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Hawley ST , Lantz PM , Janz NK , Salem B , Morrow M , Schwartz K , Liu LH , Katz SJ
Factors associated with patient involvement in surgical treatment decision making for breast cancer
Patient Education and Counseling. 2007 Mar;65(3) :387-395
PMID: ISI:000245163900015   
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Objective: To evaluate factors associated with women's reported level of involvement in breast cancer surgical treatment decision making, and the factors associated with the match between actual and preferred involvement in this decision. Methods: Survey data from breast cancer patients in Detroit and Los Angeles was merged with surgeon data for an analytic dataset of 1101 patients and 277 surgeons. Decisional involvement and the match between actual and preferred amount of involvement were analyzed as three-level dependent variables using multinomial logistic regression controlling for clustering within surgeons. Independent variables included patient demographic and clinical factors, surgeon demographic and practice factors, cancer program designation, and two measures of patient-surgeon communication. Results: We found variation in women's actual decisional involvement and match between actual and preferred involvement. Women with a surgeon-based or patient-based (versus shared) decision were significantly (p <= 0.05) younger. Women who had too little decisional involvement (versus the right amount) were younger, while women with too much involvement had less education. Patient-surgeon communication variables were significantly associated with both involvement and match, and higher surgeon volume as associated with too little involvement. Conclusion: Patient factors and patient-surgeon communication influence women's perception of their involvement in breast cancer surgical treatment decision making. Practice implications: Decision tools are needed across surgeons and practice settings to elicit patients' preferences for involvement in treatment decisions for breast cancer. (c) 2006 Elsevier Ireland Ltd. All rights reserved.
ISI Document Delivery No.: 149RI Times Cited: 0 Cited Reference Count: 40 Cited References: 2003, STATA REFERENCE MANU 2005, BREAST CANC TREATMEN *NIH, 1990, NIH CONSENSUS STATE, V8, P1 ANEMA MG, 1995, J CONTIN ED NURS, V26, P109 BALDWIN LM, 2004, CANCER, V100, P701 BIRKMEYER NJO, 2005, CANCER, V103, P435 BRUERA E, 2002, CANCER, V947, P2076 DAVISON BJ, 2002, CANCER NURS, V25, P417 DEGNER LF, 1992, J CLIN EPIDEMIOL, V45, P941 DEGNER LF, 1997, JAMA-J AM MED ASSOC, V277, P1485 DILLMAN DA, 1978, MAIL TELEPHONE SURVE FAGERLIN A, 2006, PATIENT EDUC COUNS, V64, P303 FORD S, 2003, HLTH EXPECTATIONS, V6, P72 FUNK LM, 2004, CAN J AGING, V23, P47 GAFNI A, 1998, SOC SCI MED, V47, P347 GUADAGNOLI E, 1998, SOC SCI MED, V47, P329 HAWLEY ST, 2006, MED CARE, V44, P609 HEWITT M, 1999, I MED REPORT ENSURIN, P97 JANZ NK, 2004, J CLIN ONCOL, V22, P3091 JANZ NK, 2005, QUAL LIFE RES, V14, P1467 KATZ SJ, 2005, AM J PUBLIC HEALTH, V95, P2225 KATZ SJ, 2005, CANCER, V104, P1854 KATZ SJ, 2005, J CLIN ONCOL, V23, P3001 KATZ SJ, 2005, J CLIN ONCOL, V23, P5526 KEATING NL, 2002, J CLIN ONCOL, V20, P1473 KEATING NL, 2003, BREAST CANCER RES TR, V79, P225 KEATING NL, 2003, J CLIN ONCOL, V21, P4532 KIESLER DJ, 2005, PATIENT ED COUNSELIN LANTZ PM, 2002, HEALTH SERV RES, V37, P417 LANTZ PM, 2005, HEALTH SERV RES, V40, P745 LEVINSON W, 2005, J GEN INTERN MED, V20, P531 LOCALIO AR, 2001, ANN INTERN MED, V135, P112 MONTINI T, 1997, WOMEN HEALTH, V26, P85 MORROW M, 2005, CANCER, V104, P2340 NAYFIELD SG, 1994, J NATL CANCER I, V86, P1202 PEELE PB, 2005, MED DECIS MAKING, V25, P301 ROBINSON A, 2001, QUAL HLTH CARE S, V10, P134 VARGAS C, 2005, INT J RADIAT ONCOL, V63, P1514 WENNBERG JE, 2002, BRIT MED J, V325, P961 WHELAN T, 2004, JAMA-J AM MED ASSOC, V292, P434 Hawley, Sarah T. Lantz, Paula M. Janz, Nancy K. Salem, Barbara Morrow, Monica Schwartz, Kendra Liu, Lihua Katz, Steven J.