Although physicians have traditionally been the primary decision-makers concerning medical procedures, women have come to expect a voice in decisions regarding treatment, particularly treatment for a malignant breast lump. The physician's expertise and expectation to dictate treatment, a sense of urgency about the need to make a treatment decision, and the fears and anxieties often associated with breast cancer create stress for the patient. Decision-making under stress may be less effective than decisions made under less pressured circumstances. Nurses have the opportunity to help women anticipate a potential breast cancer diagnosis and to consider available treatment alternatives well before the crises precipitated by detecting a lump. Providing a woman with information and helping her to explore personal values and relationships related to a possible loss of a breast prior to the time when a treatment decision is needed gives the woman some confidence and control when she is faced with an actual decision. Intervention strategies for facilitating decision-making are discussed.
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