Treatment decision-making, family influences, and cultural influences of Chinese breast cancer survivors: a qualitative study using an expressive writing method

Wang, Limin; Geng, Xiaotao; Ji, Lili; Li, Guohua; Lü, Qian

doi:10.1007/s00520-019-05161-w

Cited by 43 publications

(58 citation statements)

References 28 publications

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“…For introverted Chinese patients, decision-making aids may be an effective tool to help breast cancer patients who need to make surgical decisions to improving self-reported satisfaction with information and patients' perceived involvement in the decision-making process. [33] The treatment of cancer is rarely just a matter of patients, the function of patient family unit is very important in the process of decision-making, this is consistent with study of Wang, L., et al [9] Family members of Chinese breast cancer patients usually actively participate in the treatment decision of breast cancer patients. They accompanied patients to medical visits, as a medium of communication between health professions and patients, and even replace the patients who are at a loss under the impact to make surgical decisions.…”

Section: Discussionsupporting

confidence: 74%

“…[7] In addition, some Chinese think that the breast is the symbol of feminine charm and sex. [8,9] Therefore, considering the high status of breast in Chinese culture and the fact that breast conserving surgery has more bene ts than mastectomy, [10,11] it might be inferred that women who are in line with breast conserving are more likely to choose breast conserving surgery. However, even in the early stage of breast cancer, the probability of Chinese breast cancer patients choosing breast conserving surgery is still relatively low.…”

Section: Introductionmentioning

confidence: 99%

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Resection or Preservation? A Tough Surgical Decision for Chinese Breast Cancer Patients Who Are in Line with Breast Conserving

Zhu

Liu

et al. 2021

Preprint

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Purpose Breast cancer patients who are in line with breast conserving are faced more challenges in making surgery decision, because breast conservation and mastectomy have equivalent oncologic outcomes. The purpose of this study is to analyze the surgical decision-making process for breast cancer patients and further explore the reasons why do Chinese women who are in line with breast conserving are more likely to choose mastectomy. Methods A qualitative study was conducted. With the sample saturation principle, data collected by semi-structured interviews with 14 breast cancer patients who are in line with breast conserving. Colaizzi’s method of phenomenology was used for data analysis. Results Three major themes emerged from the data. The themes were the following: (1) lack of significant decision-making support (stereotyping of breast cancer surgery, Inferior quality of interaction with health professions, and without the help of decision aids); (2) can’t mull under the strike (immediacy of the decision, breasts are out of deliberating, and escape); and (3) edified by the Chinese culture (deep family values, hiding concerns about femininity, and conservative character). Conclusions Our findings explore the reasons why more Chinese breast cancer patients with breast conserving conditions choose mastectomy, and help patients to choose knowledge-based treatment options which are concordant with their needs, values, and preferences.

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Section: Discussionsupporting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Resection or Preservation? A Tough Surgical Decision for Chinese Breast Cancer Patients Who Are in Line with Breast Conserving

Zhu

Liu

et al. 2021

Preprint

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“…It has been reported that cultural factors such as the breast being seen as less sexually attractive and a greater focus on safety instead of beauty in Chinese culture, as compared to American culture, influence women's views and choices regarding treatment for breast cancer. This resulted in the situation where a greater proportion Chinese‐American women with breast cancer preferred to have a radical mastectomy instead of breast‐conserving treatment, when compared with Latina, White or Black women with breast cancer 19,20 . Moreover, Dumit et al 21 claimed that the strong reliance on God and acceptance of fate embedded in the Lebanese culture led many Lebanese people to believe that coronary interventions such as angioplasty were destined and ‘written’ by God.…”

Section: Introductionmentioning

confidence: 99%

Perceptions of patients undergoing percutaneous coronary intervention on pre‐operative education in China: A qualitative study

