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Biomedical subjects

L L Reaby

Publications and source records attributed to L L Reaby.

10 recordsLinked to original sources
PubMed1999

Breast restoration decision making.

Women diagnosed with breast cancer have many physiological and psychological adjustments to make following mastectomy. The present study described in this article sought to determine the decision-making patterns used by two groups of women. Nurses need to be well informed and professionally confident to provide the individualized care and support deserved by women throughout the breast cancer trajectory. A major outcome of such professional care is confident women who understand their disease, treatments, and methods to manage stresses as they occur.

Adult↗
PubMed1998

Breast restoration decision making: enhancing the process.

The purpose of this study was to explore the breast restoration decision-making patterns used by women who opted to have their breast cancer treated by mastectomy. Sixty-four women wearing external breast prostheses and 31 women with breast reconstructions were interviewed. Modified versions of Simon's notion of "bounded rationality" and Janis and Mann's conflict model provided the conceptual scaffolding for the study. Five breast restoration decision-making patterns emerged from the analysis of the interview data: (a) Enlightened (actively seeks information, considers positive and negative aspects, and demonstrates deliberation on the alternatives), (b) Contented (passively accepts minimum information on alternatives because of a preference toward a particular type), (c) Sideliner (uncritically adopts any alternative that is easy and simple to implement), (d) Shifter (gives over the decision to others), and (e) Panic-stricken (can make no rational decision on alternatives). In the prosthesis group, the major pattern used was the Sideliner, and in the reconstruction group it was the Contented. None of the participants used the Enlightened pattern. The data indicated that there was no evidence of active information-seeking behavior or deliberation on the alternatives as part of the women's decision-making process. The findings suggest a need for a registered nurse oncology specialist to be accessible to women during the period when decisions regarding breast restoration are made. This professional has the knowledge to interact effectively with these women and serve as their advocate during the decision-making process. Implications for professional practice and a model for competent breast restoration decision making are presented.

Adult↗
PubMed1998

Reasons why women who have mastectomy decide to have or not to have breast reconstruction.

Breast reconstruction after mastectomy is chosen by approximately 10 percent of Australian women. Younger women are more likely to have this surgical procedure. This suggests that there may be many factors determining this choice. Sixty-four women who wore an external postmastectomy breast prosthesis and 31 women who had postmastectomy breast reconstruction participated in the present study. The purpose was to gain a greater understanding through semi-structured interviews of why women who had breast reconstruction chose this alternative and why women who wore the external postmastectomy breast prosthesis elected not to have reconstruction. The study also ascertained how difficult it was for the women in both groups to decide their particular breast restoration alternative. The most frequently endorsed reasons for not having breast reconstruction in the prosthesis group included: (1) not essential for physical well being, (2) not essential for emotional well being, (3) not having enough information about the procedure, and (4) not wanting anything unnatural in the body. When each member of the group was asked to identify a major reason for not having reconstruction, two predominant issues emerged: (1) fearing complications and (2) perceiving themselves as being too old for the procedure. Twelve percent of the prosthesis group experienced difficulty in making the decision not to have reconstruction. Three factors accounted for this difficulty: (1) the lack of family support, (2) the inability to have a specific type of reconstruction, and (3) the perception that friends and acquaintances saw the surgery as cosmetic. The most frequently reported reasons given by the reconstruction group for having reconstruction included: (1) to get rid of the external breast prosthesis, (2) to be able to wear many different types of clothing, (3) to regain femininity, and (4) to feel whole again. The least influential factors were to improve marital and sexual relations. The major reason cited most often by this group was to feel whole again. None of the women in the reconstruction group experienced any difficulty when deciding their method of breast restoration. What factors are taken into consideration by women when they decide either to have or not to have reconstruction need to be understood by physicians. This knowledge will assist them in conveying appropriate information regarding alternatives and will help them deal with the women's concerns and/or misconceptions.

Adult↗
PubMed1995

Postmastectomy attitudes in women who wear external breast prostheses compared to those who have undergone breast reconstructions.

