title: Understanding normality: a qualitative analysis of breast cancer patients concepts of normality after mastectomy and reconstructive surgery.
abstract: BACKGROUND
  As survival rates increase, many people have to adjust to life after cancer. This includes adjusting to life after surgery. While previous research suggests that patients commonly strive to be 'normal' after mastectomy and reconstructive surgery, research surrounding individual perceptions of normality is lacking.
  
  
  OBJECTIVE
  The aim of this study was to explore concepts of normality within a sample of breast cancer patients eligible for reconstructive surgery following mastectomy.
  
  
  METHODS
  A total of 35 semi structured interviews, with women who had undergone or were about to undergo breast reconstructive surgery following breast cancer, were analysed using thematic analysis.
  
  
  RESULTS
  Four main themes emerged from the data. Women referred to looking normal (appearance); being able to fulfil everyday activities (behaviour); adapting to a new normal (reconstructing normality); and not being ill (health). The importance placed on each area of normality differed between patients. Additionally, patients used different standards to anchor concepts of normality. These included individual standards, social standards and clinical standards.
  
  
  CONCLUSIONS
  The results indicate that although there are commonalities between patients' concepts of normality, it is important for health care professionals to recognise potential individual differences. This may usefully aid communication and help to manage expectations among patients considering surgical options.
authors.affiliation: Peninsula Medical School, Exeter, UK. Sarah.denford@pms.ac.uk
authors.forename: Sarah
authors.initials: S
authors.lastname: Denford
authors.forename: D
authors.initials: D
authors.lastname: Harcourt
authors.forename: L
authors.initials: L
authors.lastname: Rubin
authors.forename: A
authors.initials: A
authors.lastname: Pusic
mesh_terms: D000223:Adaptation, Psychological; D001828:Body Image; D001943:Breast Neoplasms / Q000523:psychology* / Q000601:surgery; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016462:Mammaplasty / Q000523:psychology*; D008408:Mastectomy / Q000523:psychology*; D017060:Patient Satisfaction; D012649:Self Concept