title: Bridging the gap: decision-making processes of women with breast cancer using complementary and alternative medicine (CAM).
abstract: OBJECTIVE
  The purpose of this study was to explore the personal and social processes women with breast cancer engaged in when making decisions about complementary and alternative medicine (CAM). The overall aim was to develop a conceptual model of the treatment decision-making process specific to breast cancer care and CAM that will inform future information and decision support strategies.
  
  
  METHODS
  Grounded theory methodology explored the decisions of women with breast cancer using CAM. Semistructured interviews were conducted with 20 women diagnosed with early-stage breast cancer. Following open, axial, and selective coding, the constant comparative method was used to identify key themes in the data and develop a conceptual model of the CAM decision-making process.
  
  
  RESULTS
  The final decision-making model, Bridging the Gap, was comprised of four core concepts including maximizing choices/minimizing risks, experiencing conflict, gathering and filtering information, and bridging the gap. Women with breast cancer used one of three decision-making styles to address the paradigmatic, informational, and role conflict they experienced as a result of the gap they perceived between conventional care and CAM: (1) taking it one step at a time, (2) playing it safe, and (3) bringing it all together.
  
  
  CONCLUSIONS
  Women with breast cancer face conflict and anxiety when making decisions about CAM within a conventional cancer care context. Information and decision support strategies are needed to ensure women are making safe, informed treatment decisions about CAM. The model, Bridging the Gap, provides a conceptual framework for future decision support interventions.
authors.affiliation: School of Nursing, University of British Columbia, 302-6190 Agronomy Road, Vancouver, British Columbia, Canada. lynda.balneaves@nursing.ubc.ca
authors.forename: Lynda G
authors.initials: LG
authors.lastname: Balneaves
authors.forename: Tracy L O
authors.initials: TL
authors.lastname: Truant
authors.forename: Mary
authors.initials: M
authors.lastname: Kelly
authors.forename: Marja J
authors.initials: MJ
authors.lastname: Verhoef
authors.forename: B Joyce
authors.initials: BJ
authors.lastname: Davison
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000628:therapy*; D001955:British Columbia; D000529:Complementary Therapies; D003220:Conflict, Psychological; D003657:Decision Making; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged