Pieters Huibrie C, Heilemann Marysue V, Maliski Sally, Dornig Katrina, Mentes Jan
School of Nursing, University of California, Los Angeles, USA.
Oncol Nurs Forum. 2012 Jan;39(1):E10-9. doi: 10.1188/12.ONF.E10-E19.
PURPOSE/OBJECTIVES: To understand how women aged 70 years and older who had recently undergone treatment for early-stage breast cancer experienced treatment decision making.
Qualitative, descriptive study guided by grounded theory.
PARTICIPANTS' houses and apartments in southern California.
18 women, aged 70-94 years, who completed treatment for primary, early-stage breast cancer 3-15 months prior (X = 8.5 months).
Twenty-eight semistructured personal interviews that lasted, on average, 104 minutes. Data were collected and analyzed using constructivist grounded theory.
Gero-oncology perspective of treatment decision making.
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.
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.
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.
目的/目标：了解70岁及以上近期接受早期乳腺癌治疗的女性如何进行治疗决策。
以扎根理论为指导的定性描述性研究。
南加州参与者的家中和公寓。
18名年龄在70 - 94岁之间的女性，她们在3 - 15个月前（平均为8.5个月）完成了原发性早期乳腺癌的治疗。
28次半结构化个人访谈，平均持续104分钟。采用建构主义扎根理论收集和分析数据。
老年肿瘤学视角下的治疗决策。
一个主要发现是，自发建立联系的能力被用作与他人建立联系的工具。作者将这一过程称为“工具性联系”，它建立在对自己和他人相互关爱的基础之上。在这种相互关爱中，女性通过三种联系方式参与治疗决策的分享：获取信息、解读医疗服务提供者以及确定提供者的可信度。这些联系方式是自然而然且同时运用的。
这些女性运用她们建立联系的专业能力来获取所需的事实和情感信息。这些信息支持了女性认为是共同且有效的决策。
这些发现首次证明了从早期乳腺癌老年女性的个人角度来看，建立联系作为决策关键因素的重要性。这项工作为未来的临床干预和研究机会提供了一个跳板，以便为希望参与癌症护理的老年患者个性化沟通并增强有效决策。
