Decision making across the adult lifespan in the context of breast cancer
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Date
2016
Authors
Campbell-Enns, Heather
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Abstract
Background: Approximately 1.4 million women are diagnosed with breast cancer worldwide annually. Most newly diagnosed women face multiple treatment decisions, and want information about their disease and its treatment when making these decisions. While prior research investigates the psychosocial impacts of breast cancer, little is known about those impacts on the experience of decision making or how age influences decision making. There is a need to conduct research exploring this experience.
Purpose: To develop an understanding of the experience of decision making for women diagnosed with breast cancer across the lifespan. Specific objectives were to explore: 1) the meanings women assigned to decisions; 2) how psychosocial factors influenced the decision making experience, and; 3) similarities and differences in decision making across the lifespan.
Method: The tenants of constructivist grounded theory were followed. Twenty-nine semi-structured interviews were conducted with 22 women with invasive breast cancer. Women ranged in age from 32 to 80 years of age (average=55 years). Participant data was grouped by age: younger women, under 45 years (N=7), middle aged women, aged 45-64 years (N=9), and older women, aged 65 and older (N=6). Data was analyzed using the constant comparison method of data analysis.
Findings: Women with breast cancer described the experience of treatment decision making soon after diagnosis, and described their needs regarding information about cancer and its treatment. Main findings include a model depicting the process of the ways of learning in breast cancer. Two ways of learning were described by women, “learning by trusting the healthcare system” and “learning by trusting a system of connections.” Women reported barriers to information support, including emotional distress, patient-provider communication, provider-provider communication, making it personal, and access to information. Similarities and differences between age groups are presented.
Conclusion: Diagnosed women want information about cancer and its treatment regardless of their ages. Ways of learning in the context of breast cancer guide women as they worked to make treatment decisions, yet barriers to information support exist in breast cancer, occurring at the patient, provider, and health system levels.
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Keywords
Breast cancer, Decision making, Information, Learning, Lifespan, Older women, Younger women, Oncology, Psychosocial