Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Sep;184(1):665-70.
doi: 10.1016/j.jss.2013.04.057. Epub 2013 May 15.

Patient involvement in the decision-making process improves satisfaction and quality of life in postmastectomy breast reconstruction

Azra A Ashraf  1 , Salih Colakoglu, John T Nguyen, Alexandra J Anastasopulos, Ahmed M S Ibrahim, Janet H Yueh, Samuel J Lin, Adam M Tobias, Bernard T Lee
Affiliations

Patient involvement in the decision-making process improves satisfaction and quality of life in postmastectomy breast reconstruction

Azra A Ashraf et al. J Surg Res. 2013 Sep.

Abstract

Background: The patient-physician relationship has evolved from the paternalistic, physician-dominant model to the shared-decision-making and informed-consumerist model. The level of patient involvement in this decision-making process can potentially influence patient satisfaction and quality of life. In this study, patient-physician decision models are evaluated in patients undergoing postmastectomy breast reconstruction.

Methods: All women who underwent breast reconstruction at an academic hospital from 1999-2007 were identified. Patients meeting inclusion criteria were mailed questionnaires at a minimum of 1 y postoperatively with questions about decision making, satisfaction, and quality of life.

Results: There were 707 women eligible for our study and 465 completed surveys (68% response rate). Patients were divided into one of three groups: paternalistic (n = 18), informed-consumerist (n = 307), shared (n = 140). There were differences in overall general satisfaction (P = 0.034), specifically comparing the informed group to the paternalistic group (66.7% versus 38.9%, P = 0.020) and the shared to the paternalistic group (69.3% versus 38.9%, P = 0.016). There were no differences in aesthetic satisfaction. There were differences found in the SF-12 physical component summary score across all groups (P = 0.033), and a difference was found between the informed and paternalistic groups (P < 0.05). There were no differences in the mental component score (P = 0.42).

Conclusions: Women undergoing breast reconstruction predominantly used the informed model of decision making. Patients who adopted a more active role, whether using an informed or shared approach, had higher general patient satisfaction and physical component summary scores compared with patients whose decision making was paternalistic.

Keywords: Breast cancer; Breast reconstruction; Mastectomy; Patient satisfaction; Quality of life; Shared decision making.

PubMed Disclaimer

LinkOut - more resources