Qualitative analysis of how patients decide that they want risk-reducing mastectomy, and the implications for surgeons in responding to emotionally-motivated patient requests
Publication Date
May 26, 2017
Authors
Stephen L. Brown, Demian Whiting, Hannah G. Fielden, Pooja Saini, et al
Volume
12
Issue
5
Pages
e0178392
DOI
https://dx.plos.org/10.1371/journal.pone.0178392
Publisher URL
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0178392
Scopus
85019746489
Mendeley
http://www.mendeley.com/research/qualitative-analysis-patients-decide-want-riskreducing-mastectomy-implications-surgeons-responding-e
Events
Loading … Spinner

Mendeley | Further Information

{"title"=>"Qualitative analysis of how patients decide that they want risk-reducing mastectomy, and the implications for surgeons in responding to emotionally-motivated patient requests", "type"=>"journal", "authors"=>[{"first_name"=>"Stephen L.", "last_name"=>"Brown", "scopus_author_id"=>"55757780685"}, {"first_name"=>"Demian", "last_name"=>"Whiting", "scopus_author_id"=>"22982426100"}, {"first_name"=>"Hannah G.", "last_name"=>"Fielden", "scopus_author_id"=>"57194336101"}, {"first_name"=>"Pooja", "last_name"=>"Saini", "scopus_author_id"=>"25822883100"}, {"first_name"=>"Helen", "last_name"=>"Beesley", "scopus_author_id"=>"16425394700"}, {"first_name"=>"Christopher", "last_name"=>"Holcombe", "scopus_author_id"=>"35781807600"}, {"first_name"=>"Susan", "last_name"=>"Holcombe", "scopus_author_id"=>"57194348701"}, {"first_name"=>"Lyn", "last_name"=>"Greenhalgh", "scopus_author_id"=>"57194333631"}, {"first_name"=>"Louise", "last_name"=>"Fairburn", "scopus_author_id"=>"57194324098"}, {"first_name"=>"Peter", "last_name"=>"Salmon", "scopus_author_id"=>"7101704625"}], "year"=>2017, "source"=>"PLoS ONE", "identifiers"=>{"isbn"=>"1111111111", "sgr"=>"85019746489", "scopus"=>"2-s2.0-85019746489", "issn"=>"19326203", "pui"=>"616383088", "doi"=>"10.1371/journal.pone.0178392", "pmid"=>"28552971"}, "id"=>"de66619a-1bf9-36af-9891-122770489c8f", "abstract"=>"OBJECTIVE: Contemporary approaches to medical decision-making advise that clinicians should respect patients' decisions. However, patients' decisions are often shaped by heuristics, such as being guided by emotion, rather than by objective risk and benefit. Risk-reducing mastectomy (RRM) decisions focus this dilemma sharply. RRM reduces breast cancer (BC) risk, but is invasive and can have iatrogenic consequences. Previous evidence suggests that emotion guides patients' decision-making about RRM. We interviewed patients to better understand how they made decisions about RRM, using findings to consider how clinicians could ethically respond to their decisions. METHODS: Qualitative face-to-face interviews with 34 patients listed for RRM surgery and two who had decided against RRM. RESULTS: Patients generally did not use objective risk estimates or, indeed, consider risks and benefits of RRM. Instead emotions guided their decisions: they chose RRM because they feared BC and wanted to do 'all they could' to prevent it. Most therefore perceived RRM to be the 'obvious' option and made the decision easily. However, many recounted extensive post-decisional deliberation, generally directed towards justifying the original decision. A few patients deliberated before the decision because fears of surgery counterbalanced those of BC. CONCLUSION: Patients seeking RRM were motivated by fear of BC, and the need to avoid potential regret for not doing all they could to prevent it. We suggest that choices such as that for RRM, which are made emotionally, can be respected as autonomous decisions, provided patients have considered risks and benefits. Drawing on psychological theory about how people do make decisions, as well as normative views of how they should, we propose that practitioners can guide consideration of risks and benefits even, where necessary, after patients have opted for surgery. This model of practice could be extended to other medical decisions that are influenced by patients' emotions.", "link"=>"http://www.mendeley.com/research/qualitative-analysis-patients-decide-want-riskreducing-mastectomy-implications-surgeons-responding-e", "reader_count"=>13, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>1, "Researcher"=>3, "Student > Master"=>6, "Student > Bachelor"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>1, "Researcher"=>3, "Student > Master"=>6, "Student > Bachelor"=>2}, "reader_count_by_subject_area"=>{"Engineering"=>1, "Unspecified"=>2, "Nursing and Health Professions"=>2, "Medicine and Dentistry"=>3, "Neuroscience"=>1, "Sports and Recreations"=>1, "Psychology"=>3}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>3}, "Neuroscience"=>{"Neuroscience"=>1}, "Sports and Recreations"=>{"Sports and Recreations"=>1}, "Psychology"=>{"Psychology"=>3}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Unspecified"=>{"Unspecified"=>2}}, "group_count"=>2}

