• Women's Health Nursing
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• v.9 no.4
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• pp.379-389
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• 2003

Purpose: To identify the type of disease-related stress experienced by women who received mastectomy for breast cancer using Q methodology. Method: Q sample included 30 statements obtained from literature and interviews with women with mastectomy. P sample consisted of 22 patients with mastectomy. The data were collected from November to December 2002 and analyzed using QUANL program. Result : Four types of disease-related stress experienced by women with mastectomy were found. Type 1 was manifested for a short duration following surgery and characterized by lowered self-esteem, feelings of emptiness and depression because of impaired body image. Type 2 was characterized by declined physical strength, resulting in frequent fatigue in the daily life and less intimate relationship with spouse. Type 3 was manifested by perfectionists with strong sense of self-pride who received or considered breast reconstruction surgery. Type 4 was reported by those who had long period of post-surgery. This type reported a strong sense of discomfort for wearing an artificial breast but didn't show any intention of trying breast reconstruction surgery. Conclusion: Women with mastectomy were found to experience different type of disease-related distress. Therefore, nurses should assess the type of stress the patient experiences following a mastectomy to provide appropriate nursing care.

• Asian Oncology Nursing
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• v.3 no.2
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• pp.103-111
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• 2003

The purpose of this study was to identify the effect of imagery therapy on "coping mechanism and type C personality of the women with mastectomy. To achieve this purpose, 2 hours sessions of imagery therapy were given to the patients with breast cancer twice a week for 6 weeks. The period of data collection was from July, 7th to August, 12th 2002. The participants were 30 patients, 15 experimental group, 15 control group who were treated at the G University hospital in J City. This study was designed using a quasi-experimental approach with non-equivalent Pre test-Post test Design. The themes for the Imagery Therapy Program were composed of Leuner's(1969) 12 Imagery Themes: flower, green-field, stream, mountain, house, woods, significant figures, rose, lion, ideal self-image, cave and volcano. The data were analyzed with ${\chi}2-test$ and MANOVA using the SPSS program. The course of image change of the 12 imagery themes was analyzed by content analysis. The results of this study are as follows: First Hypothesis, 'The score of type C personality in the women with mastectomy who received imagery therapy will be significantly lower than that of the control group' was supported(p<.05). Second Hypothesis, 'The score of coping mechanism' in the women with mastectomy who received imagery therapy will be significantly higher than that of the control group' was rejected. In conclusion, imagery therapy is suggested as an effective nursing intervention to change type C personality of the women with mastectomy, but not effective to improve coping mechanism. Therefore, the program for the women with mastectomy should be developed to change their coping mechanism, method of problem solving and Quality of life.

• Korean Journal of Acupuncture
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• v.28 no.4
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• pp.101-112
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• 2011

Objectives : This study was done to investigate the degree of the pulse wave parameter of post-mastectomy women and to identify the relationships between each of them. Methods : Data were obtained from public health center in Busan Metropolitan city. Participants were 82 post-mastectomy women aged 31-82. the data collection was from Oct, 1, 2010 to Oct, 31, 2010. the data were analyzed with descriptive statistics, one-way ANOVA, Duncan test. A p-value less than .05 was considered significant by 2-tailed test. All statistical analyses were performed with SPSS/Win(ver 12.0). Results : As for the difference in the pulse wave by the general characteristics. The pulse energy was showed highly in the order of Chon, Quan and Chuk of left and right pulse respectively. In the pulse energy of left Quan and right Chon, the case of both mastectomy was showed highly and in the pulse energy of left Chuk, the case of right mastectomy was showed highly. Left and right pulse energy of menopause female were significantly higher than normal range except left Chon and Chuk. In h1, h2, h4, h5, t1, t2, AP and Aw, the pulse energy of left Chon was showed the largest significantly. In As, the pulse energy of right Chon was showed the smallest and in Ad, right Chuk was showed the largest. In RAI, right and left Chuk was showed the highest respectively. Conclusions : From these result, we can see that there are relation between women's age, area of operation breast and menopause after mastectomy in pulse wave. The result of this study will become basic data necessary for the Oriental Medicine treatment to reduce or prevent women's functional difficulties, symptomatology after mastectomy.

