“Câncer não tira a vida, mas me tira da vida”: Vivências de Reconstrução mamária imediata / “Cancer does not take my life, but it takes me out of my life”: Experiences of Immediate Breast Reconstruction
DOI:
https://doi.org/10.14295/idonline.v16i63.3564Palavras-chave:
Neoplasias da Mama, Procedimentos Cirúrgicos Reconstrutivos, Psico-Oncologia, Fenômenos Psicológicos, Pesquisa Qualitativa.Resumo
Resultados psicossociais, decorrentes da reconstrução imediata, no tratamento do câncer de mama, mostram-se contraditórios, quando se compara o procedimento à ausência de reconstrução ou à realizada tardiamente. Entendendo necessárias pesquisas que explorassem a vivência de mulheres submetidas à reconstrução imediata, este estudo utilizou o método fenomenológico, para analisar entrevistas de 36 mulheres, realizadas, em média, 40 dias após o procedimento cirúrgico. Os resultados obtidos indicaram que, para além da continuidade da forma física, elas almejavam a continuidade da rotina de vida, algo que a reconstrução imediata, realizada em uma única cirurgia possibilita, sendo demarcada por: 1) Discurso permeado por pensamento positivo; 2) Enfrentamento do diagnóstico e a ideia inicial de morte; 3) Atribuição de novo significado para o câncer; 4) Manejo das emoções e o recurso à espiritualidade; 5) Vivência da rede de apoio; 6) Ruptura da autonomia na rotina diária; 7) Confronto com a nova forma corporal.
Abstract: Psychosocial outcomes, resulting from immediate reconstruction in the treatment of breast cancer, are shown to be contradictory when compared to the absence of reconstruction or to the delayed one. Understanding that studies exploring the experience of these patients are necessary, this study used the phenomenological method to analyze interviews with 36 women, carried out on average 40 days after the surgical procedure. The results indicated that, besides the continuity of physical form, they wanted the continuity of daily life, something that this single surgery reconstruction makes possible. This desire was marked by 1) Speech permeated by positive thinking; 2) Coping with the diagnosis and the initial idea of death; 3) Attribution of new meaning to cancer; 4) Management of emotions and the use of spirituality; 5) Experience of the support network; 6) Rupture of autonomy in the daily routine; 7) Confrontation with the new body shape.
Keywords: Breast Neoplasms; Reconstructive Surgical Procedures; Psycho-Oncology; Psychological Phenomena; Qualitative Research
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ALVES, V.L. et al. Emoção e soma (des) conectadas em páginas de revista: as categorias temáticas do discurso prescritivo sobre os fenômenos da vida e da doença. Cien Saude Colet. 18(2), 537-543, 2013. DOI: 10.1590/S1413-81232013000200025 DOI: https://doi.org/10.1590/S1413-81232013000200025
ARROYO, J. M.; LÓPEZ, M. L. D. Psychological problems derived from mastectomy: A qualitative study. Int J Surg Oncol, 2011. DOI: 10.1155/2011/132461 DOI: https://doi.org/10.1155/2011/132461
BEESLEY, H. et al. How patients evaluate breast reconstruction after mastectomy, and why their evaluation often differs from that of their clinicians. J Plast Reconstr Aesthet Surg, 65(8),1064-1071, 2012. DOI: 10.1016/j.bjps.2012.03.005. DOI: https://doi.org/10.1016/j.bjps.2012.03.005
BERTOZZI, N. et al. One-Stage Immediate Breast Reconstruction: A Concise Review. BioMed Research International, V. 2017, Article ID 6486859, 12 pages. DOI:10.1155/2017/6486859 DOI: https://doi.org/10.1155/2017/6486859
BURY, M. The sociology of chronic illness: a review of research and prospects. Sociol Health Illn, 13(4), 451 – 468, 1991. DOI: 10.1111/j.1467-9566.1991.tb00522.x DOI: https://doi.org/10.1111/j.1467-9566.1991.tb00522.x
COLLIE, K.; LONG, B.C. Considering 'meaning' in the context of breast cancer. J Health Psychol. 10(6), 843-853, 2005. DOI: 10.1177/1359105305057318 DOI: https://doi.org/10.1177/1359105305057318
COX, C.R. et al. Considering the unspoken: the role of death cognition in quality of life among women with and without breast cancer. J. Psychosoc Oncol, 30(1), 128-139, 2012. DOI: 10.1080/07347332.2011.633980. DOI: https://doi.org/10.1080/07347332.2011.633980
DIDIER, F. et al. Does nipple preservation in mastectomy improve satisfaction with cosmetic results, psychological adjustment, body image and sexuality? Breast Cancer Res Treat. 118(3), 623-633, 2009. DOI: 10.1007/s10549-008-0238-4 DOI: https://doi.org/10.1007/s10549-008-0238-4
EXNER, R. et al. Objectively measured breast symmetry has no influence on quality of life in breast cancer patients. Eur J Surg Oncol. 38(2), 130-136, 2012. DOI: 10.1016/j.ejso.2011.10.012 DOI: https://doi.org/10.1016/j.ejso.2011.10.012
FLÓREZ, K. et. Al. Fatalism or destiny? A qualitative study and interpretative framework on Dominican women's breast cancer beliefs. J Immigr Minor Health. 11(4), 291-301, 2009. DOI: 10.1007/s10903-008-9118-6. DOI: https://doi.org/10.1007/s10903-008-9118-6
FRANK, A.W. The wounded storyteller: Body, Illness and ethics. Chicago: The University of Chicago Press, 1997. DOI: https://doi.org/10.7208/chicago/9780226067360.001.0001
GIORGI, A. The descriptive Phenomenological Method in Psychology: A modified Husserlian approach. Pittsburgh: Pennsylvania Press, 2009.
