An exploration of Australian psychologists' role in assessing women considering risk-reducing or contralateral prophylactic mastectomy. (April 2017)

• Record Type: Journal Article
• Authors: Braude, Lucy; Laidsaar-Powell, Rebekah; Gilchrist, Jemma; Kirsten, Laura; Juraskova, Ilona
• Is Part Of: Breast. Volume 32(2017)
• Page Start: 105
• Page End: 111
• Publication Date: 2017-04
• Subjects: Risk-reducing mastectomy -- Contralateral prophylactic mastectomy -- Psychologist -- Assessment -- Qualitative; Breast -- Diseases -- Periodicals; Breast -- Tumors -- Periodicals; Breast -- Periodicals; Electronic journals; Periodicals; 616
• DOI: 10.1016/j.breast.2017.01.011
• Languages: English
• ISSNs: 0960-9776

Abstract

Abstract: Objectives: Given increasing rates of risk-reducing mastectomies (RRM) and contralateral prophylactic mastectomies (CPM), and the potentially significant psychological sequelae of this irreversible procedure, health professionals (HPs) regularly refer patients to psychologists for pre-operative assessment and support. This is the first study to provide qualitative insights from HPs into the role of psychologists who are working with women considering RRM or CPM. Materials and methods: 24 HPs (psychologists, surgeons, breast care nurses and genetic counsellors) experienced in treating patients before or after RRM/CPM completed semi-structured interviews (n = 15) or participated in a focus group (n = 10). Interviews were qualitatively analysed using Framework methods. Results: Qualitative analysis revealed four interconnected themes: (1) perceived patient motivation to undergo RRM/CPM; (2) HP reasons for psychologist referral; (3) role of the psychologist; and (4) value of psychologist involvement. The reported psychologist role included: mental health assessment, checking understanding of information, ensuring informed decision-making, preparation for the procedure, and management of post-surgical challenges. Conclusion: Psychologists are perceived by HPs to have a key role in the multi-disciplinary care of patients considering RRM or CPM. Highlights: Psychologists have a key role in assessing women seeking risk-reducing or contralateral prophylactic mastectomy. Reported psychologist role encompasses mental health, social, medical and pragmatic concerns. Expectations of psychologist involvement and role vary between health professionals. Explicitly defining the role of psychologists in this context would benefit patients and multidisciplinary teams.