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The purpose of this study was to examine the relation of depression and anxiety to cancer patients' medical decision-making. Participants were 79 rural and urban cancer patients undergoing chemotherapy. The four decisional styles of the Decisional Processing Model were the independent variables. Dependent variables were anxiety and depression, measured by Spielberger's State-Trait Anxiety and the Center for Disease Control Depression Scale, respectively. Consistent with the Decisional Processing Model, analysis suggested that patients make medical decisions by information seeking, information processing, advice following, or ruminating. Decisional style did not vary according to type or stage of cancer, prognosis, time elapsed since initial diagnosis, or whether cancer was initial or recurrent. Decisional style did not systematically vary with depression and anxiety suggesting how a person makes decisions is a stable personality trait. Thus, decision-making may follow a cognitive schema. It is likely that patients' decisional styles help to manage anxiety and depression when confronted with life-threatening illness. Implications for informed consent and patients' involvement in decision-making are discussed.

Publisher Summary The Health and Safety Executive (HSE) is responsible for enforcement policy, development of new legislation, provision of information, and setting standards and international liaison. Within the framework of the legislation, the HSE's inspector is responsible for putting the enforcement policy into practice and discusses how the operational inspector fits into the overall structure. The main Act is the Health and Safety at Work Act 1974, while the subordinate legislation includes a number of Acts, for example, the Factories Act and the Offices Shops and Railway Premises Act, which apply to specific types of workplace. There are also a large number of sets of regulations that usually apply to specific processes, for example, Control of Lead at Work Regulations 1980 that apply to work with lead and lead compounds and derivatives. The Acts and Regulations are passed by Parliament and have to be complied with in toto, but there are also Approved Codes of Practice (ACOP), for example, Approved Code of Practice for the Control of Lead at Work, which is drawn up by the Health and Safety Commission after consultation with unions, management, and other interested bodies. ACOPs are enforceable at law but there is a fundamental difference between these and the Parliamentary legislation in that it is acceptable to achieve an equivalent standard by a system different from that set out in the ACOP.