Treatment decision making in breast cancer: A longitudinal exploration of women's experiences

• Published in: British journal of health psychology 2012-02, Vol.17 (1), p.155-170
• Main Authors: Swainston, Katherine, Campbell, Carol, van Wersch, Anna, Durning, Patricia
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Breast cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - therapy; Decision making; Diagnosis; England; Female; Gynecology. Andrology. Obstetrics; Health care; Humans; Interviews as Topic; Longitudinal Studies; Mammary gland diseases; Medical diagnosis; Medical personnel; Medical sciences; Middle Aged; Ownership; Patient Participation; Regret; Schemas; Sense of control; Social interaction; Tumors; Women; Women's issues; Womens health; Young Adult
• ISSN: 1359-107X; 2044-8287
• DOI: 10.1111/j.2044-8287.2011.02028.x

Objectives. To explore the lived experience of breast cancer in relation to the treatment decision‐making process over time. Design. Adopting a hermeneutic phenomenological approach, semi‐structured interviews were undertaken at three points in time during the year following diagnosis. Methods. After ethical approval had been obtained, 20 women who were recently diagnosed with breast cancer were recruited from a Symptomatic Breast Cancer Unit in the North East of England. Results. Four themes emerged: role in the treatment decision‐making process; acceptance of medical opinions; getting rid of it; and cancer schemas. The majority of women reported a passive role in the surgical treatment decision‐making process and all women did so in relation to subsequent treatment decisions. However, women adopted this role consciously and consequently were not disengaged from the process but maintained a sense of ownership and control over their health. The women did not describe experiencing decisional regret at any point in the year following diagnosis and rarely revisited the decisions made, only doing so in a positive manner. Trust in the abilities and experience of healthcare professionals and maximizing chances of survival were cited as reasons for not having had greater involvement. Despite being given information about treatment options, many women made the decision not to attend to this information perceiving this to be anxiety provoking. Conclusions. The findings from this study suggest a need for eliciting more specific psycho‐social interactions in the treatment decision‐making process in order to identify ways in which women can be supported throughout their experience.