Mónica E López1, Celia P Kaplan2, Anna M Nápoles2, E Shelley Hwang3, Jennifer C Livaudais4, Leah S Karliner5. 1. Department of Medicine, University of California San Francisco, San Francisco, USA; Medical Effectiveness Research Center for Diverse Populations, University of California San Francisco, San Francisco, USA; Center for Aging in Diverse Communities, University of California San Francisco, San Francisco, USA. 2. Department of Medicine, University of California San Francisco, San Francisco, USA; Medical Effectiveness Research Center for Diverse Populations, University of California San Francisco, San Francisco, USA; Center for Aging in Diverse Communities, University of California San Francisco, San Francisco, USA; UCSF Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, USA. 3. Department of Surgery, Duke University, Durham, USA. 4. Department of Medicine, University of California San Francisco, San Francisco, USA. 5. Department of Medicine, University of California San Francisco, San Francisco, USA; Medical Effectiveness Research Center for Diverse Populations, University of California San Francisco, San Francisco, USA; UCSF Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, USA. Electronic address: leah.karliner@ucsf.edu.
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.
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.
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