2.50
Hdl Handle:
http://hdl.handle.net/10755/157609
Type:
Presentation
Title:
Prophylactic Mastectomy: Decisionmaking and Post-Procedure Reflections
Abstract:
Prophylactic Mastectomy: Decisionmaking and Post-Procedure Reflections
Conference Sponsor:Western Institute of Nursing
Conference Year:2009
Author:Rubolino-Gallego, Maria L., MSN, RN, FNPC
P.I. Institution Name:California State University, Bakersfield, Nursing
Title:Assistant Professor
Contact Address:11806 Buffington Street, Bakersfield, CA, 93312, USA
Contact Telephone:661-587-5859
Purpose: Explore the role of fear in the decision for prophylactic mastectomy (PM) in women who have lived the experience. Rationale/Background: According to the American Cancer Society (ACS, 2008) breast cancer is the most common cancer, other than skin cancer, among women in the United States, and one in 8 women has the chance of developing breast cancer during her lifetime.  Even though the risk of dying from breast cancer is 1 in 35 (ACS, 2008), there has been a decline in the incidence of breast cancer (National Cancer Institute [NCI], 2007) as well as a decline in breast cancer related deaths (ACS, 2008).  One study demonstrated that bilateral PM correlated with a 90% reduction in breast cancer incidence and mortality over a 14 year follow up period (Hartmann et al., 1999). Methodology: Using Van Manen?s (1990) approach for phenomenologic inquiry, semi-structured audio-taped interviews were conducted with eight Caucasian women at high risk for breast cancer. The participants had all chosen to undergo either prophylactic bilateral or contralateral mastectomy. The interviews were conducted in person or by telephone. Participants were enrolled until data saturation (redundancy of themes) occurred.  Constant comparative analysis and coding of interview transcripts revealed individual, shared and contrasting themes. Trustworthiness was assured by bracketing, verbatim transcription, immersion, member checking and external validation of themes. Results and Implications for Women's Health: Essential themes emerged with many subthemes. Two of the major themes were:  Decisions were made based on fear (of cancer, disfigurement, post-operative pain, and death); and the women shared their feelings now while reflecting back on the decision (relief versus regrets, losses, reconstruction, and advising others). All reported a sense of fear prior to surgery, but few expressed major regrets. Future research should focus on benefits of PM, perceptions of laypersons compared with healthcare providers, women having undergone bilateral versus contralateral PM, and women of various races. There is no current legislation requiring insurance coverage for PM without evidence of breast cancer, providing an opportunity for advocacy and political activism for patients with demonstrated high risk of breast cancer. Implications for Nursing Practice: Findings will sensitize healthcare providers to the need for accurate information and various forms of support for women contemplating PM.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleProphylactic Mastectomy: Decisionmaking and Post-Procedure Reflectionsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157609-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Prophylactic Mastectomy: Decisionmaking and Post-Procedure Reflections</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Rubolino-Gallego, Maria L., MSN, RN, FNPC</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">California State University, Bakersfield, Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">11806 Buffington Street, Bakersfield, CA, 93312, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">661-587-5859</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">mrubolino@csub.edu, mariafnp@hotmail.com</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Explore the role of fear in the decision for prophylactic mastectomy (PM) in women who have lived the experience.&nbsp;Rationale/Background: According to the American Cancer Society (ACS, 2008) breast cancer is the most common cancer, other than skin cancer, among women in the United States, and one in 8 women has the chance of developing breast cancer during her lifetime.&nbsp; Even though the risk of dying from breast cancer is 1 in 35 (ACS, 2008), there has been a decline in the incidence of breast cancer (National Cancer Institute [NCI], 2007) as well as a decline in breast cancer related deaths (ACS, 2008).&nbsp; One study demonstrated that bilateral PM correlated with a 90% reduction in breast cancer incidence and mortality over a 14 year follow up period (Hartmann et al., 1999).&nbsp;Methodology: Using Van Manen?s (1990) approach for phenomenologic inquiry, semi-structured audio-taped interviews were conducted with eight Caucasian women at high risk for breast cancer. The participants had all chosen to undergo either prophylactic bilateral or contralateral mastectomy. The interviews were conducted in person or by telephone. Participants were enrolled until data saturation (redundancy of themes) occurred.&nbsp; Constant comparative analysis and coding of interview transcripts revealed individual, shared and contrasting themes. Trustworthiness was assured by bracketing, verbatim transcription, immersion, member checking and external validation of themes. Results and Implications for Women's Health: Essential themes emerged with many subthemes. Two of the major themes were:&nbsp; Decisions were made based on fear (of cancer, disfigurement, post-operative pain, and death); and the women shared their feelings now while reflecting back on the decision (relief versus regrets, losses, reconstruction, and advising others). All reported a sense of fear prior to surgery, but few expressed major regrets. Future research should focus on benefits of PM, perceptions of laypersons compared with healthcare providers, women having undergone bilateral versus contralateral PM, and women of various races. There is no current legislation requiring insurance coverage for PM without evidence of breast cancer, providing an opportunity for advocacy and political activism for patients with demonstrated high risk of breast cancer. Implications for Nursing Practice: Findings will sensitize healthcare providers to the need for accurate information and various forms of support for women contemplating PM.</td></tr></table>en_GB
dc.date.available2011-10-26T20:02:01Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:02:01Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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