No votes yet
Online Exclusive Article

Exploration of How Women Make Treatment Decisions After a Breast Cancer Diagnosis

Cheryl A. Spittler
Leonie Pallikathayil
Marjorie Bott
ONF 2012, 39(5), E425-E433 DOI: 10.1188/12.ONF.E425-E433

Purpose/Objectives: To examine the information needs of women after receiving a diagnosis of breast cancer, investigate how decisions about treatment options are made, and assess personal responses to the decisions made.

Design: Mixed-methods approach using quantitative and qualitative data.

Setting: The University of Kansas Medical Center and Quinn Plastic Surgery Center, both in the midwestern United States.

Sample: 102 breast cancer survivors who had completed all forms of treatment for at least three months and less than five years.

Methods: Phase I participants completed five questionnaires about informational needs, confidence and satisfaction with the decision, decisional regret, and conflict. In phase II, 15 participants were purposively sampled from the 102 survivors to participate in a focus group session. Data analysis included frequencies and multiple regression for phase I and qualitative content analysis for phase II.

Main Research Variables: Informational needs, confidence and satisfaction with the decision, and decisional regret and conflict.

Findings: The variables (widowed, confidence and satisfaction with decision, and decisional conflict and regret) significantly (p = 0.01) accounted for 14% of the variance in informational needs. Two themes emerged from the study: (a) feelings, thoughts, and essential factors that impact treatment considerations, and (b) tips for enhancing treatment consideration options.

Conclusions: The study's results show that women viewed informational needs as very important in making treatment decisions after being diagnosed with breast cancer.

Implications for Nursing: The treatment team should provide the information, with consideration of the patient's personal preferences, that will assist women to make informed, confident, and satisfied decisions about treatment choices.


American Cancer Society. (2011). Breast cancer facts and figures 2011-2012. Retrieved from <a target="_blank" href='http://www.cancer.org/Research/CancerFactsFigures/BreastCancerFactsFigur...

American Cancer Society. (2012). <i>Cancer facts and figures, 2012.</i> Retrieved from <a target="_blank" href='http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/docume...@epidemiologysurveilance/documents/document/acspc-031941.pdf</a>

Banning, M. (2007). Advanced breast cancer: Aetiology, treatment and psychosocial features. <i>British Journal of Nursing, 16</i>(2), 86-90.

Bettencourt, B. A., Schlegel, R. J., Talley, A. E., & Molix, L. A. (2007). The breast cancer experience of rural women: A literature review. <i>Psycho-Oncology, 16</i>, 875-887. doi:10.1002/pon.1235

Brehaut, J. C., O'Connor, A. M., Wood, T. J., Hack, T. F., Siminoff, L., Gordon, E., & Feldman-Stewart, D. (2003). Validation of a decision regret scale. <i>Medical Decision Making, 23</i>, 281-292. doi:10.1177/0272989X03256005

Elo, S., & Kyngäs, H. (2008). The qualitative content analysis process. <i>Journal of Advanced Nursing, 62</i>, 107-115. doi:10.1111/j.1365-2648.2007.04569.x

Estes, R., & Hosseini, J. (1988). The gender gap on Wall Street: An empirical analysis of confidence in investment decision making. <i>Journal of Psychology, 122</i>, 577-590. doi:10.1080/00223980.1988.9915532

Fitch, M. I., Gray, R. E., Godel, R., & Labrecque, M. (2008). Young women's experiences with breast cancer: An imperative for tailored information and support. <i>Canadian Oncology Nursing Journal, 18</i>(2), 74-86.

Galloway, S., Graydon, J., Harrison, D., Evans-Boyden, B., Palmer-Wickham, S., Burlein-Hall, S., … Blair, A. (1997). Informational needs of women with a recent diagnosis of breast cancer: Development and initial testing of a tool. <i>Journal of Advanced Nursing, 25</i>, 1175-1183. doi:10.1046/j.1365-2648.1997.19970251175.x

Graydon, J., Galloway, S., Palmer-Wickham, S., Harrison, D., Rich-van der Bij, L., West, P., … Evans-Boyden, B. (1997). Information needs of women during early treatment for breast cancer. <i>Journal of Advanced Nursing, 26</i>, 59-64. doi:10.1046/j.1365-2648.1997.1997026059.x

Hallenbeck, J. L. (2002). What's the story—How patients make medical decisions. <i>American Journal of Medicine, 13</i>(1), 73-74. doi:10.1016/S0002-9343(02)01189-0

Holmes-Rovner, M., Kroll, J., Schmitt, N., Rovner, D. R., Breer, M. L., Rothert, M. L., … Talarczyk, G. (1996). Patient satisfaction with health care decisions: The Satisfaction With Decision scale. <i>Medical Decision Making, 16</i>(1), 58-64. doi:10.1177/0272989X9601600114

Janis, I. L., & Mann, L. (1977). <i>Decision making: A psychological analysis of conflict, choice, and commitment.</i> New York, NY: Free Press.

Nazareth, I., Jones, L., Irving, A., Aslett, H., Ramsay, A., Richardson, A., … King, M. (2008). Perceived concepts of continuity of care in people with colorectal and breast cancer: A qualitative case study analysis. <i>European Journal of Cancer Care, 17</i>, 569-577.

O'Brien, M. A., Whelan, T. J., Charles, C., Ellis, P. M., Gafni, A., Lovrics, P., … Dimitry, S. (2008). Women's perceptions of their treatment decision-making about breast cancer treatment. <i>Patient Education and Counseling, 73</i>, 431-436. doi:10.1016/j.pec.2008.07.015

O'Connor, A. (1993). User-manual decisional conflict scale. Retrieved from <a target="_blank" href='http://www.decisionaid.ohri.ca/docs/develop/User_Manuals/UM_Decisional_C...

Patient Resource Cancer Center. (2009). <i>Cancer guide: A treatment and facilities guide for patients and their families</i> (pp. 62-68). Overland Park, KS: Patient Resource.

Reaby, L. L. (1998). Breast restoration decision making: Enhancing the process. <i>Cancer Nursing, 21</i>, 196-204. doi:10.1097/00002820-199806000-00007

Spittler, C. (2008). Breast reconstruction using tissue expanders: Assessing patients' needs utilizing a holistic approach. <i>Plastic Surgical Nursing, 28</i>(1), 27-32.

Webb, C., & Koch, T. (1997). Women's experiences of non-invasive breast cancer: Literature review and study report. <i>Journal of Advanced Nursing, 25</i>, 514-525. doi:10.1046/j.1365-2648.1997.t01-1-1997025514.x

Youngblut, J. M., & Casper, G. R. (1993). Single-item indicators in nursing research. <i>Research in Nursing and Health, 16</i>, 459-465.