The psychological predictors of satisfaction following breast reconstructive surgery

Key words: cancer, oncology, psychological, breast surgery, satisfaction Aim: A Systematic review of prospective studies examining the relationship between psychological factors prior to surgery and patients’ outcomes following breast cancer surgery Background: Increasing numbers of women are receiving breast cancer surgery every year in the UK. Ensuring post-surgical satisfaction is essential in order to increase wellbeing for these women and to save NHS resources. Psychological factors which lead to lower levels of outcomes post surgery need to be identified to allow for clinicians to focus and tailor psychological interventions. Data sources: Research studies published between 1985-2011 were identified by searching Medline, CINAHL, PsychInfo, Science Direct and Swetwise. Method: Studies were included following examination against inclusion and exclusion criteria. Reference lists of included articles were scrutinised, and key authors contacted. Results: 13 articles emerged for review. All papers were quality assessed by the author and an independent evaluator. Conclusion: A number of psychological factors pre-surgery may lead to lower levels of outcomes post-surgery: lower levels of optimism; helpless/hopeless or fatalism coping strategies; higher levels of distress, somatic anxiety, anxiety and depression; impaired social/work functioning in the year prior to surgery; higher scores on psychiatric caseness measures; higher scores on neuroticism and emotionality scales of personality tests; higher expectations of negative outcomes and the appraisal of breast cancer diagnosis as a threat. Hypothesised psychological interventions, and ideas for further research are discussed.OverviewThe portfolio is compromised of three parts: a systematic literature review; an empirical paper and appendices.Part one, the systematic literature review, looks at the pre-surgical psychological predictors of outcomes following breast cancer surgery. The review begins with a synthesis of background information relevant to the area, which leads to specific research questions. The review process is then outlined, results presented and synthesised in the discussion. Limitations of the review and ideas for further research are discussed.Part two, the empirical paper, describes a study that researches pre-surgical predictors of satisfaction following breast reconstructive surgery. The current literature in the field is introduced and reviewed, and hypotheses established. The methodology is then described, results presented and findings discussed in relation to theoretical models. Finally, limitations of the study and ideas for further research are described.Part three, the appendices, present relevant further information for parts one and two