title: Psychosocial factors affecting the therapeutic decision-making and postoperative mood states in Japanese breast cancer patients who underwent various types of surgery: body image and sexuality.
abstract: OBJECTIVE
  We conducted an empirical study to clarify how psychosocial factors (e.g. body image and sexuality) influence therapeutic decision-making and to identify the factors that affect post-operative mood states in Japanese women who underwent various types of surgery.
  
  
  METHODS
  One hundred and two patients who had undergone surgical treatment for breast cancer participated in this study. Twenty-five patients had undergone mastectomy, 67 breast conserving treatment and 11 skin-sparing mastectomy and immediate breast reconstruction. The participants were evaluated based on a battery of questionnaires including value estimates of decision-making factors, a shortened version of the Profile of Mood States and self-efficacy.
  
  
  RESULTS
  The patients regarded the possibility of cure and recurrence of cancer as well as the physician's support as important, regardless of the treatments they had chosen. The patients that had immediate breast reconstruction placed significantly more importance on their body image and sexuality (i.e. physical appearance, attractiveness to partner and self-evaluation of femininity and sexuality) than the mastectomy patients. After surgery, the former group tended to have a more negative mood on the shortened version of the Profile of Mood States than the latter group. Degree of self-efficacy had a marked influence on the patients' mood after surgery.
  
  
  CONCLUSIONS
  This study suggests the importance of discussing body image and sexuality that has tended to be disregarded in therapeutic decision-making situations in breast cancer patients in Japan. Self-efficacy is a crucial variable for improving mood after treatment.
authors.affiliation: Beppu University Faculty of Literature, Beppu, Oita, Japan. adachi13@mc.beppu-u.ac.jp
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Adachi
authors.forename: Tokumi
authors.initials: T
authors.lastname: Ueno
authors.forename: Toshio
authors.initials: T
authors.lastname: Fujioka
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Fujitomi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ueo
mesh_terms: D000328:Adult; D000339:Affect; D000368:Aged; D001828:Body Image; D001943:Breast Neoplasms / Q000523:psychology / Q000601:surgery*; D003657:Decision Making; D005260:Female; D006801:Humans; D016462:Mammaplasty; D008408:Mastectomy / Q000379:methods / Q000523:psychology*; D008875:Middle Aged; D011184:Postoperative Period; D020377:Self Efficacy; D019529:Sexuality; D011795:Surveys and Questionnaires