Developing a theoretical framework to illustrate associations among patient satisfaction, body image and quality of life for women undergoing breast reconstruction

Abstract

Within the field of breast reconstruction there is increasing focus on patient-reported outcomes related to satisfaction, body image, and quality of life. These outcomes are deemed highly relevant because the primary goal of breast reconstruction is to recreate the appearance of a breast (or breasts) that is satisfying to the patient. Prominent researchers have suggested the need to develop improved standards for outcome evaluation which can ultimately benefit patients as well as physicians. The purpose of this article is to summarize key findings in the area of patient-reported outcomes for breast reconstruction and introduce a theoretical framework for advancing research in this field. We conducted an extensive literature review of outcome studies for breast reconstruction focusing on patient-reported results. We developed a theoretical framework illustrating core patient-reported outcomes related to breast reconstruction and factors associated with these outcomes. Our theoretical model highlights domains and distinguishing features of patient satisfaction, body image, and quality of life outcomes for women undergoing breast reconstruction. This model further identifies a broad range of variables (e.g., historical/premorbid influences, disease and treatment-related factors) that have been found to influence patient-reported outcomes and need to be taken into consideration when designing future research in this area. Additional attention is given to examining the relationship between patient reported outcomes and outside evaluation of breast reconstruction. Our proposed theoretical framework suggests key opportunities to expand research in this area with the goal of optimizing body image adjustment, satisfaction, and psychosocial outcomes for the individual patient.

Breast Reconstruction Satisfaction Rates at a Large County Hospital

“…A smaller study representing 30 breast reconstruction patients demonstrated postoperative average of 64 (18) for satisfaction with the appearance of the reconstructed breast. 16 Our mean score for satisfaction with appearance of the breast was 61 (24), similar to the finding in these studies. In evaluating specific subtypes of reconstruction, a mean satisfaction score was reported as 65 (10.67) was reported 17 for 55 patients who underwent autologous reconstruction with DIEP and MS Free Tram Flaps.…”

The Psychosexual Impact of Postmastectomy Breast Reconstruction

“…The number and percentage of patients that provided each survey response (1)(2)(3)(4)(5) were calculated for all questions. As appropriate, the Fischer exact and χ 2 tests were used to determine the association between each clinical variable of interest and survey responses.…”

“…In the field of breast reconstruction (BR), the results of these studies are crucial because the primary goal of surgery is to reconstruct breasts that are pleasing to the patient. 2 Quality is also one of the major healthcare outcome measures that is going to be used in the future, and appropriate documentation in the area of BR is crucial.…”

“…2 Evaluating overall satisfaction primarily focuses on the patients' perception of their experience with health care system, and in BR, the aesthetic appearance of the reconstructed breast. Body image is multifactorial and encompasses many aspects of how women feel about their body as a whole: physically, functionally, and emotionally.…”

Body Image in Younger Breast Cancer Survivors

“…5 The theoretical framework developed by Fingeret et al (2013) is specific to body image in women with breast cancer undergoing reconstruction and includes facets of perception, cognition, behavior, and emotion, as they relate to the function of the body after diagnosis and treatment for breast cancer. 6 …”