Construction and evaluation of a decision-making process support model concerning treatment of breast cancer

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The purposes of this study are to conduct a survey from two directions-from patients and nurses-to elucidate the actual status of a decision-making process of patients and to make the decision-making process support model for breast cancer patients at the actual practice level. The results of the study are given below.1. Interviews were conducted with 19 patients who had breast cancer to elucidate the difficulty each experiences and her interactions with those around her. The difficulty was defined as decision-making forced on them in spite of their unstable psychological state: uncertainty and a lack of support from their surroundings, and a state in which they feel overwhelmed by the gravity of life and weight of the responsibility rendered the difficulty even more unbearable. When the characteristics of the role from the source of support and its limitations were clarified, the patient learned to utilize such support appropriately.2. To clarify the extent of conflict associated with … More decision-making and the factors affecting it, an attempt was made to prove the reliability of quantitative studies based on the results of qualitative research. The patient indicated a medium to high degree of conflict and the sense of difficulty showed a factor structure similar to the results from qualitative studies. Negative correlations were found between conflict and psychological capacity for recovery, satisfaction and a forward attitude, pointing to the factors that affect the conflict.3.The survey was conducted also on the type of nursing assistance that patients would acknowledge. It was found that nursing action should not be limited to offering information or giving emotional help : it should be the kind of support that deals directly with the actual therapeutic choice, such as help to reinforce the decision-making role. According to the results of survey conducted among nurses on actual nursing practice and associated difficulties, psychological support was not regarded as difficult and support was extended at a high frequency. On the other hand, services, such as providing information geared to each patient and support to encourage interactions with partners, encountered difficulty and therefore is practiced less frequently, elucidating problems that exist on the clinical scene.4.For future issues, needs were recognized for continued examination, through actual cases, of the appropriateness of the decision-making process support model for breast cancer patients that has been constructed, as well as evaluation of the model through interventional studies. Less