"You Helped Create This, Help Me Now": A Qualitative Analysis of Patients' Concerns about Breast Implants and a Proposed Strategy for Moving Forward.

Autor:	Steve AK; From the Section of Plastic Surgery, University of Calgary., Temple-Oberle C; From the Section of Plastic Surgery, University of Calgary., Yeung JK; From the Section of Plastic Surgery, University of Calgary., Lafreniere AS; From the Section of Plastic Surgery, University of Calgary., Harrop AR; From the Section of Plastic Surgery, University of Calgary.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery [Plast Reconstr Surg] 2021 Jan 01; Vol. 147 (1), pp. 16e-24e.
DOI:	10.1097/PRS.0000000000007422
Abstrakt:	Background: Some women with breast implants express concern about the safety of implants, fearing the possibility of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and breast implant-related illness. Methods: A qualitative analysis was performed to examine the perceived challenges, barriers, and worries experienced by these women. Convenience sampling was used to elicit responses from members of Canadian BIA-ALCL Facebook advocacy groups. Three independent coders read and reread the transcripts, using thematic analysis to identify emerging themes. Results: Sixty-four women answered questions posed by the president of the Canadian Society of Plastic Surgeons regarding concerns about their breast implants. Five themes were identified: informing, listening, acknowledging, clarifying, and moving forward. Patients desire improved communication about possible risks before implantation and as new information becomes available (informing), sincere listening to their concerns (listening), acknowledgement that these disease entities may be real and have psychosocial/physical impact on patients (acknowledging), clarification of implant-related problems and their treatment (clarifying), and improved processes for monitoring and treatment of patients with identified problems (moving forward). Consideration of these themes in the context of the five domains of trust theory (i.e., fidelity, competence, honesty, confidentiality, and global trust) suggests significant breakdown in the doctor-patient relationship for a subset of concerned women. Conclusions: Concerns related to BIA-ALCL and breast implant-related illnesses have undermined some women's trust in plastic surgeons. Consideration of these five themes and their impact on the five domains of trust can guide strategies for reestablishing patients' trust in the plastic surgery community. Competing Interests: Disclosure:The authors have no financial disclosures or conflicts of interest to report. (Copyright © 2020 by the American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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