title: Measuring the quality of surgical decisions for Latina breast cancer patients.
abstract: BACKGROUND
  A high-quality decision for breast cancer surgery requires that patients are well informed, meaningfully involved in decision making, and receive treatments that match their goals. There is little in the existing literature that examines a comprehensive measure of decision quality for Latina breast cancer patients.
  
  
  OBJECTIVE
  To examine the quality of surgical decisions among Latina breast cancer survivors and explore factors associated with decision quality and decision regret.
  
  
  METHODS
  Cross-sectional mailed survey.
  
  
  METHODS
  English and certified Spanish translations of Breast Cancer Surgery Decision Quality Instrument (BCS-DQI), Short Acculturation Scale for Hispanics (SASH) and decision regret.
  
  
  METHODS
  Ninety-seven breast cancer survivors of Hispanic or Spanish descent identified through the cancer registry from Orange or San Diego Counties in California.
  
  
  RESULTS
  The 97 respondents were on average 55.7 years old, 39.1% had high school diploma or more education, and 62.9% had low acculturation (SASH scores < 2.99). The average knowledge score was 48.2%, the average decision process score was 67.5%, and many (77.3%) received treatments that matched their goals. In multivariable models, there were no significant associations with education, age, acculturation and any aspect of decision quality or decision regret in this sample. Respondents who had higher decision process scores, indicating more involvement in decision making, had significantly lower decision regret.
  
  
  CONCLUSIONS
  The BCS-DQI may require some adaptation for Latina populations to improve acceptability. The different aspects of decision quality, including knowledge, decision process and concordance, did not vary by level of acculturation.
authors.affiliation: Health Decision Sciences Center, Department of General Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Sepucha
authors.affiliation: Health Decision Sciences Center, Department of General Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Sandra
authors.initials: S
authors.lastname: Feibelmann
authors.affiliation: Department of General Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Yuchiao
authors.initials: Y
authors.lastname: Chang
authors.affiliation: Health Decision Sciences Center, Department of General Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Hewitt
authors.affiliation: Department of Epidemiology, School of Medicine, University of California Irvine, Irvine, CA, USA.
authors.forename: Argyrios
authors.initials: A
authors.lastname: Ziogas
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology / Q000601:surgery*; D002140:California; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D010358:Patient Participation; D011787:Quality of Health Care
keywords: decision quality; shared decision making