GUYOMARD, V.; LEINSTER, S.; WILKINSON, M. Systematic review of studies of patients' satisfaction with breast reconstruction after mastectomy. Breast;16(6), 547-567, 2007. DOI: 10.1016/j.breast.2007.04.004 DOI: https://doi.org/10.1016/j.breast.2007.04.004
HARCOURT, D.M. et al. The psychological effect of mastectomy with or without breast reconstruction: a prospective, multicenter study. Plast Reconstr Surg; 111(3), 1060-1068, 2003. DOI: 10.1097/01.PRS.0000046249.33122.76. DOI: https://doi.org/10.1097/01.PRS.0000046249.33122.76
HOLLAND, J.; LEWIS, S. The human side of cancer. Living with hope, coping with uncertainty. New York: Harper Collins Publishers, 2000.
KIM, Z. et al. Skin-sparing mastectomy and immediate latissimus dorsi flap reconstruction: a retrospective analysis of the surgical and patient-reported outcomes. World J Surg Oncol. 10, 259-266, 2012. DOI: 10.1186/1477-7819-10-259. DOI: https://doi.org/10.1186/1477-7819-10-259
KROENKE, C.H. et al. (2013). Social networks, social support mechanisms, and quality of life after breast cancer diagnosis. Breast Cancer Res Treat. 139(2), 515-527, 2013. DOI: 10.1007/s10549-013-2477-2. DOI: https://doi.org/10.1007/s10549-013-2477-2
MEDEIROS, M.C. et al. Depression and conservative surgery for breast cancer. Clinics (Sao Paulo); 65(12), 1291-1294, 2010. DOI: 10.1590/S1807-59322010001200011 DOI: https://doi.org/10.1590/S1807-59322010001200011
PALACIOS-ESPINOSA, X.; ZANI, B. Representaciones sociales del cáncer y de la quimioterapia en pacientes oncológicos. Divers.: Perspect. Psicol. Vol. 10(2), 207-223, 2014. Disponível em: http://www.scielo.org.co/pdf/dpp/v10n2/v10n2a03.pdf DOI: https://doi.org/10.15332/s1794-9998.2014.0002.02
PANJARI M. et al. Breast cancer survivors' beliefs about the causes of breast cancer. Psychooncology. 21(7),724-729, 2012. DOI: 10.1002/pon.1949 DOI: https://doi.org/10.1002/pon.1949
PAREDES, C. et al. Impacto da reconstrução mamária na qualidade de vida de pacientes mastectomizadas atendidas no Serviço de Cirurgia Plástica do Hospital Universitário Walter Cantídio. Revista Brasileira de Cirurgia Plástica [online]. 8(1), 2013. DOI:10.1590/S1983-51752013000100017 DOI: https://doi.org/10.1590/S1983-51752013000100017
PIOT-ZIEGLER, C. et al. Mastectomy, body deconstruction, and impact on identity: a qualitative study. Br J Health Psychol; 15(3),479-510, 2010. DOI: 10.1348/135910709X472174 DOI: https://doi.org/10.1348/135910709X472174
TAYLOR E. J. Whys and wherefores: adult patient perspectives of the meaning of cancer. Semin Oncol Nurs,11 (1), 32-40, 1995. DOI: https://doi.org/10.1016/S0749-2081(95)80040-9
THOMAS-MACLEAN, R.T. Understanding breast cancer stories via Frank’s narrative types. Soc Sci Med. 58(9),1647-1657, 2004. DOI: https://doi.org/10.1016/S0277-9536(03)00372-1
WILLIG, C. Cancer diagnosis as discursive capture: Phenomenological repercussions of being positioned within the dominant constructions of cancer. Soc Sci Med. 73, 897-903, 2011. DOI: 10.1016/j.socscimed.2011.02.028. DOI: https://doi.org/10.1016/j.socscimed.2011.02.028
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