The Experience of Using Decisional Support Aids by Patients With Breast Cancer

Margaret D. Lacey

ONF 2002, 29(10), 1491-1497. DOI: 10.1188/02.ONF.1491-1497

Purpose/Objectives: To explore the lived experience of patients with breast cancer using decisional support aids during the prediagnosis, diagnosis, and treatment phases of their disease.

Research Approach: Descriptive, phenomenologic.

Setting: Community-based.

Participants: 12 women, ages 38-68, diagnosed with and treated for breast cancer.

Methodologic Approach: Audiotaped interviews were transcribed and analyzed according to Colaizzi's method.

Main Research Variables: Use of decisional support aids.

Findings: Six major themes were identified: being too stressed and overwhelmed to make a decision, feeling an internal sense of urgency to have the breast cancer managed quickly, trusting the opinion and advice of physicians about treatment decisions, appreciating the importance of support from family and friends in decision making, finding nurses were unavailable or uninvolved in decision making initially, and missing out on the benefits of a multidisciplinary approach.

Conclusions: Being presented with the diagnosis of breast cancer evokes a range of feelings and emotions. By identifying, explaining, and expressing their accounts, participants revealed their lived experience and its meaning. The description of this phenomena may assist other women diagnosed with breast cancer in the decision-making process.

Interpretation: Oncology nurses need to be aware of and understand the issues surrounding the decision-making process of patients with breast cancer. Gaps clearly exist in the information and support provided to these participants. Nurses must target areas that are insufficient in providing decisional support aids and plan for partnerships to ensure a multidisciplinary approach in this process.

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    References

    American Cancer Society. (2002). Cancer facts and figures 2002. Atlanta, GA: Author.

    Barrere, C. (1992). Breast biopsy support program: Collaboration between the oncology clinical nurse specialist and the ambulatory surgery nurse. Oncology Nursing Forum, 19, 1375-1378.

    Burns, N., & Grove, S.K. (1999). Introduction to qualitative research. In N. Burns & S.K. Grove (Eds.), Understanding nursing research (2nd ed., pp. 337-377). Philadelphia: Saunders.

    Colaizzi, P.F. (1978). Psychological research as the phenomenologist views it. In R. Valle & M. King (Eds.), Existential phenomenological alternative for psychology (pp. 48-71). New York: Oxford University Press.

    Gillis, A., & Jackson, W. (2002). Qualitative research designs. In A. Gillis & W. Jackson (Eds.), Research for nurses: Methods and interpretation (pp. 177-223). Philadelphia: F.A. Davis.

    Glanz, K., & Lerman, C. (1992). Psychosocial impact of breast cancer: A critical review. Annals of Behavioral Medicine, 14, 204-212.

    Green, L.W., & Lewis, F.M. (1986). Measurement and evaluation in health education and health promotion (pp. 50-51). Palo Alto, CA: Mayfield.

    Hughes, K.K. (1993). Decision making by patients with breast cancer: The role of information in treatment selection. Oncology Nursing Forum, 20, 623-628.

    Lauver, D., & Angerame, M. (1993). Women's expectations about seeking care for breast cancer symptoms. Oncology Nursing Forum, 20, 519-525.

    Mettlin, C. (1999). Global breast cancer mortality statistics. CA: A Cancer Journal for Clinicians, 49, 138-144.

    Neill, K.M., Armstrong, N., & Burnett, C.B. (1998). Choosing reconstruction after mastectomy: A qualitative analysis. Oncology Nursing Forum, 25, 743-749.

    Neufeld, K.R., Degner, L.F., & Dick, J.A. (1993). A nursing intervention strategy to foster patient involvement in treatment decisions. Oncology Nursing Forum, 20, 631-635.

    Pallikkathayil, L., & Morgan, S. (1991). Phenomenology as a method for conducting clinical research. Applied Nursing Research, 4, 195-200.

    Pelusi, J. (1997). The lived experience of surviving breast cancer. Oncology Nursing Forum, 24, 1343-1353.

    Pierce, P.F., & Hicks, F.D. (2001). Patient decision-making behavior: An emerging paradigm for nursing science. Nursing Research, 50, 267-274.

    Roter, D.L. (1977). Patient participation in patient-provider interaction: The effects of patient question-asking on the quality of interaction, satisfaction, and compliance. Health Education Monographs, 5, 281-315.

    Russell, G.E. (1999). Phenomenological research. In J.A. Fain (Ed.), Reading, understanding, and applying nursing research: A text and workbook (pp. 167-183). Philadelphia: F.A. Davis.

    Schaefer, K.M., Ladd, E., Gergits, M.A., & Gyauch, L. (2001). Backing and forthing: The process of decision making by women considering participation in a breast cancer prevention trial. Oncology Nursing Forum, 28, 703-709.

    Wolf, Z.R. (1991). Nurses' experiences giving post-mortem care to organ donors: A phenomenological study. Scholarly Inquiry for Nursing Practice, 5(2), 73-87.