Scopus | Further Information

{"@_fa"=>"true", "link"=>[{"@_fa"=>"true", "@ref"=>"self", "@href"=>"https://api.elsevier.com/content/abstract/scopus_id/85019746489"}, {"@_fa"=>"true", "@ref"=>"author-affiliation", "@href"=>"https://api.elsevier.com/content/abstract/scopus_id/85019746489?field=author,affiliation"}, {"@_fa"=>"true", "@ref"=>"scopus", "@href"=>"https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85019746489&origin=inward"}, {"@_fa"=>"true", "@ref"=>"scopus-citedby", "@href"=>"https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85019746489&origin=inward"}], "prism:url"=>"https://api.elsevier.com/content/abstract/scopus_id/85019746489", "dc:identifier"=>"SCOPUS_ID:85019746489", "eid"=>"2-s2.0-85019746489", "dc:title"=>"Qualitative analysis of how patients decide that they want risk-reducing mastectomy, and the implications for surgeons in responding to emotionally-motivated patient requests", "dc:creator"=>"Brown S.", "prism:publicationName"=>"PLoS ONE", "prism:eIssn"=>"19326203", "prism:volume"=>"12", "prism:issueIdentifier"=>"5", "prism:pageRange"=>nil, "prism:coverDate"=>"2017-05-01", "prism:coverDisplayDate"=>"May 2017", "prism:doi"=>"10.1371/journal.pone.0178392", "citedby-count"=>"7", "affiliation"=>[{"@_fa"=>"true", "affilname"=>"University of Liverpool", "affiliation-city"=>"Liverpool", "affiliation-country"=>"United Kingdom"}], "pubmed-id"=>"28552971", "prism:aggregationType"=>"Journal", "subtype"=>"ar", "subtypeDescription"=>"Article", "article-number"=>"e0178392", "source-id"=>"10600153309", "openaccess"=>"1", "openaccessFlag"=>true}

