A study into factors which influence breast cancer patients’ decision to accept chemotherapy


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Sophie Hancock1, Elaine Young2
1University of Manchester, Manchester, UK, 2Lancashire Teaching Hospitals NHS Trust, Lancashire, UK

Background

Ideas about acceptability of cancer treatment differ greatly between patients and healthcare professionals, hence the importance of shared decision making. A questionnaire-based study was undertaken in order to examine treatment decisions in adjuvant chemotherapy for breast cancer and how this decision is facilitated by the multi-disciplinary team.

Method

31 female patients at Royal Preston Hospital were identified to take part in the study. All had accepted adjuvant chemotherapy treatment and had no prior diagnosis of cancer. Patients completed a questionnaire regarding their support network, previous healthcare experiences, mental wellbeing, their decision making process and the information they received to supplement their decision. Responses were then statistically analysed.

Results

65% of patients were aged between 45 and 59 years. 48% of patients expressed that their family had a lot of influence on their decision making, with 13% regarding family as their primary factor. No correlation was found between previous family experience of cancer and the influence of family on treatment decisions (P = 0.30). 52% of patients rated their illness as the most stressful factor in their life, whereas 13% were most stressed about finances. There was, however, no correlation between financial worries and employment status (P = 0.24). Patients’ ideas regarding the outcome of their chemotherapy varied from complete cure to improving their quality of life. Patients who had the most pessimistic outlook on treatment all had a previous or current history of depression.

Conclusion

By making specialists more aware of decision making roles and information preferences, discussion between patient and doctor regarding these points can be encouraged. Particularly of relevance would be a history of depression, which was shown to correlate to a pessimistic outlook on treatment. Emphasis on the intended outcome of adjuvant chemotherapy should be conveyed using an information type preferred by the patient.