Shared Decision-Making Among Women Diagnosed with Breast Cancer: A Phenomenological Study and Exploration into Health Literacy Education

Little is known about how women with breast cancer experience making decisions in collaboration with their medical provider, and how these patient-provider interactions affect autonomy in choosing a treatment option. The purpose of the study is to examine the patient experience with shared decision-making (SDM) among women diagnosed with breast cancer and to explore more effective ways of educating patients when they are faced with a critical treatment choice. The research questions include: (1) What is the meaning of SDM from the perspective of women diagnosed with breast cancer? (2) What facilitates and inhibits SDM around medical treatments for women diagnosed with breast cancer? (3) What kind of health literacy education do women with breast cancer need to better support SDM? Using a phenomenological design and inductive thematic analysis procedure, a purposive sample of 6 women diagnosed with breast cancer were recruited from an academic medical center, consented, and interviewed. Ultimately, participants viewed the SDM process as empowering, self-advocating, collaborative, and inclusive. Participants described key concepts like trust, lack of understanding/ambiguity, social support, and religion/faith as important indicators for SDM. Participants also cited nutrition and mental health literacy, treatment and medication literacy, community education, and high-quality health information as priority areas for education. Conclusions and implications for practice include creating inclusive environments for patients, encouraging empowerment, utilizing diverse and multidisciplinary teams, and providing reliable health information. Future researchers should investigate how SDM may lead to increased satisfaction and improved treatment outcomes.