Journal Club
Open Access Article

The Experience of Viewing Oneself in the Mirror After a Mastectomy

Wyona M. Freysteinson

Amy S. Deutsch

Carol Lewis

Angela Sisk

Linda Wuest

Sandra K. Cesario

mastectomy, breast neoplasms
ONF 2012, 39(4), 361-369. DOI: 10.1188/12.ONF.361-369

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.

Jump to a section

    References

    Arman, M., & Rehnsfeldt, A. (2003). The hidden suffering among breast cancer patients: A qualitative metasynthesis. Qualitative Health Research, 13, 510-527. doi:10.1177/1049732302250721
    Ashing-Giwa, T.A., Padilla, G., Tejero, J., Kraemer, J., Wright, K., Coscarelli, S.C., … Hills, D. (2004). Understanding the breast cancer experience of women: A qualitative study of African American, Asian American, Latina, and Caucasian cancer survivors. Psycho-Oncology, 13, 408-428. doi:10.1002/pon.750
    Avis, N.E., Crawford, S., & Manuel, J. (2004). Psychosocial problems among younger women with breast cancer. Psycho-Oncology, 13, 295-308. doi:10.1002/pon.744
    Baucom, D.H., Porter, L.S., Kirby, J.S., Gremore, T.M., & Keefe, F.J. (2005-2006). Psychosocial issues confronting young women with cancer. Breast Disease, 23, 103-113.
    Collie, K., & Long, B.C. (2005). Considering "meaning" in the context of breast cancer. Journal of Health Psychology, 10, 843-853.
    Crompvoets, S. (2006). Comfort, control, or conformity: Women who choose breast reconstruction following mastectomy. Health Care for Women International, 27, 75-93. doi:10.1080/07399330500377531
    Feuser, J.D., Townsend, J., Bystritsky, A., McKinley, M., Moller, H., & Bookheimer, S. (2009). Regional brain volumes and symptom severity in body dysmorphic disorder. Psychiatry Research, 172, 161-167.
    Freysteinson, W.M. (1994). Mirroring: The lived experience of viewing self in the mirror for terminally ill women (Unpublished master's thesis). University of Saskatchewan, Saskatoon, Saskatchewan.
    Freysteinson, W.M. (2009a). International reflections on the use of the mirror in nursing practice. Nursing Forum, 44, 47-56.
    Freysteinson, W.M. (2009b). Therapeutic mirror interventions: An integrated review of the literature. Journal of Holistic Nursing, 27, 241-252.
    Freysteinson, W.M. (2010). The ethical community consultation model as preparation for nursing research: A case study. Nursing Ethics, 17, 749-758. doi:10.1177/0969733010379176
    Freysteinson, W.M., & Cesario, S.K. (2008). Have we lost sight of the mirrors? The therapeutic utility of mirrors in patient rooms. Holistic Nursing Practice, 22, 317-323.
    Frierson, G.M., Thiel, D.L., & Anderson, B.L. (2006). Body change stress for women with breast cancer: The breast-impact of treatment scale. Annals of Behavioral Medicine, 32, 77-81.
    Hill, O., & White, K. (2008). Exploring women's experiences of TRAM flap breast reconstruction after mastectomy for breast cancer. Oncology Nursing Forum, 35, 81-88. doi:10.1188/08.ONF.81-88
    Langellier, K.M., & Sullivan, C.F. (1998). Breast talk in breast cancer narratives. Qualitative Health Research, 8, 76-94.
    Lincoln, Y.S., & Guba, E.G. (1985). Naturalistic inquiry. Newberry Park, CA: Sage.
    Montebarocci, O., Lo Dato, F., Baldaro, B., Morselli, P., & Rossi, N.C. (2007). Anxiety and body satisfaction before and six months after mastectomy and breast reconstruction surgery. Psychological Reports, 101, 100-106. doi:10.2466/PR0.101.1.100-106
    Nano, M.T., Gill, P.G., Kollias, J., Bochner, M.A., & Malycha, P. (2005). Psychological impact and cosmetic outcome of surgical breast cancer strategies. ANZ Journal of Surgery, 75, 940-947.
    National Comprehensive Cancer Network. (2012). NCCN Clinical Practice Guidelines in Oncology: Distress management [v.1.2012]. Retrieved from http://www.nccn.org/professionals/physician_gls/pdf/distress.pdf
    Parker, P.A., Youssef, A., Walker, S., Basen-Engquist, K., Cohen, L., Gritz, E.R., … Robb, G.L. (2007). Short-term and long-term psychosocial adjustment and quality of life in women undergoing different surgical procedures for breast cancer. Annals of Surgical Oncology, 14, 3078-3089. doi:10.1245/s10434-007-9413-9
    Parse, R.R., Coyne, A.B., & Smith, M.J. (1985). Nursing research: Qualitative methods. Bowie, MD: Brady.
    Ricoeur, P. (1966). Freedom and nature: The voluntary and the involuntary (E.V. Kohak, Trans.). Evanston, IL: Northwestern University.
    Ricoeur, P. (1974). The conflict of interpretations. Evanston, IL: Northwestern University.
    Ricoeur, P. (1975). From existentialism to the philosophy of language. In R. Czerny, K. McLaughlin, & J. Costello (Trans.), The rule of metaphor: Multi-disciplinary studies of the creation of meaning in language (pp. 315-322). Toronto, Canada: University of Toronto Press.
    Ricoeur, P. (1981). Hermeneutics and the human sciences (J.B. Thompson, Ed. & Trans.). Evanston, IL: Northwestern University Press.
    Ricoeur, P. (1992). Oneself as another (K. Blamey, Trans.). Chicago, IL: University of Chicago Press.
    Susan G. Komen for the Cure. (2011). Mastectomy. Retrieved from http://ww5.komen.org/BreastCancer/Mastectomy.html
    Swanson, J., & Koch, L. (2010). The role of the oncology nurse navigator in distress management of adult inpatients with cancer: A retrospective study. Oncology Nursing Forum, 37, 69-76.