Author Affiliations: Faculty of Health and Medicine, School of Nursing and Midwifery, University of Newcastle, New South Wales, Australia (Ms Liu and Drs Hunter and Lee); Department of Nursing, School of Medicine, Xiamen University, China (Dr Zhu); and UON Singapore Campus and Priority Research Centre for Brain and Mental Health (Dr Chan), University of Newcastle, New South Wales, Australia.
Cancer Nurs. 2021;44(6):E670-E686. doi: 10.1097/NCC.0000000000000981.
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.
The aim of this study was to understand women's decision-making experience related to mastectomy.
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.
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.
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.
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.
对于女性来说，决定是否进行乳房切除术是一项具有挑战性的决策。了解与乳房切除术相关的决策过程有助于改善对此类决策的支持。
本研究旨在了解女性在乳房切除术中的决策过程。
通过检索数据库（CINAHL、MEDLINE、EMBASE、PsycINFO、PubMed、Web of Science 和中国国家知识基础设施）和之前综述的参考文献，确定了 2000 年至 2020 年发表的研究。使用混合方法评估工具 2018 版评估这些研究的方法学质量。使用内容比较分析对数据进行分析。
本综述共纳入 23 项定量研究和 6 项定性研究。纳入的研究中出现了四个主题：参与决策、寻求治疗选择信息、乳房切除术决策的术后感知以及与乳房切除术选择相关的因素。确定了一些与决策相关的负面经历。还确定了一些影响女性选择乳房切除术的临床、社会人口统计学和心理社会因素。
本综述提供了有关决策过程和影响乳房切除术选择的因素的深入信息。需要使用标准化工具对已接受乳房切除术的女性进行研究，以调查她们的决策过程。在非西方国家也需要开展相关研究。
本综述中确定的因素和经验可能有助于护士协助治疗决策过程。需要进一步研究乳房护理和其他护士在与乳房切除术相关的决策过程中的参与情况。
