Decision-making experiences related to mastectomy: A descriptive qualitative study

J Adv Nurs. 2024 May;80(5):1967-1983. doi: 10.1111/jan.15948. Epub 2023 Nov 17.

Abstract

Aim: To obtain an in-depth understanding of women's decision-making experiences related to mastectomy.

Design: A descriptive qualitative interview study.

Methods: Individual semi-structured interviews were conducted face-to-face with 27 Chinese women with breast cancer who underwent mastectomy at two tertiary hospitals in mainland China between September 2020 and December 2021 after obtaining the appropriate ethical approvals. Interviews were conducted in Mandarin. Data were analysed using inductive content analysis.

Results: Mean age of participants was 48 years (range 31-70). Most participants had low education, low monthly family income, had a partner and health insurance, had been diagnosed with early breast cancer, and had not undergone reconstructive surgery. Six categories related to decision-making experiences emerged: (1) Emotions affecting decision-making, (2) Information seeking for decision-making, (3) Beliefs about mastectomy and the breast, (4) Participation in decision-making, (5) People who influence decision-making, and (6) Post-decision reflection. Participants did not mention the role of nurses in their decision-making process for mastectomy.

Conclusions: This study adds valuable insights into the limited evidence on women's experience with decision-making about mastectomy from a Chinese perspective, which is important given the continuing high prevalence of mastectomy in many regions. Future studies from other countries and ethnic groups are recommended to gain diverse knowledge.

Impact: The findings of this study are useful for nurses and other healthcare professionals in the multidisciplinary team to better support women with breast cancer in their decision-making process regarding mastectomy. The findings could inform future interventions to support treatment decision-making and may be relevant to women living in similar socio-medical contexts to those in mainland China.

Reporting method: The study was reported following the Standards for Reporting Qualitative Research checklist.

Patient or public contribution: No patient or public contribution.

Keywords: Chinese women; breast cancer; decision‐making; mastectomy; nursing; qualitative interview.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms* / psychology
  • Decision Making
  • Emotions
  • Female
  • Humans
  • Mastectomy* / psychology
  • Middle Aged
  • Qualitative Research