title: Elder women's decision-making in breast cancer care: An Israeli study.
abstract: OBJECTIVE
  Much research has examined women's decision-making behaviour in breast cancer care. Patient age has shaped preferences, values, decision style and participation in treatment decisions. The aim of this study was to test the validity of the Michigan Assessment of Decision Style (MADS) (Pierce, 1995) in an older cohort and provide information on decision styles to identify areas of tailored decision support necessary for Israeli women.
  
  
  METHODS
  This study examined the decision-making styles of older Israeli women receiving routine mammography screening. Fifty two women over 65 years of age, attending a routine mammography screening, were administered a questionnaire containing demographic information and the MADS to determine hypothetical treatment decision-making. The MADS is a 16-item questionnaire assessing decision-making behaviour by characterizing four factors: avoiding, deferring, information-seeking and deliberation.
  
  
  RESULTS
  Age, family history of breast cancer, and having a current mammography were not significantly associated with any of the four MADS factors. Deliberation and Deferring had the highest mean scores, followed closely by Information-Seeking and Avoidance. Correlations among the factors indicate a significant, positive correlation between Deliberation and Information-Seeking and a significant negative correlation between Deliberation and Deferring, consistent with previous studies.
  
  
  CONCLUSIONS
  These findings indicate that older Israeli women's decision style is characterized by information seeking and deliberation reflecting a disposition towards engagement. The findings contribute to clinicians' understanding of women's preferences by countering the traditionally accepted stereotype that older women will employ a passive role when faced with an important health care decision.
authors.affiliation: The Henrietta Szold Hadassah-Hebrew University School of Nursing, Hadassah Medical Organization, POB 12000, Kiryat Hadassah, Jerusalem 91120, Israel. ikadmon@hadassah.org.il
authors.forename: Ilana
authors.initials: I
authors.lastname: Kadmon
authors.forename: Penny
authors.initials: P
authors.lastname: Pierce
authors.forename: Cathy L
authors.initials: CL
authors.lastname: Antonakos
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001362:Avoidance Learning; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000523:psychology / Q000628:therapy*; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D057226:Information Seeking Behavior; D007389:Internal-External Control; D007557:Israel; D008327:Mammography; D011237:Predictive Value of Tests; D011795:Surveys and Questionnaires