Decision-making process for risk-reducing salpingo-oophorectomy among Korean women with hereditary breast cancer: A grounded theory study

Purpose: To explore the decision-making process regarding Risk-Reducing Salpingo-Oophorectomy (RRSO) among women with hereditary breast cancer in Korea, with a focus on complex interpersonal interactions and sociocultural influences. Method: This qualitative, grounded theory study conducted semi-structured and in-depth interviews with 17 women with hereditary breast cancer between March and December 2021. Theoretical sampling and constant comparison were utilized for data analysis. Results: The core concept identified was ‘Navigating optimal trajectories for preserving myself,’ encompassing four stages: (1) conflicting between cancer-free health and maintaining integrated self; (2) recognizing the decision-maker: myself vs. physician; (3) seeking meaningful information; and (4) evaluating decision results and prioritizing values. Women's conflict was influenced by the time given to decide, the timing of BRCA results, complexity of surgical choices, diverse perspectives, and the quality of information. This process often reiterated until RRSO was undertaken. Conclusion: Women with hereditary breast cancer grapple with conflicting decisions to preserve their integrated selves. The decision-making process is complex and subjective, influenced by physician-dominated decision-making culture, subjective meaningful information, individual values, and decisional circumstances. Supporting women in prioritizing their values and providing comprehensive information on the physical, emotional, relational, and social impacts of each option are crucial. Oncology nurses can play a vital role in bridging the gap between physician-dominated decision-making and patient autonomy by facilitating communication and supporting patient-centered care.