Perceived Participation in Decision-Making on Primary Surgery and Associated Factors Among Early Breast Cancer Patients

Background Breast cancer patients wish to participate in the treatment decision-making, but the perceived participation was inconsistent with the willingness, leading to poor patient outcomes. Objective The aims of this study were to explore the perceived participation in the primary surgery decision-making among Chinese patients with early-stage breast cancer (BCa) and to analyze the relationships of demographic and clinical factors, participation competence, self-efficacy, social support, and doctors’ promotion of participation with the guidance of the capability, opportunity, motivation-behavior system (the COM-B system). Methods Paper surveys were used to collect data from 218 participants. The participation competence, self-efficacy, social support, and the doctor facilitation of involvement were evaluated to measure factors related to perceived participation among early-stage BCa. Results Perceived participation was low, and participants with a high level of participation competence, self-efficacy, and social support and who were employed and had a higher education level and higher family income perceived higher participation in primary surgery decision-making. Conclusions Perceived participation was low and may be facilitated by patients’ internal and external factors during the decision-making process. Health professionals should be aware that patient participation in decision-making is a type of self-care health behavior, and targeted decision support interventions should be provided to facilitate participation. Implications for Practice Patient-perceived participation may be evaluated from the perspective of self-care management behaviors among BCa patients. Nurse practitioners should emphasize their important roles in providing information, patient education, and psychological support to better contribute to the course of the treatment decision-making process for BCa patients who faced primary surgery.

[1]  Yuhan Lu,et al.  Post‐traumatic growth and related factors among 1221 Chinese cancer survivors , 2019, Psycho-oncology.

[2]  M. Al-Azri,et al.  Role of the family in Treatment Decision-Making process for Omani women diagnosed with breast cancer. , 2019, Patient education and counseling.

[3]  G. La Torre,et al.  Returning to work after breast cancer: A systematic review of reviews. , 2018, Work.

[4]  A. Jemal,et al.  Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries , 2018, CA: a cancer journal for clinicians.

[5]  Shou‐Tung Chen,et al.  Regret about surgical decisions among early‐stage breast cancer patients: Effects of the congruence between patients' preferred and actual decision‐making roles , 2018, Psycho-oncology.

[6]  Xiaodong Tan,et al.  Healthy China 2030: A Vision for Health Care. , 2017, Value in health regional issues.

[7]  R. Thomson,et al.  Implementing shared decision making in the NHS: lessons from the MAGIC programme , 2017, British Medical Journal.

[8]  K. Nakayama,et al.  Effect of a decision aid with patient narratives in reducing decisional conflict in choice for surgery among early-stage breast cancer patients: A three-arm randomized controlled trial. , 2017, Patient education and counseling.

[9]  E. Bellavance,et al.  Decision-Making in the Surgical Treatment of Breast Cancer: Factors Influencing Women’s Choices for Mastectomy and Breast Conserving Surgery , 2016, Front. Oncol..

[10]  A. Jemal,et al.  Cancer statistics in China, 2015 , 2016, CA: a cancer journal for clinicians.

[11]  M. Knobf,et al.  Primary Breast Cancer Decision-making Among Chinese American Women: Satisfaction, Regret , 2015, Nursing research.

[12]  Jie Liu,et al.  The willingness and actual situation of Chinese cancer patients and their family members participating in medical decision‐making , 2015, Psycho-oncology.

[13]  P. Hinds,et al.  Factorial Structure of a Scale: Strategies Used by People to Promote Health–Chinese Version , 2015, Cancer nursing.

[14]  Angela Fagerlin,et al.  Development and psychometric properties of a brief measure of subjective decision quality for breast cancer treatment , 2014, BMC Medical Informatics and Decision Making.

[15]  Gregory A. Miller,et al.  Conceptualizing How Couples Talk About Cancer , 2014, Health communication.

[16]  E. Hwang,et al.  Satisfaction with treatment decision-making and treatment regret among Latinas and non-Latina whites with DCIS. , 2014, Patient education and counseling.

[17]  D. Roter,et al.  Preferences for and experiences of family involvement in cancer treatment decision‐making: patient–caregiver dyads study , 2013, Psycho-oncology.

[18]  Mei-Ling Lin,et al.  Family as a whole: elective surgery patients' perception of the meaning of family involvement in decision making. , 2013, Journal of clinical nursing.

[19]  Karen R. Sepucha,et al.  Decision making about surgery for early-stage breast cancer. , 2012, Journal of the American College of Surgeons.

[20]  S. Michie,et al.  The behaviour change wheel: A new method for characterising and designing behaviour change interventions , 2011, Implementation science : IS.

[21]  Joseph D Tariman,et al.  Preferred and actual participation roles during health care decision making in persons with cancer: a systematic review. , 2010, Annals of oncology : official journal of the European Society for Medical Oncology.

[22]  N. Liu.  The sample size estimation in quantitative nursing research , 2010 .

[23]  France Légaré,et al.  Barriers and facilitators to implementing shared decision-making in clinical practice: update of a systematic review of health professionals' perceptions. , 2008, Patient education and counseling.

[24]  Deborah Schrag,et al.  Desire for information and involvement in treatment decisions: elderly cancer patients' preferences and their physicians' perceptions. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[25]  Mijung Park,et al.  Revisiting Confucianism as a Conceptual Framework for Asian Family Study , 2007, Journal of family nursing.

[26]  M. Morrow,et al.  Factors associated with patient involvement in surgical treatment decision making for breast cancer. , 2007, Patient education and counseling.

[27]  G. Caputo,et al.  Patients’ perceived involvement in care scale: , 2007, Journal of General Internal Medicine.

[28]  Peter Watson,et al.  Do patients benefit from participating in medical decision making? Longitudinal follow‐up of women with breast cancer , 2006, Psycho-oncology.

[29]  W. Lam,et al.  Gambling with your life: The process of breast cancer treatment decision making in Chinese women , 2005, Psycho-oncology.

[30]  He Zhon.  Research on current situation for cancer patient participation in curing and nursing decision-making , 2005 .

[31]  Richard Fielding,et al.  Participation and Satisfaction with Surgical Treatment Decision-Making in Breast Cancer Among Chinese Women , 2003, Breast Cancer Research and Treatment.

[32]  S. Lauri,et al.  Cancer patients' decision-making regarding treatment and nursing care. , 2003, Journal of advanced nursing.

[33]  J. Wennberg,et al.  Unwarranted variations in healthcare delivery: implications for academic medical centres , 2002, BMJ : British Medical Journal.

[34]  B. E. F. Isher,et al.  Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. , 2002 .

[35]  S. Lauri,et al.  Cancer Patients’ Views and Experiences of Participation in Care and Decision Making , 2001, Nursing ethics.

[36]  S. Owen,et al.  A measure of self-care self-efficacy. , 1996, Research in nursing & health.

[37]  V. Coates,et al.  Self-management of chronic illness: implications for nursing. , 1995, International journal of nursing studies.

[38]  A. Gafni,et al.  A Bedside Decision Instrument To Elicit a Patient's Preference Concerning Adjuvant Chemotherapy for Breast Cancer , 1992, Annals of Internal Medicine.

[39]  G. Zimet,et al.  Social support, type A behavior, and coronary artery disease. , 1987, Psychosomatic medicine.