Sixty-four women who postmastectomy wore an external breast prosthesis and 31 women who had breast reconstruction participated in the present study. It was hypothesized that the breast prosthesis group would exhibit more negative attitudes towards their mastectomy experience compared to the breast reconstruction group. Using the Mastectomy Attitude Scale (MAS) the results indicated that both groups were satisfied with their bodies, had a positive outlook towards their lives, implied that sexuality entailed more than having breasts, and felt that mastectomy treatment was necessary to save their lives. Neither group concealed that they had a mastectomy, however, they were not prone to discuss their mastectomy experiences. The findings from the study indicate that the women postmastectomy already had or developed positive attitudes towards themselves and life in general and the method chosen for breast restoration had no apparent impact on these attitudes. Reasons for the sample's positive attitudes are discussed.

Adaptation, Psychological↗
PubMed1990

The effectiveness of an education program to teach Australian nurses comprehensive physical assessment skills.

This study investigates the effectiveness of an educational program to teach 22 registered nurses comprehensive physical assessment skills. Administration of questionnaires and tests provided measures of the nurses: a) use of physical assessment skills; b) knowledge of physical assessment; c) changes in nursing practice since learning the skills; d) barriers to the use of these learned skills. The major post program findings regarding increases in the nurses' knowledge and use of physical assessment skills, positive changes in their nursing practice and lack of barriers to their use of these skills indicates that the participants did benefit from this educational experience.

Australia↗
PubMedDate not supplied

The quality and coping patterns of women's decision-making regarding breast cancer surgery.

This study addressed issues regarding the decision-making process used by women who had mastectomy as their surgical treatment for breast cancer. The seven criteria for quality decision-making and the conflict model proposed by Janis and Mann (1977) were used as the study's conceptual framework along with the notion by Simon (1957) of 'bounded rationality'. Four coping patterns emerged: vigilance (actively searches for information and advice), satisficing (being satisfied, chooses first solution that meets the desired objectives), complacency (accepts advice without questions or fully comprehending), and defensive avoidance (rationalises and avoids discussion and consideration of the problem). The participants primarily left the decision for surgical treatment of breast cancer to their surgeons using satisficing, complacency and defensive avoidance. When the option of lumpectomy was offered to some of the participants (34%), they rejected this treatment alternative using the coping patterns of satisfying and defensive avoidance. Those women who were not offered lumpectomy (66%) did not seek a rationale for not being given this alternative. The findings indicated that the women's decision-making process was halted in Stage 2 of the criteria for quality decision-making actively searched for and viewed a number of alternatives. The study's findings are discussed in relation to improving the quality of the decision-making process for women regarding their breast cancer surgical treatment.

Adaptation, Psychological↗
PubMedDate not supplied

Body image, self-concept, and self-esteem in women who had a mastectomy and either wore an external breast prosthesis or had breast reconstruction and women who had not experienced mastectomy.

The perceptions of three groups of women regarding their body image, self-concept, total self-image, and self-esteem were compared. The groups included 64 women who had mastectomies and wore external breast prostheses, 31 women who had mastectomies and underwent breast reconstruction, and a control group of 78 women who had not experienced mastectomy. The body image, total self-image, and self-esteem mean scores indicated that the prosthesis and reconstruction groups had more positive feelings regarding their bodies than did the control group. There were no significant differences in self-concept among the three groups. These findings challenge a common assumption that mastectomy automatically results in psychiatric morbidity caused by an altered body image and suggest that health professionals should not make assumptions about how a woman will psychologically respond to mastectomy.

Body Image↗
PubMedDate not supplied

Use of physical assessment skills by Australian nurses.

The use of physical assessment skills, though limited, has been an integral part of nursing since the time of Florence Nightingale, when aids such as sight and touch were relied upon to assess patients. Now with more nurses involved in primary health the use of a wider range of physical assessment has become necessary. Below is a report of how Australian nurses are putting more of these skills into practice.

Australia↗