Influence of male spouses of Japanese patients with breast cancer on the decision-making for primary treatment: A qualitative study

Objective: The dynamics of what actually occurs when couples make treatment decisions have not been fully studied. This study aimed to identify the influence of male spouses on the primary treatment decisions of patients with breast cancer in Japan and to obtain ideas for nurses to effectively help patients with breast cancer make primary treatment decisions. Methods: This qualitative study included married patients with stage I-III primary breast cancer <6 months after surgery. Semi-structured interviews were recorded and analyzed inductively. Results: This study identified three core categories that reflect the influence of spouses of Japanese patients with breast cancer on decision-making regarding primary treatment: the basis, quality, and direction of decision-making. These comprised six categories: "obtaining support that enables me to make my own choices in comfort," "living true to myself became difficult because, contrary to my expectations, I was disrespected," "examining the options together with my spouse will help me recognize values and lead me to a rational choice," "self-determination is disturbed by over-interference and psychological pressure," "rethinking their present state as a couple and exploring the future of their life together," and "not trying to look ahead, just letting things happen." Conclusions: It is important to evaluate marital relationships and leverage the strengths of joint decision-making to achieve better-quality decisions.