Qualitative Inquiry into Determinants of Decision Making for Therapeutic Mastectomy Amongst Pre and Peri- Menopausal Women, at Urban Gujarat

Abstract

Introduction: Breast Cancer (Ca Br) is one of the most common cancer amongst women globally as well in India. Amongst various available modalities of treatment, the most common treatment being advised in Ca Br is mastectomy which is commonly associated with a lot of emotion and mental challenges. For Ca Br patients, any decision in this regard forms an integral part in the diagnosis, confirmatory and treatment phase. The present study aims to explore the psychosocial determinants to undertake surgical decisions. Objective: To explore the psychosocial determinants and dilemma of undertaking decision for surgical intervention in Ca Br cases amongst pre and peri-menopausal women. Methods: The participants of pre and peri- menopausal women with Ca Br were selected purposively from a tertiary care hospital. The inclusion criteria included patients with Ca Br who underwent a therapeutic mastectomy and willing to be a part of the study were included. Qualitative Inquiry method was used for data collection and Content analysis was done using Atlas.ti. Results: Five themes emerged from the content analysis. It was observed that patriarchy dominates as decision-makers; surgical decision – is it a ' No –brainer' thing?, the big emotional burden on shoulder, motivators & demotivators, and inspiration. Women's passivity as decision-makers along with emotional distress conditions like fear of loss of feminity was always accompanied. Strong support system and will power were the major motivating factor for participants. Conclusion: The study gave a prominent and complex view on determinants of undertaking surgical decisions. Findings from the study would contribute to better strategizing the management of patients in a local context from all aspects and not just from the clinical lens.