title: Deliberating over mastectomy: survival and social roles.
abstract: BACKGROUND
  Most studies based on a woman's decision regarding breast cancer treatments have focused on surgical treatment preference and related factors. Few studies have been carried out to identify the concerns associated with coming to terms with a mastectomy and cancer diagnosis among women eligible for a mastectomy only.
  
  
  OBJECTIVE
  The aim of this study was to explore Taiwanese women's experience about facing a mastectomy and to determine their deliberations before agreeing to a recommended mastectomy.
  
  
  METHODS
  Ten women who had undergone a mastectomy participated, with 3 undergoing individual interviews and 7 participating in a focus group. Findings during the interviews guided the focus group.
  
  
  RESULTS
  Content analysis revealed 4 themes through the women's narratives of the decision-making experience when a mastectomy was recommended. These included (a) surviving is a priority, (b) fulfilling responsibility, (c) coming to terms with postsurgery alternatives, and (d) making arrangements.
  
  
  CONCLUSIONS
  The experience surrounding the decision to undergo a mastectomy among Taiwanese women may be complicated by survival concerns, the meanings of the breast, and a feeling of an uncontrolled daily life. Cultural beliefs ensured that women were fulfilling their expected social roles and always thinking about significant others first.
  
  
  CONCLUSIONS
  Recognizing women's private concerns with sensitivity and supporting women to balance their own needs and assigned social responsibilities are important considerations for women undergoing a mastectomy. Developing cultural competency is necessary for nurses working in communities with diverse ethnoculture people.
authors.affiliation: Department of Nursing, Chung-Hwa University of Medical Technology, Tainan, Taiwan.
authors.forename: Su-Ying
authors.initials: SY
authors.lastname: Fang
authors.forename: Bih-Ching
authors.initials: BC
authors.lastname: Shu
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Fetzer
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001943:Breast Neoplasms / Q000401:mortality / Q000451:nursing / Q000601:surgery*; D018864:Cultural Diversity; D005260:Female; D017144:Focus Groups; D006801:Humans; D007406:Interview, Psychological; D008408:Mastectomy / Q000523:psychology*; D008875:Middle Aged; D009859:Oncology Nursing; D017060:Patient Satisfaction; D011184:Postoperative Period; D036301:Qualitative Research; D057545:Social Stigma; D013315:Stress, Psychological; D017741:Survivors; D013624:Taiwan