D decisionmaking had lower average religiosity scores than those who reported

D decisionmaking had lower average religiosity scores than those who reported physician-based decision-making (mean score = 13.5 and 14.7 units, respectively; P = .02). Several qualitative studies explicated the role of patient MedChemExpress UNC0642 spirituality or “faith in God” in cancer treatment decision-making.36,40,43,45,47 Spirituality was cited repeatedly as both a coping mechanism and a factor in the decision-making process. Spirituality was a particularly strong coping mechanism among African Americans.40,45 Specifically, spirituality played a strong role in having faith in the providers, strengthening the relationship with providers, and following the providers’ recommendations for treatment. In these studies, prayer was not viewed as a sufficient treatment option by itself.40,45 For several minority groups, spirituality may have limited patients’ role in decision-making by causing them to put their trust in their providers and in their religious faith; alternatively, highly spiritual patients may have had a psychosocial characteristic that also stimulated a high level of faith in their providers. For example, in a study of low-acculturated Asian Americans, providers reported that patients were more passive in treatment decision-making.36 According to their providers, these patients often viewed their cancer diagnosis and treatment outcome as part of “God’s will” and relied heavily on prayer, which limited their active participation in decision-making. Attitudes about treatment and decision-making. Three quantitative studies explored the impact PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19892805 of patients’ attitudes about treatment and decision-making on the decisional process, with mixed findings.27,29,34 One study of African American men and women found that patients held strong supportive attitudes for autonomy in information seeking, but not autonomy in decision-making.34 Patients with higher educational levels had stronger supportive attitudes for autonomy in information seeking and decision-making, but attitudes were similar across income level. GSK-126 manufacturer concerns about recurrence, survival, and radiation were self-reported as the mostsignificant attitudinal factors influencing treatment decision-making for Latina, African American, and White women.27,29 One study of breast cancer patients27 found that, compared with lowacculturated Latina and White women, significantly more African American and high-acculturated Latina women reported concerns about recurrence (61.4 —64.1 vs 55.6 —55.8 of patients; P for overall trend = .044) and body image (22.3 —25.3 vs 17.2 –19.8 ; P for overall trend = .01) as important factors in decisionmaking. Significantly fewer White women reported radiation concerns as a major decisional influence than low-acculturated Latina, high-acculturated Latina, and African American women (17.2 vs 26.8 —30.9 ; P for overall trend < .001). Another study29 found that, although concerns about survival and radiation did not significantly differ between groups, low-acculturated Latina women rated concerns about appearance (i.e., body image; P ?.001), surgical consequences (P ?.001), and cost (P ?.001) as greater decisional influences than did high-acculturated Latina and White women. Four qualitative studies explored the theme of patients' attitudes in treatment and treatment decision-making in greater detail. Many of the factors or concerns around decision-making were in direct conflict, thereby heightening patients' anxiety.36,38,43,44 For example, a study with lowaccultura.D decisionmaking had lower average religiosity scores than those who reported physician-based decision-making (mean score = 13.5 and 14.7 units, respectively; P = .02). Several qualitative studies explicated the role of patient spirituality or "faith in God" in cancer treatment decision-making.36,40,43,45,47 Spirituality was cited repeatedly as both a coping mechanism and a factor in the decision-making process. Spirituality was a particularly strong coping mechanism among African Americans.40,45 Specifically, spirituality played a strong role in having faith in the providers, strengthening the relationship with providers, and following the providers' recommendations for treatment. In these studies, prayer was not viewed as a sufficient treatment option by itself.40,45 For several minority groups, spirituality may have limited patients' role in decision-making by causing them to put their trust in their providers and in their religious faith; alternatively, highly spiritual patients may have had a psychosocial characteristic that also stimulated a high level of faith in their providers. For example, in a study of low-acculturated Asian Americans, providers reported that patients were more passive in treatment decision-making.36 According to their providers, these patients often viewed their cancer diagnosis and treatment outcome as part of "God's will" and relied heavily on prayer, which limited their active participation in decision-making. Attitudes about treatment and decision-making. Three quantitative studies explored the impact PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19892805 of patients’ attitudes about treatment and decision-making on the decisional process, with mixed findings.27,29,34 One study of African American men and women found that patients held strong supportive attitudes for autonomy in information seeking, but not autonomy in decision-making.34 Patients with higher educational levels had stronger supportive attitudes for autonomy in information seeking and decision-making, but attitudes were similar across income level. Concerns about recurrence, survival, and radiation were self-reported as the mostsignificant attitudinal factors influencing treatment decision-making for Latina, African American, and White women.27,29 One study of breast cancer patients27 found that, compared with lowacculturated Latina and White women, significantly more African American and high-acculturated Latina women reported concerns about recurrence (61.4 —64.1 vs 55.6 —55.8 of patients; P for overall trend = .044) and body image (22.3 —25.3 vs 17.2 –19.8 ; P for overall trend = .01) as important factors in decisionmaking. Significantly fewer White women reported radiation concerns as a major decisional influence than low-acculturated Latina, high-acculturated Latina, and African American women (17.2 vs 26.8 —30.9 ; P for overall trend < .001). Another study29 found that, although concerns about survival and radiation did not significantly differ between groups, low-acculturated Latina women rated concerns about appearance (i.e., body image; P ?.001), surgical consequences (P ?.001), and cost (P ?.001) as greater decisional influences than did high-acculturated Latina and White women. Four qualitative studies explored the theme of patients' attitudes in treatment and treatment decision-making in greater detail. Many of the factors or concerns around decision-making were in direct conflict, thereby heightening patients' anxiety.36,38,43,44 For example, a study with lowaccultura.