• Women's Health Nursing
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• v.25 no.2
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• pp.219-231
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• 2019

Purpose: The purpose of this study was to identify the levels of body image, sexual intimacy, and sexual satisfaction, and to explore factors affecting sexual intimacy and satisfaction among women within one year of mastectomy. Methods: The present study was a cross-sectional survey and involved 101 women who had undergone mastectomy at a University hospital of D city, Korea. Measurement included the scales of body image, sexual intimacy, and sexual satisfaction. Results: Mean age of the subjects was 51 years. Scores of the body image, sexual intimacy, and sexual satisfaction were 59.62, 90.69, and 69.04, respectively. Body image, sexual intimacy, and sexual satisfaction were significantly related to each other. Sexual intimacy was higher when women were of young age (${\beta}=-.32$), had a shorter period since surgery (${\beta}=-.24$), and with higher levels of body image (${\beta}=.37$). Sexual satisfaction was higher when women had higher levels of body image (${\beta}=.19$) and greater levels of sexual intimacy (${\beta}=.74$). Conclusion: Higher levels of body image and greater levels of sexual intimacy were identified as the significant factors influencing sexual satisfaction among these women. Future research with a mixed-method research is needed to gain a deep understanding of the sexuality between women and their husbands.

• Journal of Society of Preventive Korean Medicine
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• v.14 no.3
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• pp.37-49
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• 2010

Objective : Qigong has been reported as an effective for post-mastectomy women. It consists of a series of postures combined with slow, smooth, graceful movements, and is considered a low intensity exercise. In this study, a specialist of Qigong developed a Qigong program for post-mastectomy women in a community. The object of this research is to evaluate the effect of Qigong on a subjective symptom scale, on the grade of discomfort and pain in everyday life, BMI, fat(%), muscular strength, shoulder joint movement, in post-mastectomy women. Methods : The study used a non-equivalent control group non-synchronized design. The experimental group received a Qigong 3 times a week for 12 weeks from September 7th to December 28th in 2009. The subjects were 40 patients are divided into 25 persons in experimental groups and 15 persons in contrastive group. The data were analyzed with descriptive statistics, chi-square test, t-test, Mann-Whitney U test. A P-value less than .05 was considered significant by 2-tailed test. All statistical analyses were performed with SPSS win(ver 12.0). Results : The results were as follows : The score in the subjective symptom(p=.040), and score of anxiety (p=.024), fat(%)(p=.007) were significantly decreased after Qigong program. The values for shoulder flexibility (left : p=.010, right : p=.008), and Muscular strength(grip power)(left : p=.021, right : p=.029) significantly increased after Qigong program. And Flexion(left ; p=.029), Extension(left : p=.001, right : p=.038), Adduction(left ; p=.001, right ; p<0.001) were also significantly increased after Qigong Conclusions : The Qigong is an effective health promotion program for post-mastectomy women.

• Women's Health Nursing
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• v.18 no.1
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• pp.49-61
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• 2012

Purpose: The purpose of this study was to examine the experiences of the use of external breast prostheses among breast cancer survivors in Korea. Methods: A qualitative descriptive study was conducted, using focus groups. Data were collected from breast cancer survivors who were patients of C women's hospital in Seoul, Korea. Data were analyzed using content analysis in order to identify significant themes. Results: Participants included forty breast cancer survivors who had mastectomy as a surgical treatment. Four themes emerged from the collected data were: 1) concern over the high price of external breast prosthesis, 2) irregular use of external breast prosthesis, 3) unsatisfied with mastectomy bra, and 4) wanting to hide or not to talk about using breast prosthesis openly. Conclusion: Since most participants reported irregular use and negative experiences related to external breast prosthesis or mastectomy bra use, healthcare workers should allow more time for proper fitting and counseling and consulting with breast cancer survivors. In addition, health care providers as well as family and friends should keep in mind that cancer survivors need support that can help them cope by using positive reframing. Furthermore, improvements in the coverage of costs and services are needed for these women. This would be helpful for breast prosthesis users.

• Archives of Plastic Surgery
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• v.41 no.4
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• pp.366-373
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• 2014

Background The advent of skin-sparing mastectomy has allowed for the reconstruction of the breast and nipple with improved cosmesis. However, the nipple-areolar complex (NAC) in Asian patients is more pigmented and scars easily. Therefore, commonly described incisions tend to result in poor aesthetic outcomes in Asian patients with breast cancer. Methods We describe an algorithmic approach to skin-sparing mastectomy incisions in Asian patients on the basis of the location of the biopsy scar and the tumor site and size. Four incision types are described: peri-areolar, a peri-areolar incision with a second distant skin paddle, "racquet handle," and peri-areolar with adjacent skin excision. Results 281 immediate breast reconstructions were performed between May 2001 and February 2012 after skin-sparing mastectomy. The mastectomy incisions used included the peri-areolar design (n=124, 44%), peri-areolar design with a second distant skin paddle (n=39, 14%), "racquet handle" (n=21, 7.5%), and peri-areolar design with adjacent skin excision (n=42, 14%). The traditional elliptical incision and other variants where the NAC outline was not preserved were performed in the remaining 55 patients. The average follow-up was 44.7 months during which there was 1 case of total flap loss and 7 cases of partial flap necrosis; all remaining flaps survived. 24% of the patients (68/281) underwent subsequent nipple reconstruction. Conclusions Our algorithm avoids breast incisions that are randomly placed or excessively long and prevents the unnecessary sacrifice of normal breast skin. This allows skin-sparing mastectomy and immediate breast reconstruction to be performed with a consistently achievable aesthetic result in Asian women without neglecting oncological safety.

