Date of Award

1998

Document Type

Thesis

Publisher

Edith Cowan University

Degree Name

Bachelor of Nursing Honours

School

School of Nursing

Faculty

Faculty of Health and Human Sciences

First Supervisor

Linda Kristjanson

Abstract

A descriptive correlational study was conducted to describe the factors that Western Australian women with either Stage I or Stage II Breast Cancer, perceived to be important considerations when deciding upon either Modified Radical Mastectomy (MRM) or Breast Conserving Treatment (BCT) for surgical treatment. The Conflict Theory of Decision Making (Janis & Mann, 1977) was used as the theoretical framework to guide this study. Ward, Heidrich and Wolberg's (1989) Factor List, the Multidimensional Health Locus of Control (MHLC) Scale (Wallston, Wallston & De Vellis, 1978) and a demographic questionnaire were used to measure variables. Questionnaires were mailed to a consecutive sample of370 women diagnosed with breast cancer during a six-month period and selected from the Cancer Registry at the Health Department of Western Australia. Results revealed that women who had undergone BCT rated the surgeon's preference as a more important factor and influence on decision-making than the MRM group, t (101.10) = -2.30, p = .02. These women also rated the factor concerning no difference in long term survival between the two surgeries as a more important influence than the MRM group, t (106) = -3.33, p = .00. Area of residence was also significantly associated with surgical choice. Women in rural areas tended to choose MRM rather than BCT, x2(1, N = 160) = 12.75, p = .00. Important sources of information that women used to assist them in decision-making were the surgeon, their family and General Practitioner (GP). There was a significant association between women's involvement in decision-making and use of GP as an information source, x2 (3, N = 164) = 9.94, p = .02. The majority of women (54.30%) wanted the decision for surgery to be fully their own with women in the BCT group preferring a more active role in decision-making compared to the MRM group, u = 2368.00, p = .01. Most women had participated in making their decisions as much as they desired, had enough time in which to make their decisions and had received enough information. A moderate correlation between adequacy of information and enough time for decision making was found, r (158) = .58, p = .00. Correlations were also found between the subscales of MHLC and age, information adequacy, enough time for decision-making, and level of emotional distress. These results will assist health professionals to focus on ways of providing valid information and support to women and their families at the time of decision-making. In particular, findings will assist nurses to better understand the process of decision-making for breast cancer surgery and the main issues of importance to women. Furthermore, nurses will be better able to assist women with their treatment decisions according to their preferred level of involvement.

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