Bridging the gap: decision-making processes of women with breast cancer using complementary and alternative medicine (CAM)

被引:44
作者
Balneaves, Lynda G.
Truant, Tracy L. O.
Kelly, Mary
Verhoef, Marja J.
Davison, B. Joyce
机构
[1] Univ British Columbia, Sch Nursing, Vancouver, BC V6T 1Z3, Canada
[2] British Columbia Canc Agcy, Vancouver, BC V5Z 4E6, Canada
[3] Univ Calgary, Dept Community Hlth Sci, Calgary, AB T2N 4N1, Canada
[4] Univ British Columbia, Dept Urol Sci, Vancouver, BC V5Z 1M9, Canada
基金
加拿大健康研究院;
关键词
treatment decision making; complementary and alternative medicine; breast neoplasm; decisional conflict; grounded theory;
D O I
10.1007/s00520-007-0282-3
中图分类号
R73 [肿瘤学];
学科分类号
100214 [肿瘤学];
摘要
Goals of work The purpose of this study was to explore the personal and social processes women with breast cancer engaged in when making decisions about complementary and alternative medicine (CAM). The overall aim was to develop a conceptual model of the treatment decision-making process specific to breast cancer care and CAM that will inform future information and decision support strategies. Materials and methods Grounded theory methodology explored the decisions of women with breast cancer using CAM. Semistructured interviews were conducted with 20 women diagnosed with early-stage breast cancer. Following open, axial, and selective coding, the constant comparative method was used to identify key themes in the data and develop a conceptual model of the CAM decision-making process. Main results The final decision-making model, Bridging the Gap, was comprised of four core concepts including maximizing choices/minimizing risks, experiencing conflict, gathering and filtering information, and bridging the gap. Women with breast cancer used one of three decision-making styles to address the paradigmatic, informational, and role conflict they experienced as a result of the gap they perceived between conventional care and CAM: (1) taking it one step at a time, (2) playing it safe, and (3) bringing it all together. Conclusions Women with breast cancer face conflict and anxiety when making decisions about CAM within a conventional cancer care context. Information and decision support strategies are needed to ensure women are making safe, informed treatment decisions about CAM. The model, Bridging the Gap, provides a conceptual framework for future decision support interventions.
引用
收藏
页码:973 / 983
页数:11
相关论文
共 49 条
[1]
[Anonymous], 2005, CLIN PSYCHOL-UK, DOI DOI 10.1080/13284200500221078
[2]
Use of complimentary and alternative medicine by breast cancer patients: prevalence, patterns and communication with physicians [J].
Ashikaga, T ;
Bosompra, K ;
O'Brien, P ;
Nelson, L .
SUPPORTIVE CARE IN CANCER, 2002, 10 (07) :542-548
[3]
An embedded decisional model of stress and coping: implications for exploring treatment decision making by women with breast cancer [J].
Balneaves, LG ;
Long, B .
JOURNAL OF ADVANCED NURSING, 1999, 30 (04) :882-892
[4]
Beyond convention: describing complementary therapy use by women living with breast cancer [J].
Balneaves, LG ;
Kristjanson, LJ ;
Tataryn, D .
PATIENT EDUCATION AND COUNSELING, 1999, 38 (02) :143-153
[5]
Levels of commitment: Exploring complementary therapy use by women with breast cancer [J].
Balneaves, Lynda G. ;
Bottorff, Joan L. ;
Hislop, T. Gregory ;
Herbert, Carol .
JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE, 2006, 12 (05) :459-466
[6]
Themes of holism, empowerment, access, and legitimacy define complementary, alternative, and integrative medicine in relation to conventional biomedicine [J].
Barrett, B ;
Marchand, L ;
Scheder, J ;
Plane, MB ;
Maberry, R ;
Appelbaum, D ;
Rakel, D ;
Rabago, D .
JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE, 2003, 9 (06) :937-947
[7]
Understanding why decision aids work: linking process with outcome [J].
Bekker, HL ;
Hewison, J ;
Thornton, JG .
PATIENT EDUCATION AND COUNSELING, 2003, 50 (03) :323-329
[8]
Ben-Arye Eran, 2004, J Ambul Care Manage, V27, P53
[9]
BLUMER H, 1969, SYMOBOLIC INTERACTIO
[10]
What are the experiences of women with breast cancer as they decide whether to use complementary/alternative medicine? [J].
Boon, H ;
Brown, JB ;
Gavin, A .
WESTERN JOURNAL OF MEDICINE, 2000, 173 (01) :39-39