Experiences of involvement in decision-making for patients with breast cancer. A phenomenological-hermeneutical study

Background: Patient involvement, including shared decision-making (SDM), has become a key topic in the healthcare system. Only a few studies have been conducted in Denmark on how women with breast cancer experience being involved in the decision-making process during their treatment.Aim: The aim of the study was therefore to explore patients’ experiences in the decision-making process during their treatment course and whether or not it was clear to the individual patient that they had a choice.Methods: The study is based on a qualitative semi-structured interview of 7 patients with breast cancer conducted during February 2017 at a regional hospital for cancer treatment. The design is phenomenological-hermeneutic with inspiration from Ricoeur’s interpretation theory.Results: Through analysis and interpretation of the interviews, 2 themes were identified: (1) Real choice or course determined by the health professionals and (2) Treatment efficiency at the expense of time for consideration for options. The patients experienced that there was neither time for consideration in relation to their treatment, nor time to reflect on their situation. In the decision-making situations, most of the patients felt that they gave their consent only to a treatment course organized by the health professionals. They did not feel that they had a choice, but rather that participation was a prerequisite for getting well.Conclusions: The results of this study can contribute to the improvement of person-centered care and treatment by illustrating patient attitudes to the shared decision-making process and indicating where patient education would play a crucial role in increasing patient involvement in decisions about their care