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Mastectomy patients' decision-making for or against immediate breast reconstruction

Harcourt, Diana; Rumsey, Nichola

Authors

Diana Harcourt Diana2.Harcourt@uwe.ac.uk
Professor in Appearance Research



Abstract

This multi-centred study examined how 93 women due to undergo mastectomy had elected for (n = 37) or against (n = 56) immediate breast reconstruction. Initial semi-structured interviews were conducted prior to undergoing surgery whilst follow-up interviews 6 and 12 months later examined particpants' experiences of surgery and their views on their decision. Three decision-making styles were identified. Most women (76) reported making quick, 'instant' decisions, whilst 14 sought further information before making their choice. Three women deliberated over their options and found decision-making particularly difficult. Decision-making was influenced by the perceived salience of alternatives, prevailing 'norms' regarding surgical practice within each hospital system and interactions with health professionals. Experiences of surgery often failed to match patients' pre-surgical expectations and the process of adjusting to the impact of surgery continued throughout the following year, during which women contended with a range of problems including pain, scarring and adjusting to a reconstructed breast. However, most women reported themselves satisfied with their decision and justified their choices by focussing on positive aspects of their surgery. Whilst many women make a quick decision about breast reconstruction, research needs to explore ways of facilitating decision-making amongst those who find this decision particularly difficult. Copyright © 2003 John Wiley & Sons, Ltd.

Journal Article Type Article
Publication Date Feb 1, 2004
Journal Psycho-Oncology
Print ISSN 1057-9249
Electronic ISSN 1099-1611
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 13
Issue 2
Pages 106-115
DOI https://doi.org/10.1002/pon.711
Keywords mastectomy, breast reconstruction, visible difference, body image
Public URL https://uwe-repository.worktribe.com/output/1062083
Publisher URL http://dx.doi.org/10.1002/pon.711
Additional Information Additional Information : This multi-centred study identified 3 decision making styles among women considering breast reconstruction. Findings identified a range of influential factors including interaction with health professionals. Research reported here and in output 3 led to an invitation to join the DH Cancer Reform Strategy Breast Cancer Working Group.