Elder women's decision-making in breast cancer care: An Israeli study

Decision-Making Styles and Levels of Involvement Concerning Breast Reconstructive Surgery: An Israeli Study

PURPOSE/OBJECTIVES

To address decision-making styles among breast cancer survivors considering breast reconstruction.
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DESIGN

A primary analysis of a cross-sectional sample among survivors who chose to have breast reconstruction to examine correlations among patient age, decision-making style, and the level of involvement of decision making.
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SETTING

Hadassah Medical Center in Jerusalem, Israel.
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SAMPLE

70 women who had undergone breast reconstruction surgery in the past five years.
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METHODS

Participants completed decision-making style and demographic questionnaires and an assessment of their level of involvement in the decision-making process. 
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MAIN RESEARCH VARIABLES

Level of involvement in decision making, decision-making model between provider and patient, and decision-making styles were examined.
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FINDINGS

No correlation was found between four main decision-making styles and patient age or the extent of patient decision-making involvement and age. A statistically significant correlation was found between the level of involvement in decision making and the decision-making style of the patient.
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CONCLUSIONS

Nurses should assess patient decision-making styles to ensure maximum patient involvement in the decision-making process based on personal desires regardless of age.
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IMPLICATIONS FOR NURSING

Nurses working in breast cancer care must address the decision-making process of patients diagnosed with breast cancer, including the choice to undergo breast reconstruction after mastectomy. Nurses should understand the complex factors that influence a woman's decision-making style to best help with the decision.

Evaluation of a patient information website for childhood cancer survivors

PURPOSE

Childhood cancer survivors (CCS) are in need of specialized information about late effects of treatment. In the current study, we assessed the perceived usability and satisfaction with the content of a national website with information on late effects and analyzed possible determinants related to website usability and content satisfaction.

METHODS

CCS and their parents were contacted through our local follow-up program and via online media to complete an online questionnaire regarding their baseline characteristics, medical decision style, and the usability and content of the website. Usability was evaluated using the System Usability Scale (SUS), a validated questionnaire resulting in a score from 0 to 100. For the content rating, we constructed a six-item scale resulting in a score from 1 to 5 (Cronbach's α, 0.83). Comments were analyzed qualitatively.

RESULTS

Fifty-five survivors and forty-three parents of survivors completed the questionnaire. Median age of respondents was 41 years (range, 17-58). Respondents rated the website's usability with a mean SUS score of 72.5 (95 % CI, 69.2-74.9). The mean content rating was 3.7 (95 % CI, 3.5-3.8). No determinants were significantly related to the perceived usability or content satisfaction in multivariate analyses. Qualitative analysis revealed respondents' preference for more detailed and even scientific information on late effects.

CONCLUSION

Respondents were satisfied with the usability and the contents of a website that targeted at their information needs. As knowledge about late effects is still limited among survivors, a website can be a valuable resource to improve their knowledge, promote healthy behavior, and in the end, improve their quality of life.