Mental Models of Women With Breast Implants: Local Complications

Abstract

Twenty-five women with breast implants participated in semistructured interviews designed to reveal their “mental models” of the processes potentially causing local (ie, nonsystemic) problems. The authors analyzed their responses in terms of an “expert model,” circumscribing scientifically relevant information. Most of the women interviewed had something to say about most elements in the expert model. Nonetheless, gaps in their mental models undermined decision making about their implants. One woman misunderstood the terms used by the medical community to describe implant failure (eg, rupture, leak, and bleed). Another exaggerated the implants' vulnerability to direct impacts, such as car accidents. Participants also overestimated their ability to detect localized problems and to select medical remedies. Although they were generally satisfied with their own implants, many participants were dissatisfied with the decision-making processes that lead to their choice. Their interviews are interpreted by the form and content of communications that women with implants need to help them manage their health decisions better.

Key Words:

• breast implants
• decision making
• informed consent
• mental models
• risk communication

Additional information

Notes on contributors

Sarah Thorne

Dr Byram, who died of breast cancer in June 2001, was a postdoctoral fellow in the Department of Psychology at Carnegie-Mellon University in Pittsburgh, Pennsylvania, where Dr Fischhoff is a professor in the Department of Social and Decision Sciences. Ms Embrey is a research associate in the Department of Environmental and Occupational Health at The George Washington School of Public Health and Health Services in Washington, DC. Dr Bruine de Bruin is a postdoctoral fellow in the Department of Technology Management at the Technical University of Eindhoven, The Netherlands, and Ms Thorne is with Thorne Butte: Decision Partners, in Toronto, Ontario.