title: Involvement in decision-making and breast cancer survivor quality of life.
abstract: OBJECTIVE
  This study examined the long-term effects on women's health related quality of life (HRQOL) of involvement in decision-making about their treatment for breast cancer and about follow-up care after treatment.
  
  
  METHODS
  Using a cross-sectional survey design, a sample of breast cancer survivors from Western Washington who were 2, 5, and 10 years postdiagnosis were recruited via a cancer registry and interviewed about their HRQOL and their involvement in decision-making about their cancer treatment and follow-up care.
  
  
  METHODS
  HRQOL was assessed using the SF-36.
  
  
  RESULTS
  Multiple regression analyses examining demographic and disease characteristics revealed age, and education, but not stage of cancer at diagnosis, to be significant predictors of perceived involvement in decision-making about cancer treatment and follow-up. Controlling for demographic and disease characteristics, perceived involvement in decision-making about treatment overall, surgery, chemotherapeutic treatment, and follow-up care were each associated with improved HRQOL, including the general health and vitality subscales of the SF-36 (p < .05). Involvement in decision-making about surgery was also associated with better mental health among survivors of breast cancer. Congruence of involvement in decision-making with a patient's preferred level of involvement was also associated with improved survivor HRQOL on several subscales.
  
  
  CONCLUSIONS
  Perceived involvement in decision-making about breast cancer treatment, and about follow-up care is associated with better HRQOL for survivors 2, 5, and 10 years postdiagnosis. Prospective studies may be warranted to determine the possible mechanisms by which perceived involvement in decision-making about aspects of treatment other than surgery type might influence survivor HRQOL.
authors.affiliation: Fred Hutchinson Cancer Research Center, Department of Health Services, University of Washington, Seattle, WA 98109-1024, USA. rander@fhcrc.org
authors.forename: M Robyn
authors.initials: MR
authors.lastname: Andersen
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Bowen
authors.forename: Jessica
authors.initials: J
authors.lastname: Morea
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Stein
authors.forename: Frank
authors.initials: F
authors.lastname: Baker
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D018802:Patient-Centered Care; D011788:Quality of Life; D017741:Survivors / Q000523:psychology*; D014861:Washington