Congress Abstracts 2004

22

TREATMENT DECISION-MAKING FOR THE PRIMARY TREATMENT AMONG CHINESE AMERICAN WOMEN WITH EARLY-STAGE BREAST CANCER. Shiuyu Katie Lee, RN, MSN, DNSc, National Taipei College of Nursing, Taipei, and Tish Knobf, PhD, FAAN, Yale University School of Nursing, New Haven, CT.

Promoting women as fully informed decision makers for their breast cancer is important to oncology nurses.

Women reported difficulty making the treatment decision for their breast cancer. Breast cancer is the most common cancer among Chinese American women in United States; but there is limited knowledge about how they make and evaluate the treatment decision. The purpose was to describe the primary treatment decision, decisional conflict, expectation, and values as the decision was made, and decisional satisfaction and regret in a sample of Chinese American women with early-stage breast cancer.

Ottawa Decisional Support Framework served as the framework to identify variables in treatment decision making and the evaluation of the decision.

This was a cross-sectional, descriptive study. A convenience sample of 123 Chinese American women with early-stage breast cancer was recruited in the larger New York area. Data were collected on a demographic clinic profile and four standardized instruments in Traditional Chinese with equivalence from back-translation. All four standardized instruments had appropriate reliability and validity.

Data were analyzed with univariate and bivariate statistic strategies by using SAS V8.0 program.

The results indicated that 38% of the women had breast-conserving surgery and the remaining 11.4% had mastectomy plus reconstruction. The women highly valued and expected physician and family support in treatment decision making for their breast caner, while femininity, sexuality, appearance, and attraction to the partner were less valued. The majority agreed that they were satisfied without regret. Treatment decision was related to age, options offered, surgeon and family recommendation, expectation, and value. The women who had health insurance at the time of diagnosis were more likely to have breast-conserving surgery. Decision satisfaction and regret were related to decisional conflict in treatment decision making. The women who had received a greater amount of information, who felt more comfortable in using English, and who had utilized other resources in treatment decision making reported lower decisional conflict, greater satisfaction, and less regret. Strategies are needed to improve communication and provide culturally relevant patient education to promote Chinese American women as fully informed decision makers for their breast cancer.