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Twenty patients were interviewed from the low and medium mastectomy rate units, and 25 from the high mastectomy rate unit.
He also went through the pros and cons of each one…and wrote this down.' [Patient 9, mastectomy, age 50, medium mastectomy rate unit, p4] Patients described the different roles clinicians had in providing information for making decisions.
However, in this study, the converse seemed to be the case; with high and medium mastectomy rate unit patients often displaying more comprehensive knowledge of treatment including BCT, than their low mastectomy rate unit counterparts.
Conversely, patients from the high and medium mastectomy rate units described the provision of more comprehensive less directive information, together with greater support and time for more autonomous decision making.
He also went through the pros and cons of each one…and wrote this down.' [Patient 9, mastectomy, age 50, medium mastectomy rate unit, p4] 'He went through the various options that I could take…having the lump removed and going for follow-up treatment radiotherapy, and which would be a five-week [course]…or the mastectomy.
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In contrast, medium and high mastectomy rate unit patients voiced such information readily and utilised it when making treatment decisions.
Patients were recruited via the previously published questionnaire phase of the wider research study from high, medium and low mastectomy rate breast units (Caldon et al, 2008).
In contrast, decision making within the medium and high mastectomy rate units tended to be more complex, with patients often describing periods of reflection and deliberation.
The medium and high mastectomy rate units tended to introduce the concept and explain the rationale early within the consultation, leading patients to expect involvement in decision making.
However, the decision-making experiences of women from the medium and high mastectomy rate units were similar, and differences existed between these and those of patients treated by the low mastectomy rate breast unit.
The authors identified high, medium and low mastectomy rate breast units with adjustment of raw mastectomy rate data for the units' case mix, and recruited representative units to participate.
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