Health Care Systems Factors Affecting Breast Cancer Treatment Choices

Abstract

The purpose of this research was to explore and describe health care systems factors that influence treatment decisions for women with breast cancer in the United States (U.S.) and Norway. The specific aims of the study were to: (a) explore and describe how health care systems processes create barriers and facilitators of breast cancer treatment decisions for patients diagnosed with breast cancer in the US and Norway; and (b) compare and contrast the US and Norwegian system processes to identify advantages and disadvantages of each system as they relate to breast cancer treatments. A descriptive qualitative design was used to address the research aims and questions. Data were collected from key informants from the US and Norway. Content and matrix analysis were the primary descriptive and comparative approaches used for this study. First and second order matrices were created to display and analyze data obtained from key informant interviews. Findings indicate that financing allopathic care is a significant barrier for breast cancer patients within the US and financing CAM therapies are challenging in both countries. While allopathic treatment guidelines for breast cancer care are clearly outlined in both the US and Norway, both countries currently lack CAM treatment guidelines for use in this patient population, leading to inconsistent recommendations provided for patients. There are also significant barriers that prevent patient access of CAM providers, particularly by patients in an in-patient, hospital setting. Ultimately, when evaluating care and treatment plans for women diagnosed with breast cancer, health care providers should appreciate and acknowledge the significant system factors that may act as barriers or facilitators of care.