| Objective:To understand the current status of surgical choice of patients eligible for breast-conserving surgery and to explore the factors that influence the choice of surgical for breast cancer patients eligible for breast-conserving surgery,so as to improve the knowledge of breast-conserving surgery among healthcare professionals and patients,and help healthcare professionals better guide breast cancer patients to complete the surgical decision making.Methods:1.Cross-sectional study: A cross-sectional study was conducted among breast cancer patients who met breast conservation requirements and were admitted for treatment at 2 tertiary hospitals in Shenyang between November 2021 and June 2022.Using SPSS 26.0 for statistical analysis.The researchers utilized the General Information Questionnaire,Perceived Social Support Scale(PSSS)and Facilitation of Patient Involvement Scale(FPI).The statistical analysis was carried out using the IBM SPSS26.0 software.The analysis methods included descriptive analysis,chi-square test,t-test,and binary logistic regression analysis.2.Descriptive qualitative study: Breast cancer patients eligible for breast-conserving surgery who were admitted to the breast surgery in2 tertiary hospitals in Shenyang from June 2022 to January 2023 were selected for semi-structured interviews with a total of 12 patients.Information were transcribed verbatim into text,and the data was organized and analyzed by NVivo 11.0 using content analysis.Results:1.Cross-sectional study: A total of 295 patients eligible for breast-conserving surgery were included,of which 109(36.9%)chose breast-conserving surgery and 186(63.1%)chose mastectomy.Results of univariate analysis showed that women choosing breast-conserving surgery were more likely to be younger,have higher level of education,be employed,have fewer children,live in urban and have higher monthly family income.Meanwhile,women who had smaller tumor size,lower tumor stage,negative lymph node metastasis,and no other diseases were more inclined to choose breast-conserving surgery than mastectomy.Binary logistic regression analysis showed that age(OR=0.936,95%CI:0.910～0.962),employment status(OR=0.513,95% CI:0.299～0.879),place of residence(OR=0.370,95% CI:0.186～0.736)and tumor stage(OR=0.312,95%CI:0.185～0.527)were influencing factors in the selection of surgical options for breast cancer patients who were eligible for breast-conserving surgery.2.Descriptive qualitative study: Through the content analysis method,4 themes emerged from the data:sociodemographic factors(including economic status and age);psychological factors(including fear of recurrence,body image,trust in physicians and trust in medical technology);medical-related factors(including disease severity,the status of health education from healthcare professionals and the status of involvement in surgical decision making)and factors related to others(including social support and the impact of breast cancer patients).Conclusions:1.The proportion of choosing breast-conserving surgery among women eligible for breast-conserving surgery was lower.2.The surgical choice of breast cancer patients eligible for breast-conserving surgery was influenced by a variety of factors,including sociodemographic factors(including age,occupational status,place of residence,and economic status),psychological factors(including fear of recurrence,body image,trust in physicians,and trust in medical technology),medical-related factors(including tumor stage,disease severity,the status of health education from healthcare professionals,and the status of involvement in surgical decision making)and factors related to others(including social support and the impact of breast cancer patients).To clarify the factors influencing the choice of surgical choice for breast cancer patients,to improve the knowledge of breast-conserving surgery among healthcare professionals and patients,to enable healthcare professionals to fully understand the preferences of different patients for surgical choice,and to provide individualized clinical assessment according to patients’ own conditions,so as to help patients make a more suitable and wiser choice of surgical choice,and to bring patients better efficacy and good postoperative appearance through the selection of an appropriate surgical choice. |
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