Purpose: Develop a middle-range theory and model explaining the decisional context within which women with breast cancer make treatment decisions. The overall goal of this work is to inform and guide nursing research and practice in the area of patient decision making. Organizing Construct: Decisional context of women with breast cancer. Definition: Decisional context is defined here as the set of interrelated conditions forming the biopsychosocial environment of an individual in which a choice between two or more options is made. Decisional context is dynamic, the effect of decisions feeding forward and back on the present and future of the decision maker and others, however, it may not be fully accessible nor recognizable to even those involved in the process. Method: Review of literature spanning existing years of Medline, CINAHL, and PsycINFO databases. Key words: decision-making context, meaning of illness, perceptions of cancer, breast cancer, decision making, social values, social influences, patient values, personal values, patient preferences, patient advocacy, politics, mass media, periodicals, family, cultural values, and culture of disease. Findings: A synthesis of the research findings put forth by a variety of disciplines supports the existence a definable context within which women making breast cancer treatment decisions find themselves. This context is depicted by a model of the interrelationships of six components: societal, external-patient, internal-patient, provider, decision-making process, and patient decision satisfaction. Implications for Nursing: It is intended that the Decisional Context of Patients with Breast Cancer theory and model will be readily accessible to nurses and provide them with greater understanding and guidance in their assessment, planning, and intervention in the decision-making process of women with breast cancer. Additionally, this work will provide direction to research, specifically the study of hypotheses regarding the linkages between the components of decisional context and the concepts of which these are comprised.
Session #1185 - Oncology Nursing Research
The 29th Annual MNRS Research Conference (April 1-4, 2005)