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Bridging the gap: decision-making processes of women with breast cancer using complementary and alternative medicine (CAM)

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Abstract

Goals of work

The purpose of this study was to explore the personal and social processes women with breast cancer engaged in when making decisions about complementary and alternative medicine (CAM). The overall aim was to develop a conceptual model of the treatment decision-making process specific to breast cancer care and CAM that will inform future information and decision support strategies.

Materials and methods

Grounded theory methodology explored the decisions of women with breast cancer using CAM. Semistructured interviews were conducted with 20 women diagnosed with early-stage breast cancer. Following open, axial, and selective coding, the constant comparative method was used to identify key themes in the data and develop a conceptual model of the CAM decision-making process.

Main results

The final decision-making model, Bridging the Gap, was comprised of four core concepts including maximizing choices/minimizing risks, experiencing conflict, gathering and filtering information, and bridging the gap. Women with breast cancer used one of three decision-making styles to address the paradigmatic, informational, and role conflict they experienced as a result of the gap they perceived between conventional care and CAM: (1) taking it one step at a time, (2) playing it safe, and (3) bringing it all together.

Conclusions

Women with breast cancer face conflict and anxiety when making decisions about CAM within a conventional cancer care context. Information and decision support strategies are needed to ensure women are making safe, informed treatment decisions about CAM. The model, Bridging the Gap, provides a conceptual framework for future decision support interventions.

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Acknowledgments

The authors would like to kindly acknowledge the women who participated in this study. Funding for this project was received from the Canadian Institutes of Health Research (CIHR) and the Canadian Breast Cancer Research Alliance (CBCRA). A Canadian Cancer Society Research Scientist Award (supported through the NCIC Prostate Cancer Initiative) was also awarded to Dr. Lynda Balneaves. Dr. Marja Verhoef was supported by a Canada Research Chair in Complementary Medicine.

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Authors and Affiliations

  1. School of Nursing, University of British Columbia, 302-6190 Agronomy Road, Vancouver, BC V6T 1Z3, Canada

    Lynda G. Balneaves & Mary Kelly

  2. British Columbia Cancer Agency, 600 West 10th Avenue, Vancouver, BC V5Z 4E6, Canada

    Tracy L. O. Truant

  3. Department of Community Health Science, University of Calgary, Heritage Medical Research Building Room G02, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada

    Marja J. Verhoef

  4. Department of Urologic Sciences, University of British Columbia, Room 6199, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada

    B. Joyce Davison

Authors
  1. Lynda G. Balneaves
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  2. Tracy L. O. Truant
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  3. Mary Kelly
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  4. Marja J. Verhoef
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  5. B. Joyce Davison
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Corresponding author

Correspondence to Lynda G. Balneaves.

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Balneaves, L.G., Truant, T.L.O., Kelly, M. et al. Bridging the gap: decision-making processes of women with breast cancer using complementary and alternative medicine (CAM). Support Care Cancer 15, 973–983 (2007). https://doi.org/10.1007/s00520-007-0282-3

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