College of Nursing, Texas Woman's University, P.O. Box 425498, ASB 216, Denton, TX 76204-5498, USA.
Nelda C. Stark College of Nursing, Texas Woman's University, 6700 Fannin Street, Houston, TX 77030-2897, USA.
Body Image. 2023 Sep;46:419-433. doi: 10.1016/j.bodyim.2023.07.009. Epub 2023 Aug 11.
This qualitative study aimed to describe and explore the pre and post-mastectomy experiences of women choosing flat closure after a breast cancer diagnosis. Aesthetic flat closure creates a flat contoured chest wall after a mastectomy. There is limited research on women's flat closure experiences. To fill this gap, we interviewed 19 women (Mage = 53, range 31-72) with breast cancer who underwent a bilateral mastectomy with flat closure, examining decision-making, mirror-viewing, and flat closure experiences. Using a hermeneutic phenomenological design, we generated seven themes. Broadly, women choosing flat closure experienced pressure from their clinicians to undergo breast reconstruction. We found flat closure information to be consistently lacking. Mirror-viewing experiences of women obtaining suboptimal flat closure outcomes led to shattered expectations, mirror avoidance, psychological distress, and body image disturbances. Women negotiated their new reality by discovering ways to feel comfortable with their flat bodies. Regardless of surgical outcome, decision satisfaction was high. These findings illustrate the importance of bodily autonomy and supportive healthcare environments for women making flat closure decisions. Providing comprehensive information on all surgical options and addressing post-operative expectations can improve women's decision-making and mirror-viewing experiences and assist women in adapting to their new body image.
本定性研究旨在描述和探讨选择乳腺癌诊断后行平切术的女性的术前和术后体验。美容平切术在乳房切除术后可形成平坦的胸壁轮廓。目前关于女性平切术体验的研究有限。为了填补这一空白，我们采访了 19 名（平均年龄 53 岁，范围 31-72 岁）接受双侧平切术的乳腺癌女性，研究了她们的决策过程、镜前观察和平切术体验。采用解释学现象学设计，我们生成了七个主题。总的来说，选择平切术的女性面临来自临床医生的进行乳房重建的压力。我们发现平切术相关信息普遍缺失。女性获得不理想的平切术结果后的镜前观察体验导致了期望破灭、回避镜子、心理困扰和身体形象障碍。女性通过寻找方法来适应平坦的身体，从而应对新的现实。无论手术结果如何，决策满意度都很高。这些发现说明了身体自主和支持性医疗保健环境对女性做出平切术决策的重要性。提供所有手术选择的综合信息并解决术后期望问题，可以改善女性的决策和镜前观察体验，并帮助女性适应新的身体形象。
