Understanding normality: A qualitative analysis of breast cancer patients concepts of normality after mastectomy and reconstructive surgery

Peninsula Medical School, Exeter, UK.
Psycho-Oncology (Impact Factor: 4.04). 05/2011; 20(5):553-8. DOI: 10.1002/pon.1762
Source: PubMed

ABSTRACT As survival rates increase, many people have to adjust to life after cancer. This includes adjusting to life after surgery. While previous research suggests that patients commonly strive to be 'normal' after mastectomy and reconstructive surgery, research surrounding individual perceptions of normality is lacking.
The aim of this study was to explore concepts of normality within a sample of breast cancer patients eligible for reconstructive surgery following mastectomy.
A total of 35 semi structured interviews, with women who had undergone or were about to undergo breast reconstructive surgery following breast cancer, were analysed using thematic analysis.
Four main themes emerged from the data. Women referred to looking normal (appearance); being able to fulfil everyday activities (behaviour); adapting to a new normal (reconstructing normality); and not being ill (health). The importance placed on each area of normality differed between patients. Additionally, patients used different standards to anchor concepts of normality. These included individual standards, social standards and clinical standards.
The results indicate that although there are commonalities between patients' concepts of normality, it is important for health care professionals to recognise potential individual differences. This may usefully aid communication and help to manage expectations among patients considering surgical options.

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    • "Indeed, Duggal and colleagues also reported that body image appeared to be more motiving than sexuality or femininity for many women who decided to undergo reconstruction. However, regaining a sense of normalcy may also be an important motivator for BC patients who have undergone or who will undergo breast reconstruction and who have defined normalcy as including " looking normal " (Denford, Rubin, & Pusic, 2011). Other researchers have constructed a grounded theory model of the role of breast reconstruction in women's self-image following BC (McKean, Newman, & Adair, 2013), supporting the notion that breast reconstruction might largely be about reconstructing one's sense of normal. "
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    • "Recent research has indicated a relationship between breast reconstruction surgery and sense of normality. Denford et al. (2011) explored the concept of normality within women who were awaiting or had already undergone breast reconstruction surgery. The women considered surgery to relate to normality in: their physical appearance, ability to perform daily behaviours, 'adapting to a new normal' and health status. "
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