Keywords

Breast cancer, Decision-making, Experience, Influencing factors, Integrative review, Mastectomy

 

Authors

  1. Liu, Jing PhD(c) MSc, RN
  2. Hunter, Sharyn PhD, RN
  3. Zhu, Jiemin PhD, RN
  4. Lee, Regina Lai Tong PhD, RN, FAAN
  5. Chan, Sally Wai-Chi PhD, RN, FAAN

Abstract

Background: Deciding to have a mastectomy can be challenging for women. An understanding of the decision-making experience related to mastectomy would contribute to improving the support of women making this decision.

 

Objective: The aim of this study was to understand women's decision-making experience related to mastectomy.

 

Methods: Studies published from 2000 to 2020 were identified by searching databases (CINAHL, MEDLINE, EMBASE, PsycINFO, PubMed, Web of Science, and China National Knowledge Infrastructure) and reference lists of previous reviews. Methodological quality of these studies was assessed using the Mixed Methods Appraisal Tool version 2018. Data were analyzed using content comparison analysis.

 

Results: Twenty-three quantitative and 6 qualitative studies were included in this review. Four themes emerged from the included studies: participation in decision-making, seeking information about treatment choices, postoperative perceptions of mastectomy decision-making, and factors related to mastectomy choice. Several negative experiences related to decision-making were identified. A number of clinical, sociodemographic, and psychosocial factors that influenced women to choose a mastectomy were identified.

 

Conclusions: This review provides in-depth information about decision-making experiences and factors that influence the choice of mastectomy. Research is required about women who have had a mastectomy using standardized instruments to investigate their decision-making experiences. Studies are also necessary in non-Western countries.

 

Implications for Practice: The factors and experiences identified in this review may help nurses to assist in the treatment decision-making process. Further research is required regarding breast care and other nurses' involvement in the decision-making process related to mastectomy.