title: An exploration of Australian psychologists' role in assessing women considering risk-reducing or contralateral prophylactic mastectomy.
abstract: OBJECTIVE
  Given increasing rates of risk-reducing mastectomies (RRM) and contralateral prophylactic mastectomies (CPM), and the potentially significant psychological sequelae of this irreversible procedure, health professionals (HPs) regularly refer patients to psychologists for pre-operative assessment and support. This is the first study to provide qualitative insights from HPs into the role of psychologists who are working with women considering RRM or CPM.
  
  
  METHODS
  24 HPs (psychologists, surgeons, breast care nurses and genetic counsellors) experienced in treating patients before or after RRM/CPM completed semi-structured interviews (n = 15) or participated in a focus group (n = 10). Interviews were qualitatively analysed using Framework methods.
  
  
  RESULTS
  Qualitative analysis revealed four interconnected themes: (1) perceived patient motivation to undergo RRM/CPM; (2) HP reasons for psychologist referral; (3) role of the psychologist; and (4) value of psychologist involvement. The reported psychologist role included: mental health assessment, checking understanding of information, ensuring informed decision-making, preparation for the procedure, and management of post-surgical challenges.
  
  
  CONCLUSIONS
  Psychologists are perceived by HPs to have a key role in the multi-disciplinary care of patients considering RRM or CPM.
authors.affiliation: School of Psychology, The University of Sydney, NSW, Australia. Electronic address: lbra9325@uni.sydney.edu.au.
authors.forename: Lucy
authors.initials: L
authors.lastname: Braude
authors.affiliation: School of Psychology, The University of Sydney, NSW, Australia; Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, NSW, Australia.
authors.forename: Rebekah
authors.initials: R
authors.lastname: Laidsaar-Powell
authors.affiliation: Specialist Oncology Services, Norwest Private Hospital, NSW, Australia.
authors.forename: Jemma
authors.initials: J
authors.lastname: Gilchrist
authors.affiliation: Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, NSW, Australia; Nepean Cancer Care Centre, Sydney West Cancer Network, NSW, Australia.
authors.forename: Laura
authors.initials: L
authors.lastname: Kirsten
authors.affiliation: School of Psychology, The University of Sydney, NSW, Australia; Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, NSW, Australia.
authors.forename: Ilona
authors.initials: I
authors.lastname: Juraskova
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001315:Australia; D001943:Breast Neoplasms / Q000517:prevention & control* / Q000523:psychology; D000072117:Counselors; D003657:Decision Making; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D009859:Oncology Nursing; D010348:Patient Care Team; D010819:Physician's Role; D024382:Professional Role; D000072036:Prophylactic Mastectomy / Q000523:psychology*; D011584:Psychology; D036301:Qualitative Research; D018787:Radiation Oncology; D011795:Surveys and Questionnaires
keywords: Assessment; Contralateral prophylactic mastectomy; Psychologist; Qualitative; Risk-reducing mastectomy