[The Lived Experience of Body Alteration and Body Image with Regard to Immediate Breast Reconstruction among Women with Breast Cancer]

Body Acceptance Scale for Women with Breast Cancer: Development and Validation of a Measurement

PURPOSE

Breast cancer and its treatment result in drastic physical changes that can negatively affect a woman's body image. Body acceptance in women with breast cancer is crucial in enhancing their body image and overall quality of life. Despite its significance, there are currently no specific tools to measure body acceptance among cancer patients. This study aimed to develop a Body Acceptance Scale for Women with Breast Cancer (BAS-BC).

DATA SOURCES

The scale's initial items were generated based on a conceptual framework of body acceptance and were reviewed by three clinical and five experiential experts. A preliminary instrument was developed through a content validity assessment by six clinical experts and a pilot test with 20 women with breast cancer. Validity and reliability were evaluated via an online survey of 411 women who had undergone breast cancer surgery.

CONCLUSION

The scale consists of 17 items across six factors (encountering, understanding, adaptation, return to daily life, successful transition, and leap into the future). The scale's validity-including construct validity, cross-validity, known-groups validity, and criterion validity-was satisfactory, exhibiting a Cronbach α of .91. The BAS-BC demonstrated good validity and reliability.

IMPLICATIONS FOR NURSING PRACTICE

The BAS-BC will contribute to improving the quality of life of female breast cancer survivors by providing fundamental information for future research. The BAS-BC may enable nurses to provide tailored interventions to promote body acceptance.

Influence of body image on quality of life in breast cancer patients undergoing breast reconstruction: Mediating of self-esteem

BACKGROUND

Breast cancer is considered as a major health problem for women, and the prevalence is increasing over the world. Research to improve their quality of life is necessary.

PURPOSE

This study was to examine the body image and self-esteem of breast cancer patients who underwent breast reconstruction in order to determine whether these affect their quality of life.

METHODS

A cross-sectional descriptive design was employed. This study was conducted on 140 patients who underwent breast reconstruction following breast cancer surgery at S University Hospital in Gyeonggi-do, South Korea. Measures were the general characteristics list, body image scale, self-esteem scale, and the Korean version of the Functional Assessment of Cancer Therapy-Breast Cancer Version 4 for quality of life. Data were analysed using descriptive statistics, Pearson correlation coefficient, linear regression, and process macro bootstrapping for mediation effect. Data were collected from October 2020 to March 2021.

RESULTS

The path regression coefficient was 1.59 (p < .001), and the direct effect of body image on the quality of life was 1.34 (p < .001) considering the effect of self-esteem, which is a parameter. This confirmed that self-esteem mediates body image and quality of life. The explanatory power of self-esteem for quality of life was 54%.

CONCLUSION

This study suggests that body image and self-esteem are important factors in the quality of life of breast cancer patients who underwent breast reconstruction. Also, the self-esteem has a mediating effect in the relationship between body image and quality of life.

RELEVANCE TO CLINICAL PRACTICE

In clinical practice, nurses should focus on the body image and self-esteem of breast cancer patients who have undergone breast reconstruction in order to improve their quality of life.

PATIENT OR PUBLIC CONTRIBUTION

This cross-sectional descriptive design study was conducted on patients who underwent breast reconstruction following breast cancer surgery at hospital in South Korea.

Body acceptance in women with breast cancer: A concept analysis using a hybrid model

BACKGROUND

Women with breast cancer undergo drastic physical changes which can impact their body image. Accepting the altered body has recently been highlighted as the key to body image improvement, however, there is no clear definition or conceptualization of it. This study clarified the concept of body acceptance in women with breast cancer, using a hybrid model.

METHODS

In the theoretical phase, the attributes and working definitions of the concept were identified through an extensive literature review. Individual in-depth interviews were conducted during the fieldwork phase to elucidate the concept and verify the attributes derived from the theoretical phase. Finally, in the final analytic phase, the findings were compared and integrated.

RESULTS

The theoretical and fieldwork phases included 20 out of the 579 articles extracted from the literature search and five women who had undergone breast cancer surgery, respectively. Body acceptance was defined as "acknowledging, normalizing, and overcoming changes in body appearance and function caused by breast cancer and its treatment".

CONCLUSIONS

Body acceptance has been identified as a key factor directly related to the overall quality of life. This study provides a theoretical basis for developing effective interventions and consequently facilitates their provision in practice.

A systematic review and meta-analysis on the prepectoral single-stage breast reconstruction

BACKGROUND

The use of acellular dermal matrices (ADMs) and mesh reopened the possibility for the prepectoral single-stage breast reconstruction (PBR). The complications of single-stage breast reconstruction after PRB are controversial. We conducted a systematic review and meta-analysis of the impact of implant plane on single-stage breast reconstruction. Our aim was to evaluate the different postoperative complications between patients receiving prepectoral breast reconstruction and subpectoral breast reconstruction (SBR) on single-stage breast reconstruction.

METHODS

A comprehensive research on databases including PubMed, Embase, and Cochrane libraries was performed to retrieve literature evaluating the effect of implant plane on single-stage breast reconstruction from 2010 to 2020. All included studies were evaluated the complications after single-stage breast reconstruction. Only studies comparing patients who underwent prepectoral reconstruction with a control group who underwent subpectoral reconstruction were included.

RESULTS

A total of 13 studies were included in the meta-analysis, with a total of 1724 patients. In general, compared with SBR group, the PBR significantly reduced the risk of total complications (including seroma, hematoma, necrosis, wound dehiscence, infection, capsular contraction, implant loss/remove, and rippling) after single-stage breast reconstruction (OR: 0.54, 95% CI: 0.44-0.67, p < 0.001). Compared with the SBR group, the PBR had remarkably decreased capsular contracture (OR: 0.40, 95% CI: 0.27-0.58, p < 0.001) and postoperative infection (OR: 0.58, 95% CI: 0.36-0.95, p = 0.03).

CONCLUSION

The PBR is a safe single-stage breast reconstruction with fewer postoperative complications. It is an alternative surgical method for SBR.