Being there for women : the work of breast care nurses

Abstract

Breast cancer is a major health challenge. It is also is a high profile disease with extraordinary media attention that places an immense burden on women, families, children and health resources. Over the last two decades the way in which women experience breast cancer has undergone significant changes. The implementation of the National Health Service Breast Screening Programme, development of specialist multidisciplinary teams, and greater involvement of women in decision making surrounding treatment choice are just some of these changes. A discrete clinical nurse specialism has developed to provide support and information to women undergoing treatment and care for breast cancer. This multi-method two staged study explored the work of breast care nurses supporting women with breast cancer. The particular focus was on the body image and sexuality dimensions of the breast cancer experience. Firstly, a postal survey using modified versions of the Sex Knowledge and Attitude Test (Lief and Reed 1972) and the Williams-Wilson Sexuality Survey instrument (Wilson and Williams 1989) was undertaken and completed by breast care nurses (n=100) across England. Secondly, adopting an interpretative perspective, breast care nurses (n=29), recruited via the earlier survey participated in focused conversational interviews. In addition a secondary analysis of two focus group interviews with women breast cancer patients (n=14), and a further two individual interviews with lesbian women were undertaken. The audio taped data was analysed using a thematic approach assisted by ATLAS.ti 4.1 qualitative software (Muhr 1996). Three major themes: the delivery of breast cancer care, knowing women, and the territory of breast care nursing were developed. The theme of knowing women was connected with three sub themes titled: authenticity and domesticity, moral journeys, and the (in)visibility of lesbian women. The thematic analysis presents a critical account of contemporary breast care nursing in the endeavour of "being there for women"