BREAST RESTORATION DECISION-MAKING - ENHANCING THE PROCESS

The purpose of this study was to explore the breast restoration decisi on-making patterns used by women who opted to have their breast cancer treated by mastectomy, Sixty-four women wearing external breast prost heses and 31 women with breast reconstructions were interviewed, Modif ied versions of Simon's notion of ''bounded rationality'' and Janis an d Mann's conflict model provided the conceptual scaffolding for the st udy. Five breast restoration decision-making patterns emerged from the analysis of the interview data: (a) Enlightened (actively seeks infor mation, considers positive and negative aspects, and demonstrates deli beration on the alternatives), (b) Contented (passively accepts minimu m information on alternatives because of a preference toward a particu lar type), (c) Sideliner (uncritically adopts any alternative that is easy and simple to implement), (d) Shifter (gives over the decision to others), and (e) Panic-stricken (can make no rational decision on alt ernatives). In the prosthesis group, the major pattern used was the Si deliner, and in the reconstruction group it was the Contented. None of the participants used the Enlightened pattern. The data indicated tha t there was no evidence of active information-seeking behavior or deli beration on the alternatives as part of the women's decision-making pr ocess. The findings suggest a need for a registered nurse oncology spe cialist to be accessible to women during the period when decisions reg arding breast restoration are made, This professional has the knowledg e to interact effectively with these women and serve as their advocate during the decision-making process. Implications for professional pra ctice and a model for competent breast restoration decision making are presented.