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Tyner TE, Freysteinson WM, Evans SC, Woo J. "My body, my choice": A qualitative study of women's mastectomy with flat closure experiences. Body Image 2023; 46:419-433. [PMID: 37573764 DOI: 10.1016/j.bodyim.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 07/25/2023] [Accepted: 07/25/2023] [Indexed: 08/15/2023]
Abstract
This qualitative study aimed to describe and explore the pre and post-mastectomy experiences of women choosing flat closure after a breast cancer diagnosis. Aesthetic flat closure creates a flat contoured chest wall after a mastectomy. There is limited research on women's flat closure experiences. To fill this gap, we interviewed 19 women (Mage = 53, range 31-72) with breast cancer who underwent a bilateral mastectomy with flat closure, examining decision-making, mirror-viewing, and flat closure experiences. Using a hermeneutic phenomenological design, we generated seven themes. Broadly, women choosing flat closure experienced pressure from their clinicians to undergo breast reconstruction. We found flat closure information to be consistently lacking. Mirror-viewing experiences of women obtaining suboptimal flat closure outcomes led to shattered expectations, mirror avoidance, psychological distress, and body image disturbances. Women negotiated their new reality by discovering ways to feel comfortable with their flat bodies. Regardless of surgical outcome, decision satisfaction was high. These findings illustrate the importance of bodily autonomy and supportive healthcare environments for women making flat closure decisions. Providing comprehensive information on all surgical options and addressing post-operative expectations can improve women's decision-making and mirror-viewing experiences and assist women in adapting to their new body image.
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Affiliation(s)
- Tracy E Tyner
- College of Nursing, Texas Woman's University, P.O. Box 425498, ASB 216, Denton, TX 76204-5498, USA.
| | - Wyona M Freysteinson
- Nelda C. Stark College of Nursing, Texas Woman's University, 6700 Fannin Street, Houston, TX 77030-2897, USA
| | - Stephanie C Evans
- Houston J. and Florence A. Doswell College of Nursing, Texas Woman's University, 5500 Southwestern Medical Avenue, Dallas, TX 75235-7299, USA
| | - Jennifer Woo
- Houston J. and Florence A. Doswell College of Nursing, Texas Woman's University, 5500 Southwestern Medical Avenue, Dallas, TX 75235-7299, USA
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Gill FJ, Pienaar C, Jones T. Using a 3 stage process to create a consumer research contact list in a paediatric health setting: the PARTICIPATE project. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:56. [PMID: 34364394 PMCID: PMC8349077 DOI: 10.1186/s40900-021-00300-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
The impact of child health research can be far reaching; affecting children's immediate health, their adult health, the health of future generations and the economic wellbeing of countries. Consumer and community involvement is increasingly recognised as key to successful research recruitment. Systematic approaches to research recruitment include research registries or research contact lists. OBJECTIVE Develop a process of creating a consumer research contact list for participating in future research opportunities at a children's health service. METHODS A healthcare improvement approach using a 3 stage framework; 1) evidence review and consultation 2) co-production of a research communications plan with stakeholders (including consumers), including a draft research information brochure 3) prototyping involved iteratively testing the brochure, surveying parents or carers who attended outpatient clinics or the hospital Emergency Department, and conducting follow up telephone calls. RESULTS There was overall support for the creation of a research contact list, but some unknowns remain. 367 parents or carers completed the survey and 36 participated in a follow up telephone call. Over half would be willing to join a research contact list and more than 90% of the children of parents or carers surveyed were not currently participating in research. Several potential barriers identified by health service staff were dispelled. Research communications and a future contact list should be available in electronic form. CONCLUSIONS There was strong support for creating a research contact list. The approach will inform our future directions including creation of an electronic research contact list easily accessible by consumers of the children's health service. Recruiting enough children to participate in research studies can be challenging. Establishing a registry or list of young people willing to be contacted to participate in research is one way of addressing this problem. At our children's health service, we wanted to explore the idea of developing a research contact list and we were particularly keen to involve consumers and community members in this process, which involved: 1.Reviewing other examples of research contact lists and consulting with a range of people, including consumers and community members, 2. Co-producing a research communications plan with parents, young people, health service staff and research staff, including a draft research information brochure for families, and 3. Testing the acceptability of the brochure by surveying parents or carers who attended outpatient clinics or the hospital Emergency Department, and conducting follow up telephone calls with them. 367 parents or carers completed a survey and 36 participated in a follow up telephone call. Over half were willing to join a research contact list and more than 90% of the children of parents or carers surveyed were not currently participating in research. Several potential barriers raised by consumers and health professionals in the first stage of the project were not found to be a concern for the parents or carers surveyed. Responses showed research communications and a future contact list should be available in electronic form. These findings will inform the future creation of an electronic research contact list, easily accessible by consumers of the children's health service.
