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Deliberating Over Mastectomy: Survival and Social Roles

Fang, Su-Ying PhD, RN; Shu, Bih-Ching PhD, RN; Fetzer, Susan J. PhD, MBA, RN

doi: 10.1097/NCC.0b013e3181efebaf
ARTICLES: ONLINE ONLY
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Background: Most studies based on a woman's decision regarding breast cancer treatments have focused on surgical treatment preference and related factors. Few studies have been carried out to identify the concerns associated with coming to terms with a mastectomy and cancer diagnosis among women eligible for a mastectomy only.

Objective: The aim of this study was to explore Taiwanese women's experience about facing a mastectomy and to determine their deliberations before agreeing to a recommended mastectomy.

Methods: Ten women who had undergone a mastectomy participated, with 3 undergoing individual interviews and 7 participating in a focus group. Findings during the interviews guided the focus group.

Results: Content analysis revealed 4 themes through the women's narratives of the decision-making experience when a mastectomy was recommended. These included (a) surviving is a priority, (b) fulfilling responsibility, (c) coming to terms with postsurgery alternatives, and (d) making arrangements.

Conclusion: The experience surrounding the decision to undergo a mastectomy among Taiwanese women may be complicated by survival concerns, the meanings of the breast, and a feeling of an uncontrolled daily life. Cultural beliefs ensured that women were fulfilling their expected social roles and always thinking about significant others first.

Implications for Practice: Recognizing women's private concerns with sensitivity and supporting women to balance their own needs and assigned social responsibilities are important considerations for women undergoing a mastectomy. Developing cultural competency is necessary for nurses working in communities with diverse ethnoculture people.

Background: Most studies based on a woman's decision regarding breast cancer treatments have focused on surgical treatment preference and related factors. Few studies have been carried out to identify the concerns associated with coming to terms with a mastectomy and cancer diagnosis among women eligible for a mastectomy only. Objective: The aim of this study was to explore Taiwanese women's experience about facing a mastectomy and to determine their deliberations before agreeing to a recommended mastectomy. Methods: Ten women who had undergone a mastectomy participated, with 3 undergoing individual interviews and 7 participating in a focus group. Findings during the interviews guided the focus group. Results: Content analysis revealed 4 themes through the women's narratives of the decision-making experience when a mastectomy was recommended. These included (a) surviving is a priority, (b) fulfilling responsibility, (c) coming to terms with postsurgery alternatives, and (d) making arrangements. Conclusion: The experience surrounding the decision to undergo a mastectomy among Taiwanese women may be complicated by survival concerns, the meanings of the breast, and a feeling of an uncontrolled daily life. Cultural beliefs ensured that women were fulfilling their expected social roles and always thinking about significant others first. Implications for Practice: Recognizing women's private concerns with sensitivity and supporting women to balance their own needs and assigned social responsibilities are important considerations for women undergoing a mastectomy. Developing cultural competency is necessary for nurses working in communities with diverse ethnoculture people.

Author Affiliations: Department of Nursing, Chung-Hwa University of Medical Technology (Dr Fang); Department of Nursing and Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan (Dr Shu); Department of Nursing, University of New Hampshire, Durham (Dr Fetzer).

The study was supported by Bureau of Health Promotion grant DOH94-HP-1502 in Taiwan.

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

Accepted for publication June 29, 2010.

© 2011 Lippincott Williams & Wilkins, Inc.