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Purpose: The purpose of this study was to develop an instrument to measure the experience of viewing one's reflection in the mirror for use in rehabilitation, nursing, psychology, and in research studies designed to improve the mirror-viewing experience for those who have suffered psychological or bodily trauma. A secondary purpose was to explore demographic differences in each subscale of the instrument., Methods: The developed items went through content expert validation, exploratory and confirmatory factor analyses, and internal consistency reliability testing., Results: Using an exploratory factor analysis ( n  = 137) and a confirmatory factor analysis ( n =  142), we validated a 17-item instrument for two distinct populations: veterans ( n  = 108) and individuals with upper and lower limb loss ( n  = 210). The mirror viewing comfort subscale (9 items; α  = 0.90) and the mirror avoidance subscale (8 items, α  = 0.94) were deemed reliable. Strong, significant correlations between pre-and post-comfort scores ( r  = 0.81, p  < 0.001), as well as pre-and post-avoidance scores ( r  = 0.94, p  < 0.001) provide evidence of test-retest reliability. Demographic differences were noted in the subscales., Conclusions: This instrument contributes to a greater understanding of the experience of mirror-viewing in clinical practice. In interventional research studies to improve the mirror-viewing experience, this instrument can act as a manipulation check or outcome measure.Implications for rehabilitationIndividuals who suffer actual or perceived body disfigurement due to surgery or trauma may suffer mirror discomfort or mirror trauma when viewing their bodies in a mirror. This reaction is due to a pre-frontal cortex neurological disruption and autonomic nervous system fright/flight or faint. Psychological disorders (e.g., devastation, shame, self-revulsion, decreased body image) may ensue.Falls have occurred due to mirror trauma due to an autonomic nervous system disturbance (faint) and may result in ongoing mirror avoidance. When mirrors are needed for incision visualization, mirror avoidance has led to severe surgical site infections.Although there were many scales available in the literature to measure several aspects of the effects of actual or perceived body disfigurement, there were no scales that measured the mirror-viewing experience.Clinicians and researchers can use the Mirror Comfort and Avoidance Scale (MICAS) to assess mirror comfort and avoidance.

Purpose: The aim of our study was to test an educational intervention to improve nurses' confidence in supporting and frequency of offering a mirror to patients who have recently suffered visible body disfigurement., Design/methods: Forty-eight registered nurses who worked in two acute care hospitals took part in a mixed-method one-group repeated-measures (pretest and posttest) research study. The educational intervention included a video, a presentation, and a recorded discussion., Results: Study participants experienced a significant increase in confidence in supporting and frequency of offering mirrors to patients. An overarching theme from the qualitative analysis was that the nurse participants perceived assisting patients in viewing their changed bodies in mirrors as "an act of compassion." Four subthemes emerged: (a) seeing mirrors differently, (b) there is only one first time, (c) how can we do this better, and (d) "me too" stories of their own and patients' difficult mirror-viewing experiences., Conclusion: Education enhances nurses' frequency of offering mirrors and supporting patients in mirror viewing after visible disfigurement because of trauma or surgery., Clinical Relevance: Education provides nurses with the necessary skills to assist patients in adapting to an altered body image., (Copyright © 2020 Association of Rehabilitation Nurses.)

Research has consistently demonstrated that viewing one's body in a mirror after an amputation or other perceived or visible body disfigurements can be a traumatic experience. Mirror viewing or mirroring is a taboo subject, which may be the reason this trauma has not been previously detected or acknowledged. Traumatic mirror viewing may lead to mirror discomfort, mirror avoidance, and a host of psychosocial concerns, including post-traumatic stress. As mirroring is complex, four qualitative mirror viewing studies, embodiment concepts, polyvagal theory, and memory theories were used to develop a model. In this article, foundational knowledge that led to the development of the model is shared. A neurocognitive model of mirror viewing is offered together with implications for nursing research, practice, and education., (© 2020 The Authors. Nursing Inquiry published by John Wiley & Sons Ltd.)

The researchers were invited to a transitional home for homeless women veterans to help veterans with body image issues. Convenience sampling was used to recruit 12 veterans who perceived they had a physical difference due to military service. Data were obtained in focus groups where the veterans were invited to share stories. Ricoeur's hermeneutic phenomenology guided the study. The research team learned early in the data collection stage that 11 of the 12 participants suffered military sexual trauma (MST). Three structures emerged in the data: (a) to speak up or not to speak, (b) from military pride to shameful anguish, and (c) invisible scars versus visible scars. A phenomenological interpretation of these invisible scars uncovered that viewing self in a mirror was depicted as viewing a stranger. Being with others, including family, was described as wearing a fake face. The phrase I am broken defined intimate relationships which were non-existent or strained. Shame permeated all body image structures. As the veterans listened to each other, they began to see themes in their stories. There was a shared sense of identity and a movement toward greater self-understanding and resolving. In addition to the recommendations the participants had regarding prevention of MST and recovery care of those with MST, implications for research and practice are provided.

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., (© 2014 Wiley Periodicals, Inc.)