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Affiliation(s)
- Fenella J. Gill
- Perth Children’s Hospital, Child and Adolescent Health Service, Hospital Avenue, Nedlands, WA 6009 Australia
- School of Nursing, Faculty of Health Sciences, Curtin University, Perth, Western Australia Australia
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia Australia
| | - Catherine Pienaar
- Perth Children’s Hospital, Child and Adolescent Health Service, Hospital Avenue, Nedlands, WA 6009 Australia
| | - Tanya Jones
- School of Allied Heath, Faculty of Health Sciences, Curtin University, Perth, Western Australia Australia
- Formerly of the Consumer and Community Health Research Network (Now named Consumer and Community Involvement Program), Harry Perkins Institute of Medical Research, Level 6, 6 Verdun Street, Nedlands, WA 6009 Australia
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Pii KH, Schou LH, Piil K, Jarden M. Current trends in patient and public involvement in cancer research: A systematic review. Health Expect 2018; 22:3-20. [PMID: 30378234 PMCID: PMC6351419 DOI: 10.1111/hex.12841] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 08/27/2018] [Accepted: 09/16/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Patient and public involvement (PPI) in health research is on the rise worldwide. Within cancer research, PPI ensures that the rapid development of medical and technological opportunities for diagnostics, treatment and care corresponds with the needs and priorities of people affected by cancer. An overview of the experiences, outcomes and quality of recent PPI in cancer research would provide valuable information for future research. OBJECTIVE To describe the current state of PPI in cancer research focusing on the research stages, applied methods, stated purposes and outcomes, and challenges and recommendations. METHODS A search was conducted on PubMed, CINAHL and PsycINFO for literature published from December 2006 to April 2017. Original research studies describing the involvement of cancer patients, stakeholders and carers as active partners at any stage of the research process were included. RESULTS Twenty-seven studies were included, the majority reporting PPI at the early stages of research, that is, during the definition and prioritization of research topics and the development of recruitment strategies. Few studies reported PPI at later stages and across the research process. Challenges and recommendations were only briefly described, and critical reflection on the PPI process was lacking. CONCLUSION PPI needs to be integrated more broadly in the cancer research process. The quality of reporting PPI should be strengthened through greater critical reflections including both positive and negative experiences of the PPI process. This will contribute to the further development of PPI and its potential in cancer research.
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Affiliation(s)
- Kathrine Hoffmann Pii
- Institute of Nursing and Nutrition, Copehagen University College, Copenhagen, Denmark
| | - Lone Helle Schou
- Institute of Nursing and Nutrition, Copehagen University College, Copenhagen, Denmark
| | - Karin Piil
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet Copenhagen, Denmark.,Department of Public Health, Aarhus University, Denmark
| | - Mary Jarden
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Freysteinson WM, Deutsch AS, Davin K, Lewis C, Sisk A, Sweeney L, Wuest L, Cesario SK. The Mirror Program: Preparing Women for the Postoperative Mastectomy Mirror-Viewing Experience. Nurs Forum 2015; 50:252-257. [PMID: 25130483 DOI: 10.1111/nuf.12108] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PROBLEM Preparing women for the experiences they will endure during the breast cancer trajectory improves psychological outcomes and quality of life. Women have found that it may be difficult to view themselves in a mirror after having a mastectomy. Supporting women who have had a mastectomy in mirror-viewing and body image is a relatively new yet important intervention in oncology nursing. METHODS The feasibility of a preoperative mirror program given by oncology nurse navigators to women who were scheduled for a mastectomy was examined in this randomized control study. FINDINGS Pre- and postoperative data on anxiety, body image, depression, emotional well-being, and mirror use were collected from intervention participants (n = 10) and control subjects (n = 9). CONCLUSION This article illustrates the development of the mirror program and the results of the feasibility trial, and provides a discussion with implications for future research.
