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"A Struggle Between Vanity and Life": The Experience of Receiving Breast Reconstruction in Women of Taiwan

Fang, Su-Ying MSN, RN, PhD(c); Balneaves, Lynda G. RN, PhD; Shu, Bih-Ching RN, PhD

doi: 10.1097/NCC.0b013e3181d1c853
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Background: Understanding the role of sociocultural factors on women's experiences of breast reconstruction is needed to provide better care and avoid erroneous assumptions of these women's needs.

Objective: The purpose of this study was to understand the lived experiences of Taiwanese women with breast cancer who receive breast reconstruction following mastectomy in Taiwan.

Methods: A qualitative research design, guided by the philosophy of hermeneutic phenomenology, was selected to guide the study. In-depth interviews were conducted 1 to 2 times with each participant and explored the women's experiences related to making decisions about, undergoing, and recovering from breast reconstruction.

Results: Seven women who received either autologous breast reconstruction or saline implants were recruited in southern Taiwan. Five themes were identified, including "dream of a wonderful future," "unexpected reality," "struggling to accept," "balancing vanity with life priorities," and "coming to terms: no regret."

Conclusion: Taiwanese women felt ambivalent about their new breasts, which failed to meet their expectations. This ambivalence, combined with a culture that values selflessness and the placement of family first, resulted in many women feeling guilty, vain, and superficial for requesting breast reconstruction.

Implications for Practice: Clinical implications include the importance of regular and authentic patient-health care provider communication throughout the process of breast reconstruction, including recovery, and better acknowledgement of Taiwanese women's body image concerns associated with breast reconstruction.

Background: Understanding the role of sociocultural factors on women's experiences of breast reconstruction is needed to provide better care and avoid erroneous assumptions of these women's needs. Objective: The purpose of this study was to understand the lived experiences of Taiwanese women with breast cancer who receive breast reconstruction following mastectomy in Taiwan. Methods: A qualitative research design, guided by the philosophy of hermeneutic phenomenology, was selected to guide the study. In-depth interviews were conducted 1 to 2 times with each participant and explored the women's experiences related to making decisions about, undergoing, and recovering from breast reconstruction. Results: Seven women who received either autologous breast reconstruction or saline implants were recruited in southern Taiwan. Five themes were identified, including "dream of a wonderful future," "unexpected reality," "struggling to accept," "balancing vanity with life priorities," and "coming to terms: no regret." Conclusion: Taiwanese women felt ambivalent about their new breasts, which failed to meet their expectations. This ambivalence, combined with a culture that values selflessness and the placement of family first, resulted in many women feeling guilty, vain, and superficial for requesting breast reconstruction. Implications for Practice: Clinical implications include the importance of regular and authentic patient - health care provider communication throughout the process of breast reconstruction, including recovery, and better acknowledgement of Taiwanese women's body image concerns associated with breast reconstruction.

Author Affiliations: Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan (Ms Fang); School of Nursing, University of British Columbia, Vancouver, Canada (Dr Balneaves); and Department of Nursing and Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan (Dr Shu).

Correspondence: Bih-Ching Shu, RN, PhD, Department of Nursing and Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan 701, Taiwan (shubih@mail.ncku.edu.tw).

Accepted for publication December 28, 2009.

© 2010 Lippincott Williams & Wilkins, Inc.