"Waiting for breast reconstruction": An interpretative phenomenological analysis of heterosexual couples' experiences of mastectomy for breast cancer. (October 2019)

• Record Type: Journal Article
• Authors: Lamore, Kristopher; Flahault, Cécile; Fasse, Léonor; Untas, Aurélie
• Is Part Of: European journal of oncology nursing. Volume 42(2019)
• Page Start: 42
• Page End: 49
• Publication Date: 2019-10
• Subjects: Breast cancer -- Breast reconstruction -- Couple -- Interpretative phenomenological analysis -- Qualitative analysis; Cancer -- Nursing -- Periodicals; Cancer -- Research -- Periodicals; Oncology -- Periodicals; Oncology Nursing -- Periodicals; Neoplasms -- nursing -- Periodicals; Cancer -- Soins infirmiers -- Périodiques; Cancer -- Recherche -- Périodiques; Cancérologie -- Périodiques; Verpleegkunde; Kanker; Cancer -- Nursing; Cancer -- Research; Oncology; Electronic journals; Periodicals; Electronic journals; 616.9940231
• DOI: 10.1016/j.ejon.2019.07.008
• Languages: English
• ISSNs: 1462-3889

Abstract

Abstract: Purpose: Treatment decisions, such as breast reconstruction is made by the dyad patient-physician, but close others can have an influence on the process. Shared decision-making models include close others but current studies generally investigate physician-patient interactions only. Moreover, little is known about couples' interactions throughout the breast cancer journey and treatment decision-making. Thus, the aim of the present study was to explore couples' experiences of mastectomy and breast reconstruction decision-making, the month following the mastectomy. Method: Ten unstructured individual interviews, with five couples facing mastectomy for breast cancer, were conducted. A dyadic interpretative phenomenological analysis (IPA) was carried on the data set. Results: Eight super-ordinate themes emerged from the data. Couples' experiences were marked by the experience of the disease, the mastectomy and the impact they produced. The relationships with health professionals and partners were also important. Partners were not only supportive and protective, but directly (i.e., couples talk about treatments) and indirectly influenced (i.e., women make a decision taking into consideration how it will impact their couple) the women in their decision to have or not a breast reconstruction. The interpretative accounts underline how women and partners cope with the disease thinking about the aftertreatment. Conclusions: This study explains for the first time how intimate partners influence breast reconstruction decision-making and how couples cope individually with the disease immediately after mastectomy. Health professionals need to involve partners more in the treatment decision-making process as the women consider and talks to them about the choices they have to make. Highlights: Couples' interactions through breast cancer treatment decision-making were never studied. Women and their partners think about breast reconstruction (BR) since the diagnosis. Women project themselves into the future by thinking to BR (coping strategy). When talking about BR, partners show their fear of the unknown (coping strategy). Couples also cope together by using supportive and common dyadic coping strategies.