Age Differences in Treatment Decision Making for Breast Cancer in a Sample of Healthy Women: The Effects of Body Image and Risk Framing

Kathleen M. Romanek

Kevin D. McCaul

Anna Sandgren

ONF 2005, 32(4), 799-806. DOI: 10.1188/05.ONF.799-806

Purpose/Objectives: To examine the effects of age, body image, and risk framing on treatment decision making for breast cancer using a healthy population.

Design: An experimental 2 (younger women, older women) X 2 (survival, mortality frame) between-groups design.

Setting: Midwestern university.

Sample: Two groups of healthy women: 56 women ages 18-24 from undergraduate psychology courses and 60 women ages 35-60 from the university community.

Methods: Healthy women imagined that they had been diagnosed with breast cancer and received information regarding lumpectomy versus mastectomy and recurrence rates. Participants indicated whether they would choose lumpectomy or mastectomy and why.

Main Research Variables: Age, framing condition, treatment choice, body image, and reasons for treatment decision.

Findings: The difference in treatment selection between younger and older women was mediated by concern for appearance. No main effect for risk framing was found; however, older women were somewhat less likely to select lumpectomy when given a mortality frame.

Conclusions: Age, mediated by body image, influences treatment selection of lumpectomy versus mastectomy. Framing has no direct effect on treatment decisions, but younger and older women may be affected by risk information differently.

Implications for Nursing: Nurses should provide women who recently have been diagnosed with breast cancer with age-appropriate information regarding treatment alternatives to ensure women's active participation in the decision-making process. Women who have different levels of investment in body image also may have different concerns about treatment, and healthcare professionals should be alert to and empathetic of such concerns.

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