Exploring women's experiences of TRAM flap breast reconstruction after mastectomy for breast cancer.

PURPOSE/OBJECTIVES To explore and describe women's experiences of transverse rectus abdominus musculocutaneous (TRAM) flap breast reconstruction following mastectomy for breast cancer. DESIGN Qualitative, exploratory, and descriptive. SETTING A private hospital in Perth, Western Australia. SAMPLE Purposive sampling. Inclusion criteria were English-speaking women who had undergone TRAM flap breast reconstruction 6-24 months prior to the study. Response rate was 78%. Ten women were recruited, five who had undergone immediate breast reconstruction and five who had undergone delayed breast reconstruction. METHODS Data were collected through individual semistructured interviews and analyzed with a thematic approach. Saturation was reached after 10 interviews. Coding and categorizing were undertaken with each transcript until the process revealed recurring themes. A focus group interview was conducted with the participants. FINDINGS Three major themes emerged from the data: losing a breast matters, adjusting to a changing body image, and redefining normality. CONCLUSIONS The study highlights the significant impact of breast cancer, mastectomy, and breast reconstruction on the lives of women. All facets of a woman's life may be affected, often resulting in a holistically life-changing experience. Support needs for the women were not fully met. A greater understanding of the holistic experience and expectations of women who choose to have breast reconstruction following mastectomy is required to facilitate improved education and support. IMPLICATIONS FOR NURSING Nurses play an important role, not only in the provision of physical care to women postoperatively, but also for education and psychosocial support. This study gives practicing nurses greater insight into the holistic experience of women undergoing TRAM flap breast reconstruction.