The young women's network: a case study in community development

A prospective and population-based inquiry on the use and acceptability of peer support for women newly diagnosed with breast cancer

The degree to which peer support is used and accepted as a supportive care approach by women with breast cancer is unclear. We examine peer support use across three major modalities (i.e. support groups, online platforms, one-on-one) and identify enablers and barriers to peer support using the beliefs framework of the theory of planned behaviour. A population-based sample of women newly diagnosed with breast cancer (n = 3105) who were on average 54.08 weeks since diagnosis completed mailed surveys at baseline measuring beliefs about peer support and intention. Peer support use was measured via telephone interview at baseline and prospectively at 12-month follow-up (n = 2780). In all, 37% of women had used at least one peer support service since diagnosis (support group = 20%, online = 18%, one-on-one = 10%). A path analysis examined what beliefs enabled or acted as barriers to peer support use at follow-up adjusting for past behaviour (i.e. baseline use), sociodemographic characteristics, and treatment. In order of relative strength, enablers included beliefs that peer support is an outlet for honest expression of feelings (β = .35), a source of empathy (β = .30), approved by doctors (β = .07), and approved by family/partner (β = .04). Barriers were beliefs that it encourages dwelling about breast cancer (β = - .06) and involves exposure to negative stories about this disease (β = - .04). Strategies which communicate the potential emotional support benefits of a shared illness experience and social approval by others, particularly the medical profession, may help to promote acceptance of peer support and encourage service uptake in breast cancer.

Advocacy, support and survivorship in prostate cancer

Across Australia, prostate cancer support groups (PCSG) have emerged to fill a gap in psychosocial care for men and their families. However, an understanding of the triggers and influencers of the PCSG movement is absent. We interviewed 21 SG leaders (19 PC survivors, two partners), of whom six also attended a focus group, about motivations, experiences, past and future challenges in founding and leading PCSGs. Thematic analysis identified four global themes: illness experience; enacting a supportive response; forming a national collective and challenges. Leaders described men's feelings of isolation and neglect by the health system as the impetus for PCSGs to form and give/receive mutual help. Negotiating health care systems was an early challenge. National affiliation enabled leaders to build a united voice in the health system and establish a group identity and collective voice. Affiliation was supported by a symbiotic relationship with tensions between independence, affiliation and governance. Future challenges were group sustainability and inclusiveness. Study findings describe how a grassroots PCSG movement arose consistent with an embodied health movement perspective. Health care organisations who seek to leverage these community resources need to be cognisant of SG values and purpose if they are to negotiate effective partnerships that maximise mutual benefit.

Doctor-patient communication: a study of Australian ethnic urological cancer patients

Purpose

– The purpose of this paper is to examine doctor-patient communication, focusing on ethnic Australian urological cancer patients.

Design/methodology/approach

– Samples of 50 Australian urological cancer patients of ethnic origin were chosen to participate in this study. The patients completed a 31-question survey, followed by a one-on-one semi-structured 30-40-minute interview with the patient.

Findings

– Most (90 per cent,n=45) of the patients indicated that they can communicate with their doctor without feeling stereotyped or judged. However, despite these responses 48 per cent (n=24) of the patients reported they did not ask for the doctor to explain the medical terms or meanings they did not understand. This resulted in 46 per cent (n=23) of the patients not knowing the stage of their cancer.

Research limitations/implications

– This is only a pilot study and the sample was limited to 50 patients. The limitations of this study make the results of the findings more suggestive rather than definitive. Further research would benefit by repeating this study with a larger sample size, to address the shortcomings of the study and to venture further into the realm of doctor and overseas patients communication in Australia.

Practical implications

– This research found that patients from lower socioeconomic backgrounds for whom English is not their first language have low levels of medical literacy and therefore require additional written information about their illness and treatment such as informative brochures, educational booklets and educational videos on their illness.

Originality/value

– To the knowledge, this is the first study that focuses on ethnic Australian urological cancer patients and their doctor-patient communication.

Systematic review of peer-support programs for people with cancer

OBJECTIVE

To identify models of peer support for cancer patients and systematically review evidence of their effectiveness in improving psychosocial adjustment.

METHODS

CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE and PsychINFO databases were used to identify relevant literature published from 1980 to April 2007. Data on characteristics of the peer-support program, sample size, design, measures, and findings were extracted and papers were also rated with respect to research quality (categories 'poor', 'fair' or 'good').

RESULTS

Forty-three research papers that included data from at least 1 group were reviewed in detail, including 26 descriptive papers, 8 non-randomized comparative papers, and 10 papers reporting eight randomized controlled trials (RCTs). Five models of peer support were identified: one-on-one face-to-face, one-on-one telephone, group face-to-face, group telephone, and group Internet.

CONCLUSION

Papers indicated a high level of satisfaction with peer-support programs; however, evidence for psychosocial benefit was mixed.

PRACTICE IMPLICATIONS

One-on-one face-to-face and group Internet peer-support programs should be given priority when considering ways to offer peer support. Nevertheless, the other models discussed in this review should not be dismissed until further research is conducted with a wide range of cancer populations.

Issues and concerns of young Australian women with breast cancer

GOALS OF WORK

Young women tend to experience many similar issues to that of their older counterparts, although more negatively and intensively. However, they also have specific concerns, which are not so apparent in studies that include a wide age range of participants. The aim of this study was to identify and explore the issues and concerns of Australian women diagnosed with breast cancer before age 41 years.

PARTICIPANTS AND METHODS

We conducted in-depth, semi-structured interviews with a self-selected, convenience sample of 35 Australian women with breast cancer, diagnosed at 40 years of age or younger and no more than 4 years previously. Themes found within the literature about 'younger' women up to 50 years of age provided guidance to the interviews. The audiotaped interviews were transcribed verbatim. The data were analysed using the basic analytical principles of data reduction, data display and drawing conclusions. The data were initially subdivided according to the literature-derived themes. Content analysis was performed on the categories developed, revealing the most pressing concerns of participants.

MAIN RESULTS

Second to fear of recurrence and future uncertainty, children and family were the most commonly reported major personal concern. Consumer-related issues and concerns for children and family were equally reported as the greatest general concern of young women with breast cancer. The greatest unmet need of participants was support.

CONCLUSIONS

Age-appropriate information and support for this group of young women with breast cancer remains a challenge. This paper suggests ways young Australian women with breast cancer can access additional support with the use of technology.