Decisional Conflict, Patient Involvement, and the Associated Psychological Factors Relating to Mastectomy Decisions Among Women With Breast Cancer

Liu, Jing; Chan, Sally Wai-Chi; Guo, Dongmei; Lin, Qin; Hunter, Sharyn; Zhu, Jiemin; Lee, Regina

doi:10.1097/ncc.0000000000001256

Cited by 2 publications

(7 citation statements)

References 40 publications

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“…In this study, most women perceived that they had participated in the treatment decision-making process. This result is consistent with previous quantitative studies from mainland China (Liu et al, 2023) and Germany (Feiten et al, 2022), which reported that women who had a mastectomy reported an overall high degree of involvement in the decision-making process. In this study, all women who reported non-participation were with moderate or high decisional conflict.…”

Section: Discussionsupporting

confidence: 92%

“…Making treatment decisions to undergo a mastectomy can be challenging for women because they may need to consider not only survival outcomes but also their physical appearance issues . Research has demonstrated that many women who have had a mastectomy experience decisional conflict (Liu et al, 2023), which is defined as the uncertainty surrounding this treatment decision (O'Connor, 1995). This feeling of uncertainty could lead to dissatisfaction and regret with treatment decisions (Lee & Knobf, 2015).…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…This study employed purposive sampling and selected participants from a pool of women in a previous survey that investigated decisional conflict, patient involvement, and factors related to mastectomy decisions among Chinese women with breast cancer (Liu et al, 2023). The study took place at two tertiary hospitals in Xiamen city between September 2021 and December 2022.…”

Section: Sampling and Recruitmentmentioning

confidence: 99%

“…At the recruitment of the survey, the researchers approached participants who had undergone mastectomy for breast cancer treatment within the past 6 months at the breast clinics and departments, during either their post-operative hospital stay or follow-up care visits, and provided them with study flyers (Liu et al, 2023).…”

Section: Sampling and Recruitmentmentioning

confidence: 99%

“…Participants who expressed willingness to participate were also given the option to complete a further interview. After the completion of the survey, the researchers selectively contacted participants who had consented to further interviews based on their reported levels of decisional conflict regarding mastectomy (high, moderate, or low) from the previous survey (Liu et al, 2023). This sampling method considers the heterogeneity of decisional conflict regarding mastectomy and enables the results to possibly reflect a wide variety of experiences (Etikan et al, 2016).…”

Section: Sampling and Recruitmentmentioning

confidence: 99%

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Decision‐making experiences related to mastectomy: A descriptive qualitative study

Liu,

Chan,

Guo

et al. 2023

Journal of Advanced Nursing

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AimTo obtain an in‐depth understanding of women's decision‐making experiences related to mastectomy.DesignA descriptive qualitative interview study.MethodsIndividual semi‐structured interviews were conducted face‐to‐face with 27 Chinese women with breast cancer who underwent mastectomy at two tertiary hospitals in mainland China between September 2020 and December 2021 after obtaining the appropriate ethical approvals. Interviews were conducted in Mandarin. Data were analysed using inductive content analysis.ResultsMean age of participants was 48 years (range 31–70). Most participants had low education, low monthly family income, had a partner and health insurance, had been diagnosed with early breast cancer, and had not undergone reconstructive surgery. Six categories related to decision‐making experiences emerged: (1) Emotions affecting decision‐making, (2) Information seeking for decision‐making, (3) Beliefs about mastectomy and the breast, (4) Participation in decision‐making, (5) People who influence decision‐making, and (6) Post‐decision reflection. Participants did not mention the role of nurses in their decision‐making process for mastectomy.ConclusionsThis study adds valuable insights into the limited evidence on women's experience with decision‐making about mastectomy from a Chinese perspective, which is important given the continuing high prevalence of mastectomy in many regions. Future studies from other countries and ethnic groups are recommended to gain diverse knowledge.ImpactThe findings of this study are useful for nurses and other healthcare professionals in the multidisciplinary team to better support women with breast cancer in their decision‐making process regarding mastectomy. The findings could inform future interventions to support treatment decision‐making and may be relevant to women living in similar socio‐medical contexts to those in mainland China.Reporting MethodThe study was reported following the Standards for Reporting Qualitative Research checklist.Patient or Public ContributionNo patient or public contribution.

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Section: Discussionsupporting

confidence: 92%

Section: Backg Rou N Dmentioning

confidence: 99%

Section: Sampling and Recruitmentmentioning

confidence: 99%

Section: Sampling and Recruitmentmentioning

confidence: 99%

Section: Sampling and Recruitmentmentioning

confidence: 99%

See 3 more Smart Citations

Decision‐making experiences related to mastectomy: A descriptive qualitative study

Liu,

Chan,

Guo

et al. 2023

Journal of Advanced Nursing

Self Cite

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A study of the mediating effect of social support on self-disclosure and demoralization in Chinese older adult homebound breast cancer patients

Liu,

Qin,

Wang

2024

Front. Psychol.

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PurposeDemoralization is common in older adult homebound breast cancer patients, seriously affecting their quality of life. This study aimed to investigate the demoralization of older adult homebound breast cancer patients and to analyse the mediating effects of social support between self-disclosure and demoralization.MethodsThe study enrolled 368 older adult homebound breast cancer patients reviewed in outpatient clinics of three hospitals from January 2022 to August 2023. A questionnaire survey was conducted using the general information questionnaire, the distress disclosure index (DDI), the social support revalued scale (SSRS), and the demoralization scale (DS). Path analysis was conducted to test the hypothesised serial mediation model.ResultsThe total scores of self-disclosure, social support, and demoralization were 37 (25–42), 34 (19–48.75), and 46.5 (35–68), respectively. The results indicated a positive correlation between self-disclosure and social support (p < 0.01). In contrast, a statistically significant negative correlation was observed between self-disclosure, social support, and various demoralization dimensions (p < 0.01). Social support played a partial mediation effects between self-disclosure and demoralization, indirect effect =0.6362, SE = −0.591, 95% CI (−0.785 ~ −0.415); Self-disclosure direct effect demoralization, direct effect =0.3638, SE = −0.337, 95% CI (−0.525 ~ −0.144); total effect, SE = −0.929, 95% CI (−0.945 ~ −0.904).DiscussionSocial support a partial mediated between self-disclosure and demoralization in Chinese older adult homebound breast cancer patients. Clinical staff should focus on developing a social support system for Chinese older adult homebound breast cancer patients, encouraging patients to reveal their minds, and providing psychological counselling to enhance self-confidence and rebirth from adversity.

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Decisional Conflict, Patient Involvement, and the Associated Psychological Factors Relating to Mastectomy Decisions Among Women With Breast Cancer

Cited by 2 publications

References 40 publications

Decision‐making experiences related to mastectomy: A descriptive qualitative study

Decision‐making experiences related to mastectomy: A descriptive qualitative study

A study of the mediating effect of social support on self-disclosure and demoralization in Chinese older adult homebound breast cancer patients

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