  
Viktoria Aue ◽  
Simone Wesselmann ◽  
Anne Brédart ◽  
Sylvie Dolbeault ◽  
...  

<b><i>Background:</i></b> In recent years, germline testing of women with a risk of developing breast and ovarian cancer has increased rapidly. This is due to lower costs for new high-throughput sequencing technologies and the manifold preventive and therapeutic options for germline mutation carriers. The growing demand for genetic counseling meets a shortfall of counselors and illustrates the need to involve the treating clinicians in the genetic testing process. This survey was undertaken to assess their state of knowledge and training needs in the field of genetic counseling and testing. <b><i>Methods:</i></b> A cross-sectional survey within the European Bridges Study (Breast Cancer Risk after Diagnostic Gene Sequencing) was conducted among physician members (<i>n</i> = 111) of the German Cancer Society who were primarily gynecologists. It was designed to examine their experience in genetic counseling and testing. <b><i>Results:</i></b> Overall, the study revealed a need for training in risk communication and clinical recommendations for persons at risk. One-third of respondents communicated only relative disease risks (31.5%) instead of absolute disease risks in manageable time spans. Moreover, almost one-third of the respondents (31.2%) communicated bilateral and contralateral risk-reducing mastectomy as an option for healthy women and unilateral-diseased breast cancer patients without mutations in high-risk genes (e.g. <i>BRCA1</i> or <i>BRCA2)</i>. Most respondents expressed training needs in the field of risk assessment models, the clinical interpretation of genetic test results, and the decision-making process. <b><i>Conclusion:</i></b> The survey demonstrates a gap of genetic and risk literacy in a relevant proportion of physicians and the need for appropriate training concepts.


2021 ◽  
pp. 1-5
Author(s):  
Ayu Ratuati Setiawan ◽  
Feny Tunjungsari ◽  
Mochamad Aleq Sander

BACKGROUND: Cancer is a disease caused by abnormal growth of body cells that turn malignant and continue to grow uncontrollably. One of the treatments for breast cancer is mastectomy. The quickness of decision-making determines the survival rate of prognosis patients. OBJECTIVE: This study aimed to determine the relationship of self-acceptance with decision-making duration in cancer patients to perform a mastectomy. METHODS: An analytic observation method with cross-sectional design. The samples were taken by purposive sampling method with 50 samples of breast cancer patients. Data collected include age, last level of education, marital status, profession, stage of cancer during mastectomy, self-acceptance score, and decision-making duration to perform a mastectomy. RESULTS: The data analyzed with the Kruskal–Wallis test. The test showed the relationship of self-acceptance (p = 0.027) with decision-making duration in breast cancer patients to perform a mastectomy. CONCLUSION: In Conclusion, there is a relationship of self-acceptance with decision-making duration in breast cancer patients to perform a mastectomy.


2013 ◽  
pp. 311-321
Author(s):  
Catharine Clay ◽  
Alice Andrews ◽  
Dale Vidal

Author(s):  
Julie D. Johnson ◽  
Cleora S. Roberts ◽  
Charles E. Cox ◽  
Douglas S. Reintgen ◽  
Judi S. Levine ◽  
...  

2021 ◽  
Author(s):  
Shaun Treweek ◽  
Viviane Miyakoda ◽  
Dylan Burke ◽  
Frances Shiely

