Experiences of women undergoing abdominoplasty in the public sector: a qualitative study

Introduction: This study was designed to improve understanding of the experiences of women un-dergoing abdominoplasty in a public hospital setting, including their experience of processes of care, surgical treatment and outcomes of surgery. Methods: This was a prospective, qualitative study, with one-to-one interviews with women, tran-scription of interviews and development of themes. Results: Twenty interviews were carried out with 16 women, with four women being interviewed before and after surgery and the remaining 12 being interviewed one time only. Messages emerging from the interviews included gratitude for treatment in the public sector, uncertainty associated with waiting times and surgeon allocation, and varied satisfaction with outcomes. This article also explores the evidence for the association between physical symptoms and rectus diastasis (separa-tion of the rectus abdominis muscles) as well as mental health improvement. Conclusion: Women undergoing abdominoplasty in the public sector are not a homogenous group, either in their motivations for surgery or their reported outcomes. This qualitative study found evidence for improvement in physical symptoms and psychological wellbeing in women undergoing abdominoplasty, which supports existing quantitative studies, but also highlights a need for clear information for public sector patients, especially relating to scars, and for liaison psy-chiatry. Criteria-based assessment contributes an additional burden for these patients.

Experiences of depression in older adults from non-white and ethnic minority groups: A thematic synthesis of qualitative studies

OBJECTIVES

Older adults from black, Asian and minority ethnic communities, sometimes referred to as BAME, are at an increased risk of experiencing depression and yet are underrepresented in healthcare services. Qualitative research could help to provide insight into how the condition is experienced and managed by these groups. The current review is a thematic synthesis of qualitative studies examining lived experience of depression in older adults from BAME groups.

METHODS

A systematic search of five databases was conducted. The methodology of articles was evaluated and findings synthesised.

RESULTS

Twelve articles were identified capturing the experiences of 210 older adults across three continents: North America, South America and Asia. Studies met the majority or all of the quality appraisal criteria. Three themes emerged from the analysis: (i) How depression is understood in minority groups; demonstrating while older adults were familiar with the term depression, their understanding of the condition was limited; (ii) The socio-cultural norms of minority groups for managing depression; suggesting experiences of depression are typically kept hidden and managed in secret; (iii) How minority groups experience Western treatments for depression; reporting there are a number of barriers to seeking treatment, however, those who have received care valued the opportunity to share their difficulties.

CONCLUSIONS

While there is growing interest in this area, the evidence-base and research methodologies utilised to capture and explore experiences remains limited. The findings of this review have implications for informing the diagnosis, management and treatment of depression in older adults from BAME communities.

A qualitative study of life events and psychological needs underlying the decision to have cosmetic surgery

Objective A thorough psychological assessment of patients requesting cosmetic surgery can help to protect them from the risk of postoperative dissatisfaction and the onset and/or aggravation of psychiatric disorders. This study seeks to shed more light on why people desire cosmetic surgery and thus help surgeons, psychiatrists, and psychologists to conduct assessments before surgery. Methods In-depth interviews were conducted with 35 subjects who requested cosmetic surgery. The interviews were recorded and transcribed and then analyzed qualitatively with Grounded Theory. Themes and categories were identified and compared in logical order, to build a consistent theoretical model. Results In each interview, we identified one or more recent events that the subjects considered to be contributing factors in their decisions to have cosmetic surgery. We observed that 33 of 35 patients said they sought cosmetic surgery at a time when they were experiencing, or had just experienced, one or more major changes in their bodies or their relationships. Recent life events triggered or strengthened specific psychological needs in the subjects: to cope with the past and with change, attain a consistent identity, find or regain a positive self-image, alter others' perceptions, define themselves in relation to others, or please themselves or others. Patients said that they chose plastic surgery to fulfill one or more of these needs. Conclusions This study identifies the role of recent events in inciting individuals to resort to cosmetic surgery. This factor provides new perspectives for surgeons to understand those patients and opens new avenues for research.