The Dyadic Experience of a New Breast Cancer Diagnosis Into the Shared Decision-Making Process: A Qualitative Analysis

Abstract

Objective: This study explores the dyadic experience of patients newly diagnosed with breast cancer and their caregivers, focusing on emotional responses, informational needs, and shared involvement in clinical decision-making. Methods: Twenty-three patient-caregiver dyads participated in semi-structured interviews conducted by psychologists specializing in clinical and health psychology. The interviews were analyzed using Qualitative Thematic Analysis to identify core themes reflecting the dyadic experience. Results: Findings highlighted the central role of the patient-caregiver relationship in coping with diagnosis and treatment planning. Both patients and caregivers valued sharing medical information, participating together in medical consultation and jointly engaging in treatment decisions, which fostered a sense of unity, reduced anxiety and improved understanding of treatment choice. Trust in healthcare providers, particularly their clarity, empathy, and expertise, emerged as a critical factor in alleviating patients' decisional regret and sustaining caregivers' confidence in supporting the patient. Although both patients and caregivers faced emotional challenges, their fears and concerns often differed, underscoring the need for individualized emotional support. Inclusion of caregivers in clinical discussions was considered essential for promoting a cohesive and supportive care experience. Conclusions: The study underscores the emotional complexity and interdependence of the patient-caregiver dynamic following a breast cancer diagnosis. Being the patient-caregiver relationship central to cancer care, it is important to encourage coordinated involvement of both parties in the clinical process may reduce psychological distress, alleviate decisional conflict, and enhance overall quality of life. These findings support the adoption of a person-centered, relational model of care that recognizes the dyad as a unit of support and decision-making.