Satisfaction with treatment decision-making and treatment regret among Latinas and non-Latina whites with DCIS

Patient Educ Couns. 2014 Jan;94(1):83-9. doi: 10.1016/j.pec.2013.09.005. Epub 2013 Sep 17.

Abstract

Objective: To examine differences in treatment decision-making participation, satisfaction, and regret among Latinas and non-Latina whites with DCIS.

Methods: Survey of Latina and non-Latina white women diagnosed with DCIS. We assessed women's preferences for involvement in decision-making, primary treatment decision maker, and participatory decision-making. We examined primary outcomes of satisfaction with treatment decision-making and treatment regret by ethnic-language group.

Results: Among 745 participants (349 Latinas, 396 white) Spanish-speaking Latinas (SSL) had the highest mean preference for involvement in decision-making score and the lowest mean participatory decision-making score and were more likely to defer their final treatment decision to their physicians than English-speaking Latinas or whites (26%, 13%, 18%, p<0.05). SSLs reported lower satisfaction with treatment decision-making (OR 0.4; CI 95%, 0.2-0.8) and expressed more regret than whites (OR 6.2; CI 95%, 3.0-12.4). More participatory decision-making increased the odds of satisfaction (OR 1.5; CI 95%, 1.3-1.8) and decreased the odds of treatment regret (OR 0.8; CI 95%, 0.7-1.0), independent of ethnicity-language.

Conclusion: Language barriers impede the establishment of decision-making partnerships between Latinas and their physicians, and result in less satisfaction with the decision-making process and more treatment regret.

Practice implications: Use of professional interpreters may address communication-related disparities for these women.

Keywords: Decision-making; Doctor–patient communication; Ductal carcinoma in situ; Health disparities; Language barriers; Latina health.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Breast Neoplasms / ethnology
  • Breast Neoplasms / therapy*
  • California
  • Carcinoma, Intraductal, Noninfiltrating / ethnology
  • Carcinoma, Intraductal, Noninfiltrating / therapy*
  • Communication*
  • Decision Making*
  • Emotions
  • Female
  • Hispanic or Latino / psychology*
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Language
  • Middle Aged
  • Patient Participation
  • Patient Satisfaction*
  • Personal Satisfaction
  • Physician-Patient Relations
  • Socioeconomic Factors
  • Treatment Outcome
  • White People / psychology*
  • White People / statistics & numerical data
  • Young Adult