Impact of silicone implants on the lives of women with breast cancer.

PURPOSE/OBJECTIVES: To describe the impact of silicone implants on the lives of women with breast cancer. DESIGN: Qualitative analysis of telephone interview data. SAMPLE: 120 women from across the United States who have reported to the Food and Drug Administration problems with breast implants following mastectomies. METHODS: Telephone interviews were used to gather responses to 110 questions. Qualitative analysis of narrative data was linked with quantitative data. MAIN RESEARCH VARIABLES: Concerns and feelings about breast implants; potential problems with silicone implants; source of information about problems; how they coped with the silicone implant controversy; problems related to their breast implants; the effect of health problems on day-to-day activities, relationships with significant others, work, and any other important aspects of their lives; and advice they would give other women regarding breast implant surgery. By linking the qualitative analysis of narrative data with quantitative data, the investigators sought to answer the following research question: Do the patterns of responses differ based on specific systemic physical problems, reported localized breast problems, or implant problems? FINDINGS: The women reported poorer quality of life and feelings of worry and anger because of health problems. They perceived they had received incomplete information and often had complaints dismissed by their healthcare providers. Most of them would not recommend silicone implants for patients undergoing mastectomy. The women's levels of satisfaction were directly associated with their feelings of being informed and the type of health problems they experienced. CONCLUSIONS: Women need reconstruction options following mastectomy, however, use of silicone implants can result in additional health problems and decreased quality of life as a result of those problems. IMPLICATIONS FOR NURSING PRACTICE: Nurses can assume the role of breast health educator, which includes counseling women with breast cancer about breast implants and other reconstructive options. Study results will help health providers care both for those patients considering treatment options and those coping with the problems and concerns related to their breast implants. Women should be told the inherent risks and complications associated with breast implants and also told when "we don't know."

Breast cancer screening for primary care trainees: comparison of two teaching methods.

BACKGROUND: This study compared the efficacies of two methods of teaching breast cancer screening to primary care trainees. METHODS: Fifty-one nurse-practitioner students were assigned by class section and 47 medical residents by practice site to receive a lecture-demonstration class or individual/small-group instruction from a standardized patient. Prior to instruction and one year later, participants took a written test to assess knowledge and standardized patients evaluated their skills. RESULTS: Overall, the participants improved their breast cancer screening skills. CONCLUSION: The standardized patient teaching method was of greater benefit to the nurse-practitioner students.

Breast cancer screening education: comparing outcome skills of nurse practitioner students and medical residents.

BACKGROUND: Nurse practitioner students, along with all primary care trainees, need breast cancer screening education. The purpose of the study was to compare the performances of nurse practitioner students and medical residents before and after receiving training. METHODS AND RESULTS: In a pretest/posttest design, 51 nurse practitioner students and 47 medical residents received training either from a standardized patient or from a lecture/demonstration class. Before training and 1 year after, participants took the written test and had their skills evaluated by a standardized patient. There were no significant differences between the nurse practitioner students and the medical residents in the mean scores on the written pretest or on the written posttest with both groups improving their scores. The nurse practitioner students had significantly higher scores on the practicum posttest (P <.05). CONCLUSIONS: Nurse practitioner students perform well in learning breast cancer screening. More than one method of teaching is effective.

An analysis of printed breast cancer information for African American women.

BACKGROUND: The 1995-1998 Delta Project was designed to increase breast cancer screening among disadvantaged African American women with limited literacy skills by educating their health care professionals about breast health. The research team intended to provide onsite training and appropriate educational materials; however, they found no suitable materials. This article presents the results of an assessment of available materials and defines the need for suitable materials. METHODS: Nineteen organizations that develop cancer-related publications submitted materials intended for African American audiences. Sixty-one documents were examined for readability and cultural sensitivity. The Flesch Reading Ease (FRE), Flesch-Kincaid (F-K), and Cultural Sensitivity Assessment Tools (CSAT) were used in testing. RESULTS: The mean FRE score of 65 yielded a F-K mean grade level of 7.5 (desired level: 3.5). Using CSAT, 16 documents (26%) were eliminated because they had no visuals. Twenty-two publications (37%) were culturally sensitive for all audiences and 19 (31%) were for white audiences. Four (6%) pieces specifically addressed African American women. CONCLUSIONS: Printed educational materials on breast cancer do not adequately provide information to undereducated, economically disadvantaged African American women.