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Decision Regret following Breast Reconstruction: The Role of Self-Efficacy and Satisfaction with Information in the Preoperative Period

Zhong, Toni M.D., M.H.S.; Hu, Jiayi M.D.; Bagher, Shaghayegh M.Sc.; O’Neill, Anne C. M.Sc., Ph.D.; Beber, Brett M.D.; Hofer, Stefan O. P. M.D., Ph.D.; Metcalfe, Kelly A. R.N., Ph.D.

Plastic and Reconstructive Surgery: November 2013 - Volume 132 - Issue 5 - p 724e–734e
doi: 10.1097/PRS.0b013e3182a3bf5d
Breast: Original Articles

Background: The relationship between satisfaction with information and decision regret has not been previously studied in breast reconstruction patients. The objective of this study, therefore, was to assess this relationship and the factors that may influence satisfaction with preoperative information, including self-efficacy (confidence with seeking medical knowledge).

Methods: All patients who underwent breast reconstruction between January of 2009 and March of 2011 were approached to complete the Modified Stanford Self-Efficacy Scale (1 to 10), the satisfaction with information subscale of the BREAST-Q (1 to 100), and the Decision Regret Scale (1 to 100). Two multinomial logistic regression models were built to assess the relationship between patient-reported satisfaction with information and decision regret, and to evaluate the relationship among satisfaction with information, self-efficacy level, and sociodemographic characteristics.

Results: In 100 participants (71 percent response rate), the mean Decision Regret Scale score was 9.3 ± 17.3 of 100, and the majority of patients experienced no regret (60 percent). We found that regret was significantly reduced when patients were more satisfied with the preoperative information that they received from their plastic surgeons (β = 0.95; 95 percent CI, 0.93 to 0.96). Furthermore, patients reported higher satisfaction with information when they possessed more self-efficacy irrespective of their sociodemographic characteristics (β = 1.06; 95 percent CI, 1.04 to 1.09).

Conclusions: Patients who possess lower levels of self-efficacy are at greater risk for experiencing dissatisfaction with the information that they receive in the preoperative period, and ultimately suffered more regret over their decision to undergo breast reconstruction.


Toronto, Ontario, Canada

From the Division of Plastic and Reconstructive Surgery, Department of Surgery and Surgical Oncology, University Health Network; the Division of Plastic and Reconstructive Surgery, Faculty of Medicine, and the Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; and the Division of Plastic and Reconstructive Surgery, Women’s College Hospital.

Received for publication April 11, 2013; accepted May 29, 2013.

Presented at the 66th Annual Meeting of the Canadian Society of Plastic Surgeons, in Toronto, Ontario, Canada, June 5 through 9, 2012.

Disclosure: No authors have any conflicts of interest.

Toni Zhong, M.D., M.H.S., Plastic and Reconstructive Surgery, University Health Network, Toronto General Hospital, Room 8NU-871, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada,

©2013American Society of Plastic Surgeons