Problem: Incorporating mirrors into nursing is a relatively new field of research and practice. The focus of two studies was to explore (a) the meaning of women's mirror experiences following a mastectomy and (b) the experience of viewing self in the mirror for women who were terminally ill. The goal of the research was to establish a conceptual foundation for the development of nursing mirror interventions., Methods: Open-ended questions and dialogical engagement in one-to-one audio-taped interviews were used in both studies. Ricoeur's hermeneutic phenomenology was used to analyze the findings., Findings: Four concepts were uncovered in the experience of viewing self in the mirror: decision, seeing, understanding, and consent., Conclusion: Exemplar composite case studies across the care continuum are provided as examples of the way in which mirrors may be utilized in nursing practice., (© 2014 Wiley Periodicals, Inc.)

Use of the mirror is an everyday phenomenon for most individuals. There seems to be limited evidence-based studies that address mirror viewing and the appropriate use of mirrors for patients with dementia. Using a case study, the purpose of this study is to begin a dialogue with the nursing community on practical nursing interventions and the need for research in this area.

Body image in oncology is a relatively unexplored field. Recent interventions have focused on the use of the mirror in assessing body image. The purpose of this narrative is to increase oncology nurses' awareness of the need to adopt such interventions based on expert judgment and practice when empirical evidence is limited.

A preliminary survey of the mirrors available to residents was conducted in 10 long-term care homes. The framework underlying the study was Lawton's theory that the planned environment functions to maintain, support, and stimulate. The findings were discouraging. Some facilities had no mirrors available for bedbound residents or wheelchair users. In most facilities, a resident could not view his or her lower body in a mirror. The majority of mirrors were obstructed from view. This pilot study suggests a need for future mirror research. Implications for nursing are discussed, and placement of mirrors is described., (Copyright 2010, SLACK Incorporated.)

There is no known literature to guide the critical care nurse in the use of mirrors in patient care. This article explores how the author came to believe that mirrors were essential to nursing practice. Misconceptions and assumptions concerning mirrors are explored. A framework that conceptually explores the experience of viewing self in the mirror from the perspective of a person is presented. Five situations in which the mirror may be used in critical care are discussed. This article does not present an authoritative view on mirrors in nursing; rather, it is an invitation to dialogue about a unique element in the environment that may be used to enhance nursing care.

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 (M age = 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. • Aesthetic Flat Closure is a valid surgical option for women undergoing mastectomy. • Access to flat closure education and photo galleries are needed. • Women felt unprepared for the flat closure mirror-viewing experience. • Suboptimal flat closures led to psychological distress and body image disturbances. • Body comfort/acceptance improved with time and flat closure revision surgery. [ABSTRACT FROM AUTHOR]

Aims: To appraise the current literature on the mirror viewing experience of women undergoing a mastectomy. Design: Whittemore and Knafl's approach to integrative reviews, Braun and Clarke's thematic analysis, and PRISMA guidelines were utilized for this review. Data Sources: A systematic search of primary peer‐reviewed articles from April 2012 to 2022 was conducted using PubMed, CINAHL, Academic Search Complete and Google Scholar databases. Review Methods: Eighteen studies met the inclusion criteria (15 qualitative and 3 quantitative) and were appraised using the Johns Hopkins evidence‐based practice appraisal instrument. Results: Five themes describing the mirror viewing experience were revealed: Mirror viewing motives, mirror viewing preparedness, mirror viewing experience, mirror comfort/avoidance and women's mirror viewing recommendations. Conclusion: The review findings were found to align with Freysteinson's Neurocognitive Mirror Viewing Model highlighting the occurrence of short‐term memory disruptions and an autonomic nervous system response that can lead women to experience a flight/fright or faint response, mirror trauma and mirror avoidance when looking at themselves in the mirror after a mastectomy. Impact Women reported feeling unprepared to look at themselves in the mirror, with some experiencing shock and emotional distress, which led to mirror avoidance behaviours as a way to cope with their new body image. Nursing interventions aimed at improving women's mirror viewing experiences may help mitigate this autonomic nervous system response and minimize mirror trauma and mirror avoidance. Preparing women to view themselves in the mirror for the first time may help reduce psychological distress and body image disturbances in women undergoing a mastectomy. No Patient or Public Contribution: This integrative review did not involve patient or public contributions. The authors reviewed currently published peer‐reviewed literature in writing this manuscript. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To describe the experience of viewing oneself in a mirror following a mastectomy.Research Approach: Ricoeur's hermeneutic phenomenology.Setting: Three hospitals in a nonprofit healthcare system in the southwestern United States.Participants: Purposive sample of 12 women 3-12 months postmastectomy.Methodologic Approach: Structural analysis and phenomenologic interpretation of tape-recorded interviews.Main Research Variables: Viewing oneself in the mirror after a mastectomy.Findings: Viewing or not viewing one's own body, energizing and dispiriting thoughts, and supportive and unsupportive others helped to explain the experience of women who have had a mastectomy. The phenomenologic interpretation yielded four themes: I am, I decide, I see, and I consent.Conclusions: The current study offers an understanding of the multifaceted experience of women postmastectomy. Mirrors appear to be essential in viewing and caring for the mastectomy site.Interpretation: Nurses should consider discussing the mirror experience with women who are having a mastectomy pre- and postoperatively. Nurses also may choose to offer a mirror to their patients when doing the initial dressing change and teaching wound care. Educational materials are needed for patients and nurses. In addition, future research is warranted on the use of mirrors when caring for patients who have had a mastectomy. [ABSTRACT FROM AUTHOR]