title: Breast cancer treatment decision making among Latinas and non-Latina Whites: a communication model predicting decisional outcomes and quality of life.
abstract: OBJECTIVE
  Deciding among medical treatment options is a pivotal event following cancer diagnosis, a task that can be particularly daunting for individuals uncomfortable with communication in a medical context. Few studies have explored the surgical decision-making process and associated outcomes among Latinas. We propose a model to elucidate pathways through which acculturation (indicated by language use) and reports of communication effectiveness specific to medical decision making contribute to decisional outcomes (i.e., congruency between preferred and actual involvement in decision making, treatment satisfaction) and quality of life among Latinas and non-Latina White women with breast cancer.
  
  
  METHODS
  Latinas (N = 326) and non-Latina Whites (N = 168) completed measures six months after breast cancer diagnosis, and quality of life was assessed 18 months after diagnosis. Structural equation modeling was used to examine relationships between language use, communication effectiveness, and outcomes.
  
  
  RESULTS
  Among Latinas, 63% reported congruency in decision making, whereas 76% of non-Latina Whites reported congruency. In Latinas, greater use of English was related to better reported communication effectiveness. Effectiveness in communication was not related to congruency in decision making, but several indicators of effectiveness in communication were related to greater treatment satisfaction, as was greater congruency in decision making. Greater treatment satisfaction predicted more favorable quality of life. The final model fit the data well only for Latinas. Differences in quality of life and effectiveness in communication were observed between racial/ethnic groups.
  
  
  CONCLUSIONS
  Findings underscore the importance of developing targeted interventions for physicians and Latinas with breast cancer to enhance communication in decision making.
authors: Institute for Health Care Studies, Feinberg School of Medicine, Northwestern University, USA.
authors: Betina
authors: B
authors: Yanez
authors: Annette L
authors: AL
authors: Stanton
authors: Rose C
authors: RC
authors: Maly
mesh_terms: D000069:Acculturation; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000208:ethnology* / Q000628:therapy*; D003142:Communication; D003657:Decision Making; D005260:Female; D006630:Hispanic or Latino / Q000208:ethnology / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D044465:White People / Q000523:psychology