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Decision‐support networks of women newly diagnosed with breast cancer
Author(s) -
Wallner Lauren P.,
Li Yun,
McLeod M. Chandler,
Hamilton Ann S.,
Ward Kevin C.,
Veenstra Christine M.,
An Lawrence C.,
Janz Nancy K.,
Katz Steven J.,
Hawley Sarah T.
Publication year - 2017
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.30848
Subject(s) - medicine , breast cancer , deliberation , population , demography , epidemiology , cancer , family medicine , environmental health , law , sociology , politics , political science
BACKGROUND Little is known about the size and characteristics of the decision‐support networks of women newly diagnosed with breast cancer and whether their involvement improves breast cancer treatment decisions. METHODS A population‐based sample of patients newly diagnosed with breast cancer in 2014 and 2015, as reported to the Georgia and Los Angeles Surveillance, Epidemiology, and End Results registries, were surveyed approximately 7 months after diagnosis (N = 2502; response rate, 68%). Network size was estimated by asking women to list up to 3 of the most important decision‐support persons (DSPs) who helped them with locoregional therapy decisions. Decision deliberation was measured using 4 items assessing the degree to which patients thought through the decision, with higher scores reflecting more deliberative breast cancer treatment decisions. The size of the network (range, 0‐3 or more) was compared across patient‐level characteristics, and adjusted mean deliberation scores were estimated across levels of network size using multivariable linear regression. RESULTS Of the 2502 women included in this analysis, 51% reported having 3 or more DSPs, 20% reported 2, 18% reported 1, and 11% reported not having any DSPs. Married/partnered women, those younger than 45 years, and black women all were more likely to report larger network sizes (all P < .001). Larger support networks were associated with more deliberative surgical treatment decisions ( P < .001). CONCLUSIONS Most women engaged multiple DSPs in their treatment decision making, and involving more DSPs was associated with more deliberative treatment decisions. Future initiatives to improve treatment decision making among women with breast cancer should acknowledge and engage informal DSPs. Cancer 2017;123:3895‐903 . © 2017 American Cancer Society .