Instrumental relating and treatment decision making among older women with early-stage breast cancer.
OBJECTIVE
To understand how women aged 70 years and older who had recently undergone treatment for early-stage breast cancer experienced treatment decision making.


METHODS
Qualitative, descriptive study guided by grounded theory.


METHODS
PARTICIPANTS' houses and apartments in southern California.


METHODS
18 women, aged 70-94 years, who completed treatment for primary, early-stage breast cancer 3-15 months prior (X = 8.5 months).


METHODS
Twenty-eight semistructured personal interviews that lasted, on average, 104 minutes. Data were collected and analyzed using constructivist grounded theory.


METHODS
Gero-oncology perspective of treatment decision making.


RESULTS
A major finding was that the power of relating spontaneously was used as a vehicle to connect with others. That process, which the authors called "instrumental relating," was grounded in a foundation of mutual caring for themselves and others. Within that mutual caring, the women participated in three ways of relating to share in treatment decision making: obtaining information, interpreting healthcare providers, and determining the trustworthiness of their providers. Those ways of relating were effortlessly and simultaneously employed.


CONCLUSIONS
The women used their expert abilities of relating to get the factual and emotional information that they needed. That information supported what the women perceived to be decisions that were shared and effective.


CONCLUSIONS
The findings are the first evidence of the importance of relating as a key factor in decision making from the personal perspective of older women with early-stage breast cancer. This work serves as a springboard for future clinical interventions and research opportunities to individualize communication and enhance effective decision making for older patients who wish to participate in their cancer care.
School of Nursing, University of California, Los Angeles, USA. hpieters@sonnet.ucla.edu
Huibrie C
HC
Pieters
Marysue V
MV
Heilemann
Sally
S
Maliski
Katrina
K
Dornig
Jan
J
Mentes
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000451:nursing* / Q000523:psychology*; D003657:Decision Making; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D009859:Oncology Nursing / Q000379:methods*; D057240:Patient Preference / Q000523:psychology*; D012648:Self Care; D012944:Social Support