title: Gambling with your life: the process of breast cancer treatment decision making in Chinese women.
abstract: Treatment decision making (TDM) studies have primarily focused on assessing TDM quality and predominantly presume rational analytic processes as the gold standard. In a grounded theory study of 22 Hong Kong Chinese women following breast surgery who completed an in-depth interview exploring the process of TDM in breast cancer (BC), narrative data showed that discovery of a breast abnormality and emotional responses to BC diagnosis influence the TDM process. Lack of guidance from surgeons impaired TDM. Decisions were, for the most part, made using intuitive, pragmatic and emotionally driven criteria in the absence of complete information. The experience of TDM, which was likened to gambling, did not end once the decision was made but unfolded while waiting for surgery and the post-operative report. In this waiting period, women were emotionally overwhelmed by fear of death and the uncertainty of the surgical outcome, and equivocated over whether they had made the 'right' choice. This suggests that Chinese women feel they are gambling with their lives during TDM. These women are particularly emotionally vulnerable whilst waiting for their surgery and the post-surgical clinical pathology results. Providing emotional support is particularly important at this time when these women are overwhelmed by uncertainty.
authors.affiliation: Department of Nursing studies, University of Hong Kong, People's Republic of China. wwtlam@hkucc.hku.hk
authors.forename: Wendy Wt
authors.initials: WW
authors.lastname: Lam
authors.forename: Richard
authors.initials: R
authors.lastname: Fielding
authors.forename: Miranda
authors.initials: M
authors.lastname: Chan
authors.forename: Louis
authors.initials: L
authors.lastname: Chow
authors.forename: Amy
authors.initials: A
authors.lastname: Or
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000523:psychology*; D001943:Breast Neoplasms / Q000208:ethnology* / Q000601:surgery*; D002681:China / Q000208:ethnology; D003657:Decision Making; D004644:Emotions; D005260:Female; D006723:Hong Kong; D006801:Humans; D008408:Mastectomy / Q000523:psychology*; D008875:Middle Aged; D010817:Physician-Patient Relations