Difficulties Experienced by Breast Cancer Patients in Selecting Their Initial Treatment

Abstract

Abstract

The aims of this study were to elucidate the sorts of difficulties experienced by patients with breast cancer during the process of selecting their initial treatment, and to identify nursing interventions to support patients’ decision-making. The participants in this study were 21 women diagnosed with stage Ⅰ or Ⅱ breast cancer who were offered options as to their initial treatment by their treating physicians. Data were collected through semi-structured interviews and participant observations, and were evaluated using qualitative induction analysis.

We identified 8 categories of difficulty, comprising “inability to properly understand and create a mental image of my condition”, “difficulty making decisions in an uncertain situation based on generalisations”, “hesitation and holding back in discussing things with doctors and nurses”, “not wanting to be a burden to the family, and can’t expect support from them”, “too anxious and worried about everything”, “inability to think clearly due to feelings of distress and unfairness”, “troubled by mood swings under the influence of too much information and other people”, and “feeling overwhelmed by the weight of responsibility in making life and death decisions”. The core problem for these patients with breast cancer was their inability to think clearly when they were asked to make a decision in spite of their unstable emotional state. Difficulty in identifying the basis for their decision-making, difficulty obtaining support from their families and medical service providers, and the weight of responsibility in making life and death decisions, were factors that further destabilised their emotional states.