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Cancer patient autonomy support associated with higher decision quality scores

A study in breast cancer patients found a link between self-managing ​treatment and satisfaction with quality of care

Patients with breast cancer who have more options and power over the decisions about their treatment and management tend to report less psychological or psychiatric morbidity, as well as higher levels of satisfaction with the quality of their care.

This American study, which analysed information from a large diverse population data set, from the iCanCare Study, explored the proposition that newly diagnosed women with breast cancer who reported higher levels of support for their independence of will and preferences would similarly report improved quality of choice.

Data from 1,690 women who completed various survey measures, including a decision quality score for surgery, were analysed. The study sample were predominantly white (55%), with black women the next largest group (17%), 17% were Hispanic and

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Patients with breast cancer who have more options and power over the decisions about their treatment and management tend to report less psychological or psychiatric morbidity, as well as higher levels of satisfaction with the quality of their care.

Breast cancer screening
A study in breast cancer patients found a link between self-managing
treatment and satisfaction with quality of care
Picture: Science Photo Library

This American study, which analysed information from a large diverse population data set, from the iCanCare Study, explored the proposition that newly diagnosed women with breast cancer who reported higher levels of support for their independence of will and preferences would similarly report improved quality of choice.

Data from 1,690 women who completed various survey measures, including a decision quality score for surgery, were analysed. The study sample were predominantly white (55%), with black women the next largest group (17%), 17% were Hispanic and 9% Asian. The mean age was 61.5 years. Most of the women underwent lumpectomy as their primary treatment modality; however, approximately a fifth of the population equally endured either a unilateral or bilateral mastectomy.

Self-reported observations of the interactions with clinicians that provided high levels of patient-centred autonomy support were significantly associated with higher decision quality scores.

Significant differences in these scores related to the women’s background. Women from the Hispanic and black populations reported worse decision quality, even when preferred communication styles were accounted for. This result indicates there may be other facts implicated in the experience of decision making for patients from black and minority groups, which warrants further investigation.


Martinez K, Resnicow K, Williams G et al (2016) Does physician communication style impact patient report of decision quality for breast cancer treatment? Patient Education and Counseling. 99, 12, 1947-1954.

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