The mirror viewing experience of women undergoing a mastectomy: An integrative review

Abstract

To appraise the current literature on the mirror viewing experience of women undergoing a mastectomy. Whittemore and Knafl's approach to integrative reviews, Braun and Clarke's thematic analysis, and PRISMA guidelines were utilized for this review. A systematic search of primary peer-reviewed articles from April 2012 to 2022 was conducted using PubMed, CINAHL, Academic Search Complete and Google Scholar databases. Eighteen studies met the inclusion criteria (15 qualitative and 3 quantitative) and were appraised using the Johns Hopkins evidence-based practice appraisal instrument. Five themes describing the mirror viewing experience were revealed: Mirror viewing motives, mirror viewing preparedness, mirror viewing experience, mirror comfort/avoidance and women's mirror viewing recommendations. The review findings were found to align with Freysteinson's Neurocognitive Mirror Viewing Model highlighting the occurrence of short-term memory disruptions and an autonomic nervous system response that can lead women to experience a flight/fright or faint response, mirror trauma and mirror avoidance when looking at themselves in the mirror after a mastectomy. Women reported feeling unprepared to look at themselves in the mirror, with some experiencing shock and emotional distress, which led to mirror avoidance behaviours as a way to cope with their new body image. Nursing interventions aimed at improving women's mirror viewing experiences may help mitigate this autonomic nervous system response and minimize mirror trauma and mirror avoidance. Preparing women to view themselves in the mirror for the first time may help reduce psychological distress and body image disturbances in women undergoing a mastectomy. This integrative review did not involve patient or public contributions. The authors reviewed currently published peer-reviewed literature in writing this manuscript.