Low-income women with early-stage breast cancer: physician and patient decision-making styles.

Abstract:

BACKGROUND:Poor women have low rates of breast conservation therapy not explained by differences in insurance status or treatment preferences. The purpose of this study was to explore how low-income women make decisions about breast cancer treatment. METHODS:Twenty-five women diagnosed with early-stage breast cancer through the Nebraska Every Woman Matters program were interviewed about their experiences selecting treatment options. These interviews were transcribed and then analysed using established qualitative techniques. RESULTS:More than half of the women (n=16) described playing a passive role in decision making. Choice was determined by medical factors or not offered by their physicians. Intense emotional distress affected some women's ability to compare options. The women who did engage in a rational decision-making process (n=9) based their choices on concerns about body image and fear of recurrence. CONCLUSIONS:When presented with a choice, and when able to objectively weigh treatment options, low-income women base their treatment decisions on the same issues as those of higher income. Whether differences in income strata alter the doctor-patient power dynamic in favor of physician control over decision making, or whether low-income women are less prepared to engage in a rational deliberative process warrants further study.

journal_name

Psychooncology

journal_title

Psycho-oncology

authors

McVea KL,Minier WC,Johnson Palensky JE

doi

10.1002/pon.503

keywords:

subject

Has Abstract

pub_date

2001-03-01 00:00:00

pages

137-46

issue

2

eissn

1057-9249

issn

1099-1611

pii

10.1002/pon.503

journal_volume

10

pub_type

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