Counter

  • {"month"=>"5", "year"=>"2017", "pdf_views"=>"42", "xml_views"=>"32", "html_views"=>"671"}
  • {"month"=>"6", "year"=>"2017", "pdf_views"=>"42", "xml_views"=>"6", "html_views"=>"182"}
  • {"month"=>"7", "year"=>"2017", "pdf_views"=>"10", "xml_views"=>"3", "html_views"=>"40"}
  • {"month"=>"8", "year"=>"2017", "pdf_views"=>"9", "xml_views"=>"1", "html_views"=>"39"}
  • {"month"=>"9", "year"=>"2017", "pdf_views"=>"4", "xml_views"=>"2", "html_views"=>"41"}
  • {"month"=>"10", "year"=>"2017", "pdf_views"=>"7", "xml_views"=>"1", "html_views"=>"67"}
  • {"month"=>"11", "year"=>"2017", "pdf_views"=>"12", "xml_views"=>"1", "html_views"=>"125"}
  • {"month"=>"12", "year"=>"2017", "pdf_views"=>"2", "xml_views"=>"1", "html_views"=>"155"}
  • {"month"=>"1", "year"=>"2018", "pdf_views"=>"8", "xml_views"=>"1", "html_views"=>"44"}
  • {"month"=>"2", "year"=>"2018", "pdf_views"=>"4", "xml_views"=>"0", "html_views"=>"36"}
  • {"month"=>"3", "year"=>"2018", "pdf_views"=>"7", "xml_views"=>"0", "html_views"=>"34"}
  • {"month"=>"4", "year"=>"2018", "pdf_views"=>"3", "xml_views"=>"1", "html_views"=>"39"}
  • {"month"=>"5", "year"=>"2018", "pdf_views"=>"2", "xml_views"=>"1", "html_views"=>"25"}
  • {"month"=>"6", "year"=>"2018", "pdf_views"=>"7", "xml_views"=>"4", "html_views"=>"23"}
  • {"month"=>"7", "year"=>"2018", "pdf_views"=>"6", "xml_views"=>"3", "html_views"=>"20"}
  • {"month"=>"8", "year"=>"2018", "pdf_views"=>"5", "xml_views"=>"1", "html_views"=>"16"}
  • {"month"=>"9", "year"=>"2018", "pdf_views"=>"13", "xml_views"=>"0", "html_views"=>"27"}
  • {"month"=>"10", "year"=>"2018", "pdf_views"=>"2", "xml_views"=>"1", "html_views"=>"7"}
  • {"month"=>"11", "year"=>"2018", "pdf_views"=>"12", "xml_views"=>"0", "html_views"=>"25"}
  • {"month"=>"12", "year"=>"2018", "pdf_views"=>"5", "xml_views"=>"0", "html_views"=>"11"}
  • {"month"=>"1", "year"=>"2019", "pdf_views"=>"4", "xml_views"=>"2", "html_views"=>"11"}
  • {"month"=>"2", "year"=>"2019", "pdf_views"=>"1", "xml_views"=>"0", "html_views"=>"11"}
  • {"month"=>"3", "year"=>"2019", "pdf_views"=>"11", "xml_views"=>"0", "html_views"=>"23"}
  • {"month"=>"4", "year"=>"2019", "pdf_views"=>"8", "xml_views"=>"0", "html_views"=>"10"}
  • {"month"=>"5", "year"=>"2019", "pdf_views"=>"8", "xml_views"=>"1", "html_views"=>"13"}
  • {"month"=>"6", "year"=>"2019", "pdf_views"=>"5", "xml_views"=>"0", "html_views"=>"17"}
  • {"month"=>"7", "year"=>"2019", "pdf_views"=>"7", "xml_views"=>"0", "html_views"=>"15"}
  • {"month"=>"8", "year"=>"2019", "pdf_views"=>"7", "xml_views"=>"0", "html_views"=>"7"}
  • {"month"=>"9", "year"=>"2019", "pdf_views"=>"10", "xml_views"=>"0", "html_views"=>"11"}
  • {"month"=>"10", "year"=>"2019", "pdf_views"=>"7", "xml_views"=>"0", "html_views"=>"13"}
  • {"month"=>"11", "year"=>"2019", "pdf_views"=>"2", "xml_views"=>"1", "html_views"=>"5"}

PMC Usage Stats

  • {"unique-ip"=>"10", "full-text"=>"9", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"6"}
  • {"unique-ip"=>"6", "full-text"=>"4", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"7"}
  • {"unique-ip"=>"9", "full-text"=>"10", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"8"}
  • {"unique-ip"=>"11", "full-text"=>"16", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"9"}
  • {"unique-ip"=>"11", "full-text"=>"9", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"10"}
  • {"unique-ip"=>"9", "full-text"=>"12", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"11"}
  • {"unique-ip"=>"6", "full-text"=>"6", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"12"}
  • {"unique-ip"=>"9", "full-text"=>"8", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"1"}
  • {"unique-ip"=>"1", "full-text"=>"1", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"2"}
  • {"unique-ip"=>"6", "full-text"=>"5", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"3"}
  • {"unique-ip"=>"10", "full-text"=>"9", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"1"}
  • {"unique-ip"=>"9", "full-text"=>"6", "pdf"=>"8", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"11"}
  • {"unique-ip"=>"12", "full-text"=>"13", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"9"}
  • {"unique-ip"=>"3", "full-text"=>"3", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"12"}
  • {"unique-ip"=>"11", "full-text"=>"10", "pdf"=>"7", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"4"}
  • {"unique-ip"=>"12", "full-text"=>"12", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"5"}
  • {"unique-ip"=>"12", "full-text"=>"7", "pdf"=>"8", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"6"}
  • {"unique-ip"=>"6", "full-text"=>"6", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"7"}
  • {"unique-ip"=>"12", "full-text"=>"12", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"8"}
  • {"unique-ip"=>"14", "full-text"=>"12", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"10"}
  • {"unique-ip"=>"13", "full-text"=>"12", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"2"}
  • {"unique-ip"=>"10", "full-text"=>"9", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"3"}
  • {"unique-ip"=>"11", "full-text"=>"12", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"4"}
  • {"unique-ip"=>"6", "full-text"=>"5", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"5"}
  • {"unique-ip"=>"9", "full-text"=>"9", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"8"}
  • {"unique-ip"=>"10", "full-text"=>"8", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"9"}
Loading … Spinner
There are currently no alerts