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.503-506
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• 2009

Purpose: Unilateral breast reconstruction after mastectomy confront the challenges of recreating a natural appearing breast mound and achieving symmetricalness of the breasts. If the patient's remaining breast is large compared to reconstructed breast, the most common procedure is reduction mammoplasty of the large breast side. The authors experienced a new method of breast reconstruction using the excess breast tissue from the contralateral breast after breast reduction. Methods: The excess tissue from the contralateral breast after vertical reduction mammoplasty with superior pedicle and remaining lower breast tissue were transferred to the mastectomy site breast through the subcutaneous tunnel on the chest wall. The main blood supplies of the flap are perforator branches of the 4th, 5th and 6th anterior intercostal artery. After elevating and detaching the flap on the lower lateral area of the breast, the turn overed flap is fixed on the upper portion of the chest wall of the mastectomy site. Results: On two cases of the breast reconstructions, remaining excess breast tissue from reduction mammoplasty was transferred to the contralateral breast side as pedicles. Both patient and operator were satisfied with the outcome of the reconstruction as the breasts were symmetrical and natural shape. Conclusion: We have performed unilateral breast reconstruction using the excess breast tissue after reduction mammoplasty of the contralateral breast. As Oriental women's breasts are relatively smaller than that of Caucasian women, delayed breast reconstruction cases of Oriental women with large breasts(macromastia) seem to be ideal for this procedure.

• Asian Oncology Nursing
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• v.8 no.2
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• pp.86-92
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• 2008

Purpose: This study was designed to investigate the body-image and quality of life in breast cancer patients with mastectomy. Methods: Data were obtained by self-reported questionaries from 110 patients undergone mastectomy from August 1 to 31, 2007. And data were analyzed using SPSS/PC WIN 12.0 program and frequency, percentage, mean, minimum, maximum, t-test, ANOVA, Scheffe test, Pearson's Correlation Coefficient were used. The results of the study were as follows; 1) Mean of Body image of the subjects was $52.54{\pm}6.67$ (range of scale; 17 to 85). Mean of quality of life was $118.01{\pm}34.37$ (range of scale; 0 to 10). 2) There was no significant difference with the score of body image by demographic and disease-related characteristics of subjects. 3) There was significant difference with the score of quality of life by the work type and economic status of subjects. 4) Relationship between body image and quality of life showed moderately strong positive correlation (r=0.408, p<0.0001). Conclusion: Mean of body image and of quality of life in mastectomy patients were moderate. Relationship between body image and quality of life showed moderately strong positive correlation. Therefore, for improving the quality of life, it is needed to improve body image in breast cancer patients with mastectomy.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.2079-2084
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• 2013

Background: Breast cancer is the most prevalent cancer among Iranian women and mastectomy comprises 81% of surgeries for treatment of breast cancer. Mastectomy may create feelings such as deformation or impairment in patients, cause body-image disorder, and reduce sexuality and sexual activity which in turn may entail mental disorders. The study aimed to elaborate coping processes. Materials and Methods: A grounded theory method was used in conducting this study. Twenty Iranian participants undergoing mastectomy were recruited with purposive sampling. An open, semi-structured questionnaire were developed. Obtaining consent, conversations were recorded and immediately transcribed after each session. Data analysis was carried out with the constant comparative method using the Strauss Corbin approach. Results: Analyzing the collected data, the study came up with seven main categories which affected the coping process in patients with breast cancer, namely: reactions to mastectomy; loss and death contest; reconstruction of evaluation system; consent for undergoing mastectomy; reactions and troubles after loss; confrontation of loss and health; and reorganization and compatibility with changes. Conclusions: The results of the study indicated: when patients become informed of their breast cancer and the necessity of undergoing mastectomy as the treatment, they probably pass through seven categories to adapt after mastectomy. Having insight about them is likely to contribute medical personnel in leading patients to the highest degree of feeling healthy.