The decision-making journey of Malaysian women with early breast cancer: a qualitative study
Document Type
Article
Publication Date
1-1-2013
Abstract
Background: The survival outcomes for women presenting with early breast cancer are influenced by treatment decisions. In Malaysia, survival outcome is generally poor due to late presentation. Of those who present early, many refuse treatment for complementary therapy. Objective: This study aimed to explore the decision making experiences of women with early breast cancer. Materials and Methods: A qualitative study using individual in-depth interviews was conducted to capture the decision making process of women with early breast cancer in Malaysia. We used purposive sampling to recruit women yet to undergo surgical treatment. A total of eight participants consented and were interviewed using a semi-structured interview guide. These women were recruited from a period of one week after they were informed of their diagnoses. A topic guide, based on the Ottawa decision support framework (ODSF), was used to facilitate the interviews, which were audio recorded, transcribed and analysed using a thematic approach. Results: We identified four phases in the decision-making process of women with early breast cancer: discovery (pre-diagnosis); confirmatory ('receiving bad news'); deliberation; and decision (making a decision). These phases ranged from when women first discovered abnormalities in their breasts to them making final surgical treatment decisions. Information was vital in guiding these women. Support from family members, friends, healthcare professionals as well as survivors also has an influencing role. However, the final say on treatment decision was from themselves. Conclusions: The treatment decision for women with early breast cancer in Malaysia is a result of information they gather on their decision making journey. This journey starts with diagnosis. The women's spouses, friends, family members and healthcare professionals play different roles as information providers and supporters at different stages of treatment decisions. However, the final treatment decision is influenced mainly by women's own experiences, knowledge and understanding.
Keywords
Decision making in-depth interviews early breast cancer qualitative study Malaysia single institution information survival choice experiences surgery health
Divisions
fac_med
Publication Title
Asian Pacific Journal of Cancer Prevention
Volume
14
Issue
12
Additional Information
ISI Document Delivery No.: AB1CM Times Cited: 0 Cited Reference Count: 23 Abdullah, Adina Abdullah, Khatijah Lim Yip, Cheng Har Teo, Soo-Hwang Taib, Nur Aishah Ng, Chirk Jenn CARIF; HIR Grant from the Ministry of Higher Education of Malaysia UM.C/HIR/MOHE/06 This project was funded by CARIF and the HIR Grant UM.C/HIR/MOHE/06 from the Ministry of Higher Education of Malaysia. The authors would like to acknowledge the hard work of Madam Lee Sian Boy in organising the data collection phase of the study, Miss Elaine Seymour for proofreading the manuscript and all the breast surgeons and breast care nurses from University Malaya Medical Centre and Hospital Tengku Ampuan Rahimah, Klang. Very special thanks to all the women involved in this study for allowing us to interview them during the most difficult journey of their lives. Asian pacific organization cancer prevention Gyeonggi-do