The 1993 Schering Lecture: Family decision-making processes about early stage breast cancer treatment

Abstract

What role patients and their families should assume in making decisions about their care has stimulated much debate. What role they assume nad want to assume and how they go about making decisions has received little study. This paper will present data on family decision-making about breast cancer treatment from a large longitudinal study of family adjustment to early stage breast cancer. Family interviews were done at the time fo diagnosis and three weeks, three months, eight months and 12 months after diagnosis. Grounded theory methods were used to analyze the qualitative data. Fifty-five women, both partnered and not partnered, as well as their partners and children, participated. Four patterns of family decision-making were identified: "Defer to Physician", "Minimal Exploration", "Joint Participation" and "Extensive Deliberative Examination". The patterns reflected varying degrees and nature of patient, family and physician participation. Particular factors influenced how families made these decisions, the nature of the process and the outcomes. Facilitatin strategies for family decision-making which nurses might use in their practice are described.