Zhuo

Liang

Bai

et al. 2020

Health Expectations

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Objectives To explore the perceptions of patients undergoing percutaneous coronary intervention (PCI) regarding their pre‐operative health education. Methods A qualitative study using semi‐structured, in‐depth interviews was conducted in one cardiology unit in China from July 2019 to December 2019. Purposeful sampling of 17 patients undergoing PCI was interviewed about their perceptions of pre‐operative health education. Thematic analysis of the transcribed data was then used to identify the themes. Results Four themes emerged from the data:(a) triple roles of pre‐operative education with the categories of relief (reliving fear); burden (leading to stress); and meaningless (changing nothing); (b) family member involvement with the categories of shared responsibility and family members’ duty; (c) facilitators in the process of pre‐operative health education with the categories of emotional support, plain language and individualized pre‐operative education; (d) inhibitors in the process of pre‐operative health education with the categories of contradiction and threatening words. Conclusions Pre‐operative health education for patients undergoing PCI should be aligned with the individual patients’ information‐seeking styles and personal differences, emphasizing individualized patient education. Traditional Chinese philosophy should be considered in the practice of pre‐operative education for patients undergoing PCI, which emphasizes family member involvement; at the same time, patient empowerment and self‐care should also be stressed. In addition, emotional support and plain language from health professionals are important in pre‐operative health education for patients undergoing PCI; contradiction should be avoided, and threatening words should be used with caution and with consideration for cultural variations during pre‐operative education for patients undergoing PCI.

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“…Facing with complicated treatment decisions, BC patients always require to weigh e cacy, safety, post-operation complications, cost, quality of life and follow-up treatment. A qualitative research have reveal the decision-making progress were in uenced by many factors, such as nancial burden, family factors, traditional culture and faltalism in china [7].When confronted with surgical decision, BC patients always experienced anxiety, illness uncertainty , depress, hesitation and decision con ict [8].Facing with many treatment options, BC patients experienced moods uctuate and always given the decision-making right to physicians ,which just considered survival time and didn't consider patients' preference . A survey showed 6-23% of cancer patients experience decision regret [9].…”

Section: Introductionmentioning

confidence: 99%

“…Regrets was often considered to be negative psychological and emotional feelings related with considering a past or future choice [9,10].Prior studies have shown that the active involvement in treatment decision can get more satisfaction about decision-making process [11,12] . In uenced by traditional medical environment, more patient play a passive role in decision-making progress and tend to let the physicians or family members make treatment decision in China [7]. The decision regret associated with various factors including lack of treatment information, individual value, personality traits, decision con ict, decision attitudes and culture factors [13,14].…”

Section: Introductionmentioning

confidence: 99%

Relationship Between Decision Conflict and Decision Regret Among Postoperative Breast Cancer Patients in China: The Regulating Role of Decision-Making Preparation

Wang¹,

Zhang²,

Pang³

et al. 2021

Preprint

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Objective: Different surgical methods have different risks and benefits. The Chinese breast cancer(BC) patients’ decision-making of surgical treatment become a critical research question. Patients are often offered several options before surgery, and decision preparation play an important role in decision process. However some patients regret the original decision afterward. To understand the current situation, this study explore mainly explores the status of decision regret among newly diagnosed BC patients,and tests the relationship between decision conflicts, decision-making preparation, and decision regrets. Methods: A cross-sectional survey was conducted. Totally 320 postoperative BC patients were studied using a self-made general data scale, Decision Regret Scale, Decision Conflict Scale, and Preparation for Decision Making Scale. Basic descriptive analyses, Pearson’s correlation analyses and regression analyses were performed. Results: The average score of decision regret among BC patients after surgery was 34.28. Decision regret was positively associated with decision conflict (r=0.853, p<0.01), and negatively associated decision preparation (r=-0.404, p<0.01). Decision-making preparation plays a regulatory role for the emergence of decision conflicts and regrets. The correlation between decision conflicts and decision regrets increases with the increase of decision-making preparation. Conclusion: The adverse effects of decision conflicts on decision regrets gradually increase with the increase of decision-making preparation. Results indicate that reducing decision preparation can be expected to improve the level of decision regret among Chinese BC patients.Thus, Clinical staffs should encourage patients to actively participate in decision-making, provide specialized information support, and improve the level of decision regret among Chinese BCpatients after surgery.

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Treatment decision-making, family influences, and cultural influences of Chinese breast cancer survivors: a qualitative study using an expressive writing method

Cited by 43 publications

References 28 publications

Resection or Preservation? A Tough Surgical Decision for Chinese Breast Cancer Patients Who Are in Line with Breast Conserving

Resection or Preservation? A Tough Surgical Decision for Chinese Breast Cancer Patients Who Are in Line with Breast Conserving

Perceptions of patients undergoing percutaneous coronary intervention on pre‐operative education in China: A qualitative study

Relationship Between Decision Conflict and Decision Regret Among Postoperative Breast Cancer Patients in China: The Regulating Role of Decision-Making Preparation

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