Abstract Background: Randomised trials support improved decision-making through the data they collect. One important piece of data is the primary outcome – so called because it is what the investigators decide is the most important. Secondary outcomes provide additional information to support decision-making. We were interested in knowing how important patients and healthcare professionals consider the outcomes (especially the primary outcome) measured in a selection of published trials. Methods: The work had three stages: 1. We identified a body of late-stage trials in two clinical areas, breast cancer management and nephrology. 2. We identified the primary and secondary outcomes for these trials. 3. We randomly ordered these outcomes and presented them to patients and healthcare professionals (with experience of the clinical area), and we asked them to rank the importance of the outcomes. They were not told which outcomes trial authors considered primary and secondary. Results: In our sample of 44 trials with 46 primary outcomes, 29 patients, one patient representative and 12 healthcare professionals together ranked the primary outcome as the most important outcome 13/46 times, or 30%. Breast cancer patients and health care professionals considered the primary outcome to be the most important outcome for 8/21 primary outcomes chosen by trialists. For nephrology, the equivalent figure was 5/25. The primary outcome appeared in a respondent’s top 5 ranked outcomes 151/178 (85%) times for breast cancer and 225/259 (87%) times for nephrology even if the primary wasn’t considered the most important outcome. Conclusions: The primary outcome in a trial is the most important piece of data collected. It is used to determine how many participants are required, and it is the main piece of information used to judge whether the intervention is effective or not. Our study found that in the view of patients and healthcare professionals, teams doing trials in breast cancer management and nephrology got their choice of primary outcome wrong 70% of the time.


Author(s):  
Larissa Elisabeth Hillebrand ◽  
Ulrike Söling ◽  
Norbert Marschner

Background: Breast cancer is still the most common malignancy in women worldwide. Once metastasized, breast cancer treatment primarily aims at reducing symptom burden, thereby trying to maintain and improve a patient´s quality of life (QoL), delaying disease progression, and prolonging survival. Curing the disease is not possible in the palliative setting. To better understand metastatic breast cancer patients, their symptoms and wishes, which are important for treatment-decision making and outcome, patient-reported outcomes (PROs) are of great importance, giving an impression of what really matters to and concerns a patient. Summary: Many advances have been made to implicate PROs in clinical trials, non-interventional studies, registries, and clinical routine care of metastatic breast cancer. For example, large phase III trials like PALOMA-3 (NCT01942135), MONALEESA-7 (NCT02278120), HER2CLIMB (NCT02614794), and KEYNOTE-119 (NCT02555657) trials implemented PROs in their trial design to assess the QoL of their trial patients. Also, non-interventional studies on metastatic breast cancer, like e.g., the NABUCCO study (IOM-02240), and prospective non-interventional, multicenter registries e.g., the tumor registry breast cancer (NCT01351584) or the breast cancer registry platform OPAL (NCT03417115), have implemented PROs to assess QoL during the anti-cancer treatment periods of the patients. Key Message: Using PROs in metastatic breast cancer can support shared treatment-decision making and management of symptoms, eventually leading to an improvement in QoL. Progressively, regulatory authorities take PROs into consideration for the approval of new drugs. Hence, the implication of PROs in cancer treatment, and especially in MBC, is of significant value.


BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Teresa García-García ◽  
Alberto Carmona-Bayonas ◽  
Paula Jimenez-Fonseca ◽  
Carlos Jara ◽  
Carmen Beato ◽  
...  

Abstract Background The aim of this study was to analyze biopsychosocial factors affecting how patients cope with cancer and adjuvant treatment and to appraise psychological distress, coping, perceived social support, quality of life and SDM before and after adjuvant treatment in breast cancer patients compared to colon cancer patients. Methods NEOcoping is a national, multicenter, cross-sectional, prospective study. The sample comprised 266 patients with colon cancer and 231 with breast cancer. The instruments used were the Brief Symptom Inventory (BSI), Mini-Mental Adjustment to Cancer (Mini-MAC), Multidimensional Scale of Perceived Social Support (MSPSS), Shared Decision-Making Questionnaire-Patient (SDM-Q-9) and Physician’s (SDM-Q-Doc), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ). Results Breast cancer patients reacted worse to the diagnosis of cancer with more symptoms of anxiety, depression, and somatization, and were less satisfied with their involvement than those with colon cancer (p = 0.003). Participants with colon cancer were older and had more physical symptoms and functional limitations at the beginning of adjuvant treatment, while there were scarcely any differences between the two groups at the end of adjuvancy, at which time both groups suffered greater psychological and physical effects and scored lower on coping strategies, except for anxious preoccupation. Conclusions Breast cancer patients need more information and involvement of the oncologist in shared decision-making, as well as and more medical and psychological support when beginning adjuvant treatment. Both breast and colon cancer patients may require additional psychological care at the end of adjuvancy.


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