THE QUALITY AND COPING PATTERNS OF WOMENS DECISION-MAKING REGARDING BREAST-CANCER SURGERY

This study addressed issues regarding the decision-making process used by women who had mastectomy as their surgical treatment for breast ca ncer. The seven criteria for quality decision-making and the conflict model proposed by Janis and Mann (1977) were used as the study's conce ptual framework along with the notion by Simon (1957) of 'bounded rati onality'. Four coping patterns emerged: vigilance (actively searches f or information and advice), satisficing (being satisfied, chooses firs t solution that meets the desired objectives), complacency (accepts ad vice without questions or fully comprehending), and defensive avoidanc e (rationalises and avoids discussion and consideration of the problem ). The participants primarily left the decision for surgical treatment of breast cancer to their surgeons using satisficing, complacency and defensive avoidance; When the option of lumpectomy was offered to som e of the participants (34%), they rejected this treatment alternative using the coping patterns of satisfying and defensive avoidance. Those women who were not offered lumpectomy (66%) did not seek a rationale for not being given this alternative. The findings indicated that the women's decision-making process was halted in Stage 2 of the criteria for quality decision-making actively searched for and viewed a number of alternatives. The study's findings are discussed in relation to imp roving the quality of the decision-making process for women regarding their breast cancer surgical treatment. (C) 1998 John Wiley & Sons, Lt d.