Readiness to engage in treatment decision-making during initial surgical oncology consultation for early stage breast cancer

Abstract

Following diagnosis with early stage breast cancer (ESBC), many difficult treatment decisions must be made.  Due to the preference sensitive nature of the surgical treatment decision for ESBC, survivors need adequate treatment knowledge and the opportunity to reflect on personal preferences for expected treatment outcomes. The purpose of this study was to explore factors influencing women’s readiness to engage in surgical treatment decision-making during their initial consultation for ESBC including: (1) knowledge of ESBC and surgical treatment options, 2) health literacy, (3) decision conflict; and (4) preferred treatment decision-making role. The majority of women had knowledge deficits, with only one answering all 7 items on the ESBC knowledge scale correctly. Those with low levels of health literacy had significantly lower levels of knowledge (p < .05). African American women were more likely to have lower levels of knowledge, and significantly more likely to have limited health literacy (p = .05). Women with lower levels of knowledge had higher levels of decision conflict (p < .05). The majority preferred a patient-centered or active role in decision-making; however, they were poorly prepared for meaningful participation.As informed participation in treatment decision-making is a tenet of patient-centered care, this finding is problematic and likely contributes to poor healthcare outcomes, especially for at-risk groups of women with ESBC.