Search

AIM: This paper critically examines the research literature relating to the psychological aspects of breast reconstruction. Particular attention is given to the role of specialist breast care nurses in supporting women faced with the decision of whether or not to opt for reconstructive surgery. BACKGROUND: Breast reconstruction is intended to offer psychological benefits (e.g. improvements to quality of life, body image, anxiety and depression) to women treated by mastectomy following diagnosis of breast cancer. METHODS: A literature search was carried out on the PSYCHINFO, MEDLINE and CINAHL databases using the terms 'breast reconstruction', 'mastectomy', 'reconstructive surgery', 'breast surgery', 'breast implants', 'transverse rectus adominis myocutaneous (TRAM) flap' and 'Lat-dorsi'. Further relevant articles were identified from the reference lists of papers detected by this literature search. Finally, proceedings of recent psychological and surgical meetings were scrutinized to identify any conference papers on this topic. FINDINGS: A thorough search of the existing literature revealed a lack of theoretically based studies examining breast reconstruction in terms of relevant psychological constructs, especially in relation to coping and decision-making. This review highlights the methodological flaws with much of the existing research in this area, in particular the reliance upon retrospective designs and the inappropriate use of randomised controlled trials. Suggestions are given for further research in this topical area. CONCLUSIONS: Existing research into the psychological aspects of breast reconstruction is limited and not sufficiently conclusive to inform changes to policy and the provision of care. More methodologically rigorous research is needed. [ABSTRACT FROM AUTHOR]

The following paper presents the findings of an exploratory ethnography, the purpose of which was to identify and describe heart health associated beliefs and behaviours of year seven (Y7) and year 10 (Y10) secondary school young people of African and African Caribbean descent in two UK cities. Data were collected by the data collection technique of focus groups. However, eight focus groups were conducted involving 47 Y7 young people and 29 Y10 pupils, 76 pupils in total. The data were analysed utilizing ATLAS/ti qualitative data analysis software. This software is informed by grounded theory. Data from the study formed six themes. The findings informed the development of an interactive health promotion website which can be found at http://www.shef.ac.uk/web/uni/projects/mshhp. The paper argues that in order to provide meaningful programmes of health promotion to be developed by health care providers including school nurses and health visitors, it is essential that interventions are informed by an understanding of the health beliefs and behaviours of African and African Caribbean young people. [ABSTRACT FROM AUTHOR]

‘The Awful Rowing Toward God’: therapeutic conversations with a woman following major surgery ¶ Listening is a complex event requiring skills and competencies that encompass the personhood of the listener. This paper explores a clinical conversation with a woman experiencing serious illness. The ideas of Klein offer the theoretical means for understanding exchanges. Reflexivity is addressed through exploring the writer’s thoughts and feelings in response to significant events. The benefits of supervision, as support and guidance, are discussed in context. The discussion concludes with the suggestion that although many layers of interpretation are possible, and can be informed by various ways of knowing, the act of listening offers potential benefits. [ABSTRACT FROM AUTHOR]