Factors and Perceptions Affecting Treatment Choices of Breast Cancer Patients

Study Overview
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Brief Summary
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A Multi-center Cross-sectional quantitative study with a preliminary qualitative study part aiming to identify and analyze demand factors, supply factors and perceptions affecting Breast Cancer patients' treatment choices of Breast Cancer patients in 5 key decision points: participation role in the decision making process, hospital choice, treatment regimen choice, surgical extent and surgeon choice. 25 patients and caregivers will participate in the qualitative part and 425 Israeli Breast Cancer patients will participate in the quantitative study.

Detailed Description
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Background: Breast Cancer (BC) is the most common cancer in women worldwide. Newly diagnosed BC patients are asked to participate in a number of treatment related decisions. No research has systematically studied the full decision sequence in a disease such as BC, analyzing demand factors, supply factors and patient perceptions. Study goal: Identify and analyze demand factors, supply factors and perceptions affecting BC patients' treatment choices, and model the demand function of BC patients in 5 key decision points: participation role in the decision making process, hospital choice, treatment regimen choice, surgical extent and surgeon choice. Study hypothesis: Patient perceptions will have at least as much impact as demand and supply factors. Study design: Two stage study. A preliminary qualitative study, holding depth interviews with 20 breast cancer patients, 2 spouses and 3 staff members is taking place these days. The qualitative study findings will be used to develop a survey questionnaire for a cross sectional quantitative study, interviewing a quota sample of 425 breast cancer survivors, diagnosed up to 5 years prior to joining the study, who have successfully completed all radiation therapy and chemotherapy. Data analysis: Qualitative data will be analyzed according to the Criteria Bases Qualitative Methodology. Quantitative data will be analyzed by two-variable statistical analysis and multi-variable statistical analysis adjusted to the nature of the dependent and independent variables. Possible policy recommendations: Forming consulting teams for cancer patients. Improving medical information communication. Focusing patients on the key decisions they face. Evaluating patient needs using demand factors, supply factors and perceptions to create systemic tools helping them face treatment decisions.

Official Title
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Factors and Perceptions Affecting Treatment Choices of Breast Cancer Patients. Multi-center Cross-sectional Study in Israel Among Breast Cancer Survivors, With a Preliminary Qualitative Study

Conditions
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Breast Cancer

Intervention / Treatment
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* Other: Factors and perceptions questionnaire
* Other: Qualitative interview


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Hebrew speaking Jewish women Aged 30 - 75 years Diagnosed with breast cancer up to 5 years prior to study recruitment Successfully completed all chemotherapy and radiotherapy treatments Considered Cancer free Exclusion Criteria: Any type of residual cancer Any type of chemotherapy or radiotherapy

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Kaplan Hospital<br>Breast cancer survivors recruited at the Kaplan Medical Center | Other: Factors and perceptions questionnaire<br>* A detailed questionnaire inquiring about demand factors, supply factors and perceptions affecting patients' treatment choices in 5 key decision points: participation role in the decision making process, hospital choice, treatment regimen choice, surgical extent and surgeon choice.<br>Other: Qualitative interview<br>* Depth interviews with 20 breast cancer patients, 2 spouses and 3 staff members.<br>|
| Rambam Hospital<br>Breast cancer survivors recruited at the Rambam Medical Center | Other: Factors and perceptions questionnaire<br>* A detailed questionnaire inquiring about demand factors, supply factors and perceptions affecting patients' treatment choices in 5 key decision points: participation role in the decision making process, hospital choice, treatment regimen choice, surgical extent and surgeon choice.<br>Other: Qualitative interview<br>* Depth interviews with 20 breast cancer patients, 2 spouses and 3 staff members.<br>|
| Sheba<br>Breast cancer survivors recruited at the Sheba Medical Center | Other: Factors and perceptions questionnaire<br>* A detailed questionnaire inquiring about demand factors, supply factors and perceptions affecting patients' treatment choices in 5 key decision points: participation role in the decision making process, hospital choice, treatment regimen choice, surgical extent and surgeon choice.<br>|
| Barzilai<br>Breast cancer survivors recruited at the Barzilai Medical Center | Other: Factors and perceptions questionnaire<br>* A detailed questionnaire inquiring about demand factors, supply factors and perceptions affecting patients' treatment choices in 5 key decision points: participation role in the decision making process, hospital choice, treatment regimen choice, surgical extent and surgeon choice.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of active, collaborative and passive patients according to the Control Preferences Scale | According to the Control Preferences Scale, a questionnaire developed by Degner and Colleagues (Degner, 1997), patients can take fully active role in the treatment decision process or be mostly active, collaborative, mostly passive or fully passive. The study will look at the factors and perceptions affecting patient's decision role. | Through study completion, an average of 18 months. | 
| Large or small hospital choice | The study interviews patients treated at two large Hospitals (Rambam, Sheba), and two small hospitals (Kaplan, Barzilay) looking for the factors and perceptions affecting large or small hospital choice. | Through study completion, an average of 18 months. | 
| Proportion of patients who chose an oncological regimen more intense than recommended by clinical guidelines. | The study will look at the factors and perceptions affecting patient's choice to undergo an oncological treatment more intense than recommended by clinical guidelines. | Through study completion, an average of 18 months. | 
| Proportion of patients choosing radical mastectomy over lumpectomy | The study will look at the factors and perceptions affecting patient's choice to undergo a surgical cancer removal procedure more radical than recommended by clinical guidelines. | Through study completion, an average of 18 months. | 
| Specific surgeon choice | The study will look at the factors and perceptions affecting patient's choice a specific surgeon in the Israeli healthcare system. | Through study completion, an average of 18 months. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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breast cancer, treatment choice, factor, perception