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Affiliation(s)
| | - Amy S Deutsch
- System Cancer Services, Memorial Hermann Health System, Houston, TX
| | - Karen Davin
- Memorial Hermann Memorial City Hospital, Memorial Hermann Health System, Houston, TX
| | - Carol Lewis
- Memorial Hermann the Woodlands Hospital, Formally of Memorial Hermann Health System, Houston, TX
| | - Angela Sisk
- Memorial Hermann Northwest Hospital, Memorial Hermann Health System, Houston, TX
| | - Lilian Sweeney
- Memorial Hermann Southwest Hospital, Memorial Hermann Health Systems, Houston, TX
| | - Linda Wuest
- Memorial Hermann Northeast Hospital, Memorial Hermann Health Services, Houston, TX
| | - Sandra K Cesario
- Nelda C. Stark College of Nursing, Texas Woman's University, Houston, TX
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Concannon TW, Fuster M, Saunders T, Patel K, Wong JB, Leslie LK, Lau J. A systematic review of stakeholder engagement in comparative effectiveness and patient-centered outcomes research. J Gen Intern Med 2014; 29:1692-701. [PMID: 24893581 PMCID: PMC4242886 DOI: 10.1007/s11606-014-2878-x] [Citation(s) in RCA: 299] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Revised: 01/16/2014] [Accepted: 04/19/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We conducted a review of the peer-reviewed literature since 2003 to catalogue reported methods of stakeholder engagement in comparative effectiveness research and patient-centered outcomes research. METHODS AND RESULTS We worked with stakeholders before, during and after the review was conducted to: define the primary and key research questions; conduct the literature search; screen titles, abstracts and articles; abstract data from the articles; and analyze the data. The literature search yielded 2,062 abstracts. The review was conducted on 70 articles that reported on stakeholder engagement in individual research projects or programs. FINDINGS Reports of stakeholder engagement are highly variable in content and quality. We found frequent engagement with patients, modestly frequent engagement with clinicians, and infrequent engagement with stakeholders in other key decision-making groups across the healthcare system. Stakeholder engagement was more common in earlier (prioritization) than in later (implementation and dissemination) stages of research. The roles and activities of stakeholders were highly variable across research and program reports. RECOMMENDATIONS To improve on the quality and content of reporting, we developed a 7-Item Stakeholder Engagement Reporting Questionnaire. We recommend three directions for future research: 1) descriptive research on stakeholder-engagement in research; 2) evaluative research on the impact of stakeholder engagement on the relevance, transparency and adoption of research; and 3) development and validation of tools that can be used to support stakeholder engagement in future work.
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Shippee ND, Domecq Garces JP, Prutsky Lopez GJ, Wang Z, Elraiyah TA, Nabhan M, Brito JP, Boehmer K, Hasan R, Firwana B, Erwin PJ, Montori VM, Murad MH. Patient and service user engagement in research: a systematic review and synthesized framework. Health Expect 2013; 18:1151-66. [PMID: 23731468 DOI: 10.1111/hex.12090] [Citation(s) in RCA: 390] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2013] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND There is growing attention towards increasing patient and service user engagement (PSUE) in biomedical and health services research. Existing variations in language and design inhibit reporting and indexing, which are crucial to comparative effectiveness in determining best practices. OBJECTIVE This paper utilizes a systematic review and environmental scan to derive an evidence-based framework for PSUE. DESIGN A metanarrative systematic review and environmental scan/manual search using scientific databases and other search engines, along with feedback from a patient advisory group (PAG). ELIGIBLE SOURCES English-language studies, commentaries, grey literature and other sources (including systematic and non-systematic reviews) pertaining to patient and public involvement in biomedical and health services research. DATA EXTRACTED Study description (e.g. participant demographics, research setting) and design, if applicable; frameworks, conceptualizations or planning schemes for PSUE-related endeavours; and methods for PSUE initiation and gathering patients'/service users' input or contributions. RESULTS Overall, 202 sources were included and met eligibility criteria; 41 of these presented some framework or conceptualization of PSUE. Sources were synthesized into a two-part framework for PSUE: (i) integral PSUE components include patient and service user initiation, reciprocal relationships, colearning and re-assessment and feedback, (ii) sources describe PSUE at several research stages, within three larger phases: preparatory, execution and translational. DISCUSSION AND CONCLUSIONS Efforts at developing a solid evidence base on PSUE are limited by the non-standard and non-empirical nature of much of the literature. Our proposed two-part framework provides a standard structure and language for reporting and indexing to support comparative effectiveness and optimize PSUE.
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Affiliation(s)
- Nathan D Shippee
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
| | - Juan Pablo Domecq Garces
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.,Henry Ford Hospital, Detroit, MI, USA
| | - Gabriela J Prutsky Lopez
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.,Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine/Detroit Medical Center, Detroit, MI, USA
| | - Zhen Wang
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Tarig A Elraiyah
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Mohammed Nabhan
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.,Saint Joseph Mercy Hospital, Ann Arbor, MI, USA
| | - Juan P Brito
- Endocrinology Division, Mayo Clinic, Rochester, MN, USA
| | - Kasey Boehmer
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Rim Hasan
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Belal Firwana
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | | | - Victor M Montori
- Mayo Clinic, Rochester, MN, USA.,Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
| | - M Hassan Murad
- Mayo Clinic, Rochester, MN, USA.,Knowledge Synthesis Program, Mayo Clinic, Rochester, MN, USA
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Freysteinson WM. Use of Mirrors as a Nursing Intervention to Promote Patients' Acceptance of a New Body Image. Clin J Oncol Nurs 2012; 16:533-6. [DOI: 10.1188/12.cjon.533-536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Freysteinson WM, Deutsch AS, Lewis C, Sisk A, Wuest L, Cesario SK. The Experience of Viewing Oneself in the Mirror After a Mastectomy. Oncol Nurs Forum 2012; 39:361-9. [DOI: 10.1188/12.onf.361-369] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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