Perception of Self through Mirror-Viewing: Insight into the Experience Following Limb Amputation

Monday, 30 October 2017

Wyona M. Freysteinson, PhD, MN, BSN
Nelda C. Stark College of Nursing, Texas Woman's University, Houston, TX, USA
Lisa Thomas, DNP
School of Nursing, The University of Texas Health Science Center, Houston, TX, USA

Purpose: The purpose of this study was to address a knowledge gap identified in both academic and clinical educational programs, regarding the experience of viewing self in the mirror after amputation of a limb. Study authors sought to generate a description of the trajectory of the experience of this phenomenon, and describe considerations for supportive nursing interventions. There is an important impact on self-image, linked to early experiences in the hospital, which occurs for these individuals, and many are not aware of what to expect, or how to best facilitate the experience. Nurses, occupational therapists, physical therapists, and psychologists have no evidence based interventions to guide individuals who have had an amputation in the mirror-viewing experience.

Methods: Reviewing the transcripts from four facilitated focus groups and one 1:1 interview, a multidisciplinary team of investigators worked to extract the essential meaning of the mirror viewing phenomenon. The qualitative research approach of hermeneutic phenomenology informed the process, as each investigator provided a naive reading, and gave feedback that informed the evolving structural analysis and phenomenological interpretation, validated in a final focus group that included interested study participants.

Results: Individuals (N=17) who had suffered an amputation of a limb were invited to discuss their mirror experiences in semi-structured audio-taped focus groups. Data was analyzed using Ricoeur’s hermeneutic phenomenology. The trajectory of viewing self in the mirror after an amputation has three key stages: mirror shock, mirror anguish, and acceptance of a new normal as one becomes increasingly comfortable viewing self in the mirror. The participants presented us with a detailed description of how nurses can support amputees in viewing self in the mirror.

Conclusion: The findings of this study provide nurses with a unique perspective of what is often a highly emotional and sensitive experience. While viewing self in a mirror was related as an everyday occurrence, it is not one offered in health care facilities, and that first moment of viewing self is key. This study provides an academic foundation as to why nurses should support individuals when they view self in the mirror after an amputation.