Patient Information Needs and Breast Reconstruction After Mastectomy: A Qualitative Meta-Synthesis.
Tracey L Carr, Gary Groot, David Cochran and 1 others
PMID 29734255WHAT IT FOUND
Women often expected breast reconstruction to match surgeon photos but were unprepared for pain, scarring, breast feel, and recovery length.
Clear consultation and nurse navigator support may help set realistic expectations.
Key findings
01Women's expectations were shaped mainly by the surgeon consultation and photos, and unmet expectations produced disappointment.
02Women were often unprepared for the reconstructed breast's look, feel, movement, pain, and scarring, and for the length of recovery.
03The emotional shock of cancer diagnosis made it hard for women to absorb and remember surgical consultation information.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The synthesis relied on the original authors' interpretations and did not apply a formal quality appraisal tool to each study. Many included studies used retrospective interviews, so women's recollections may reflect how they felt later rather than during the consultation. The studies varied by country, healthcare system, surgical procedure, and participant demographics, so the themes are broad rather than precise. Only English qualitative studies about reconstruction experiences were included, and studies focused only on decision-making or other treatments were excluded. The synthesis focused on women's statements and did not include partners' perspectives, even though partners were interviewed in two studies.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the disappointment themes as evidence that breast reconstruction is a bad choice. The synthesis describes women's experiences of unmet information needs, not a comparison with no reconstruction, and many women were happy with their decision after recovery.