| ObjectiveTo investigate the current situation of breast cancer patients’ participation in treatment decision making and decision regret.To explore the influencing factors of breast cancer patients’ participation in treatment decision making and decision regret and to provide references for making decision support tools.MethodsThis study used a cross-sectional design.A questionnaire survey was conducted among breast cancer patients who meet the inclusion and exclusion criteria in two hospitals in Shandong province from August 2020 to January 2021 through convenient sampling.The survey tools included self-designed general data questionnaires(demographic and disease characteristics data),Cancer patients’participation in treatment and care questionnaire,Decision Regret Scale,Decision Conflict Scale,All Aspects of Health Literacy Scale,Social Support Rating Scale,Decision Self Efficacy Scale,and Preparation for Decision Making Scale.SPSS 25.0 and PROCESS 3.3 tool were used for statistical analysis.The specific methods included descriptive analysis,chi-square test,independent sample t-test,nonparametric.test,paired sample t-test,Pearson correlation analysis,hierarchical multiple linear regression,Bootstrap mediation effect test,etc.Results1.The score of the degree of participation in treatment decision-making of breast cancer patients was 1.87±0.57,and the score of the attitude of participation in treatment decision-making was 1.34±0.38.68.0%of breast cancer patients had a low degree of participation in treatment decision-making,while 69.7%of breast cancer patients had a positive attitude of participation,and there was a difference between the degree of participation in treatment decision-making and the attitude of participation(t=-18.172,P<0.001).The percentage score of decision regret in breast cancer patients was 24.98±13.14.2.Univariate analysis showed the degree of participation of breast cancer patients was statistically significant(P=0.001)between different treatment methods,and the difference between metastasis or not was statistically significant(P=0.011).The difference in decision regret of breast cancer patients in in the time of cancer diagnosis was statistically significant(P=0.039),and the difference in treatment methods was statistically significant(P=0.016).3.The percentage score of decision conflict in breast cancer patients was 30.11±20.97,55.8%of the patients had decision dilemma and 36.7%of the patients had delayed decision.The score of health literacy in breast cancer patients was 24.80±4.54;The social support score of breast cancer patients was 45.66±6.15;The self-efficacy score of breast cancer patients was 65.46±27.51;The percentage score of breast cancer patients’ decision readiness was 49.50±31.47,and 60.9%of the patients had insufficient treatment decision readiness.4.Pearson correlation analysis showed that the attitude of breast cancer patients to participate in treatment decision-making was positively correlated with the degree of participation(r=0.502,P<0.001),and there was no statistically significant correlation with decision regret(r=0.093,P>0.05).There was a positive correlation between decision conflict,participation and decision regret in breast cancer patients(r=0.632,P<0.001;r=0.453,P<0.001);There was a negative correlation between health literacy and participation and decision regret in breast cancer patients(r=-0.307,P<0.001;r=-0.278,P<0.001);There was a negative correlation between social support,participation and decision regret in breast cancer patients(r=-0.336,P<0.001;r=-0.236,P<0.001);There was a negative correlation between decision self-efficacy and decision regret in breast cancer patients(r=-0.480,P<0.001;r=-0.417,P<0.001);There was a negative correlation between decision self-efficacy and decision regret in breast cancer patients(r=-0.554,P<0.001;r=-0.511,P<0.001)5.The mediating effect analysis method proposed by Wen Zhonglin was adopted.With decisional conflict as the dependent variable and sociodemographic and disease characteristic variables were controlled,and multiple linear regression analysis was conducted with attitude to treatment decision making,health literacy,social support,decisional self-efficacy and preparation of decision making as independent variables.The results showed that the attitude of decision making(β=0.120,P<0.05),decisional self-efficacy(β=-0.199,P<0.05)and preparation of decision making(β=-0.313,P<0.001)had predictive effects on decisional conflict.The degree of breast cancer patients’ participation in treatment decision making was taken as the dependent variable,and the sociodemographic and disease characteristic variables were controlled.The attitude of patients’ participation in treatment decision making,health literacy,social support,decisional self-efficacy and preparation of decision making as independent variables,and decisional conflict was taken as the mediating variable to be included in the regression equation.The results showed that the attitude of treatment decision making,preparation of decision making and decisional conflict directly predicted the degree of treatment decision making(β=0.364,β=-0.230,β=0.382,all P<0.001).In addition,attitude of treatment decision making,decisional self-efficacy and preparation of decision making had indirect predictive effects on degree of patients’participation in treatment decision making through decisional conflict,and indirect predictive effects were 0.046,-0.076,-0.120.Bootstrap results showed that the mediating effect of decisional conflict was significant,with 95%confidence intervals(0.001,0.091),(-0.143,-0.016),(-0.190,-0.059),excluding 0.The decisional regret of breast cancer patients was taken as the dependent variable,and the sociodemographic and disease characteristic variables were controlled.The attitude of patients’ participation in treatment decision making,health literacy,social support,decisional self-efficacy and preparation of decision making as independent variables,and decisional conflict was taken as the mediating variable to be included in the regression equation.The results showed that decisional conflict and preparation of decision making directly predicted decisional regret(β=0.249,β=-0.316,all P<0.001).Decisional conflict also had an indirect predictive effect on decisional regret through decisional conflict,and the indirect effect was-0.078.Bootstrap results showed that decisional conflict played a significant mediating role between preparation of decision making and decisional regret,with 95%confidence intervals(-0.151,-0.022),excluding 0Conclusions1.Breast cancer patients have a positive attitude towards treatment decision-making,but a low degree of participation,and the degree of participation is inconsistent with the attitude2.Breast cancer patients have a low degree of decision regret in treatment.Most breast cancer patients are satisfied with the treatment decision.3.The attitude of participation in treatment decision making and decisional conflict can directly and positively predict the degree of breast cancer patients’participation;preparation of decision making directly and negatively predicted the degree of breast cancer patients’ participation in treatment decision making;patients’attitude to participate in treatment decision making can indirectly and positively predict the degree through decisional conflict.Decisional self-efficacy and preparation of decision making indirectly and negatively predicted the degree of participation in treatment decision making through decisional conflict.4.Decisional conflict in breast cancer patients can directly and positively predict decisional regret;Preparation of decision making can directly and negatively predict decisional regret,or indirectly and negatively predict decisional regret through decisional conflict. |
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