Why do hospital mastectomy rates vary? Differences in the decision-making experiences of women with breast cancer
作者： L J M Caldon , K A Collins , D J Wilde , S H Ahmedzai , T W Noble
DOI: 10.1038/BJC.2011.141
关键词:
摘要: Background: Hospital mastectomy rates vary. This study explores the relationship between and breast cancer patients consultation decision-making experiences with specialist clinicians. Methods: Qualitative semi-structured interviews were conducted 65 from three purposively selected units a single UK region. Patients provided choice of surgery (breast conservation therapy (BCT) or mastectomy) recruited high, medium low case-mix-adjusted rate units. Results:Low unit markedly different to those high units. Treatment variation was associated perception most reassuring least disruptive treatment; content style information provision (equipoise directed); level patient participation in decision making; time process making autonomy making. The more comprehensive less directive greater autonomy, support independent lower uptake BCT. Conclusion: Variation hospital differences patients. Higher facilitation informed autonomous
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