title: Information-seeking behaviour and coping style of women opting for either implant or DIEP-flap breast reconstruction.
abstract: BACKGROUND
  High satisfaction rates have been reported after autologous breast reconstruction. Yet, most mastectomy patients receive implant reconstructions (ImBR). Independent and active decision makers have shown mainly to choose for autologous reconstructions, such as the Deep inferior epigastric perforator (DIEP) flap (DiepBR). To further explore the decision making to opt for either ImBR or DiepBR, we investigated patient knowledge, informational resources used, effect of plastic surgeons' advice, coping style and personal independence.
  
  
  METHODS
  A total of 153 women, who were planned for DiepBR or ImBR preoperatively, completed a study-specific and standardised validated psychological questionnaire. Analyses were aimed at information-seeking behaviour, personal independence and coping styles associated with autonomous decision making regarding reconstruction.
  
  
  RESULTS
  DiepBR women reported different informational resources to be very important and they were more active information seekers, compared with ImBR women. ImBR women found their physician's advice to be more important in their decision making than DiepBR women. Actively seeking for information regarding BR was positively correlated with active coping, sensitivity to others and the decision for DIEP-flap BR.
  
  
  CONCLUSIONS
  Women opting for DIEP-flap BR were more active and independent in their decision making regarding the type of BR. Women opting for implant BR seemed less well-informed and more dependent on their physician in their decision compared with women opting for DIEP-flap BR. To undergo a complex type of BR, active and independent information seeking may be required. However, clinical and logistic characteristics need to be considered, as some patients were limited in their reconstruction options.
authors.affiliation: Centre for Human and Clinical Genetics, Leiden University Medical Centre, Leiden, The Netherlands. j.p.gopie@lumc.nl
authors.forename: Jessica P
authors.initials: JP
authors.lastname: Gopie
authors.forename: Reinier
authors.initials: R
authors.lastname: Timman
authors.forename: Medard T
authors.initials: MT
authors.lastname: Hilhorst
authors.forename: Stefan O P
authors.initials: SO
authors.lastname: Hofer
authors.forename: Marc A M
authors.initials: MA
authors.lastname: Mureau
authors.forename: Aad
authors.initials: A
authors.lastname: Tibben
mesh_terms: D000223:Adaptation, Psychological; D018427:Breast Implants; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D057226:Information Seeking Behavior; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D026684:Personal Autonomy; D011446:Prospective Studies; D013524:Surgical Flaps