Peer support for women with breast cancer: the role of empathy and self‐disclosure

This study examined how women with breast cancer perceived different styles of peer helping. Forty recently diagnosed breast cancer patients evaluated three audiotaped conversations between a breast cancer patient and an (ex‐patient) volunteer helper; the conversations differed in terms of the empathy and self‐disclosure offered by the helper. The findings supported the first hypothesis, that a helping style involving high self‐disclosure would be positively evaluated only in the presence of high empathy. However, the findings did not support the second hypothesis, that in conversations where high empathy is present, a helping style involving high self‐disclosure would be evaluated more positively than one involving low self‐disclosure. Qualitative data suggested that the helper's ability to listen to the patient and the helper's appropriate sharing of her own experience of breast cancer were both perceived as important components of effective helping. Implications for the training and practice of volunteer helpers are discussed. Copyright © 1999 John Wiley & Sons, Ltd.     

The role of social support in women’s health and recovery processes

The aim of this study was to assess the psychological state of women who have undergone surgery for breast cancer or cardiac surgery, including examination of the role of social support in both groups. The study included 48 women (mean age: 66.04?±?8.3 years). They were divided into two groups according to diagnosis: 23 women (mean age: 69.2?±?8.6 years) who underwent heart surgery (cardiac group, CG) and 25 women (mean age: 63.2?±?7.0 years) treated for breast cancer and associated with the Women After Mastectomy Club (oncology group, OG). In addition to the assessment of socio-demographic variables, the following self-report questionnaires were administered: Satisfaction with Life Scale, Acceptance of Illness Scale, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory as well as Berlin Social Support Scale. In the CG, the severity of depressive symptoms was two times higher than in OG (p?=?.003). In both groups, there was a high percentage (80%) of women with severe symptoms of anxiety (p?=?.37). In both groups, the level of life satisfaction was similar (p?=?.58), but OG was characterized by a higher level of acceptance of the disease (p?=?.003). The correlation analysis showed that in both groups, social support was related differently to the parameters of emotional state. Women treated for breast cancer were in a better mental condition than women treated for heart disease. The support coming from other women in similar circumstances (Women After Mastectomy Club) seems to be more effective than the support coming from the patient’s immediate environment. The results for social support ought to be interpreted not only through the prism of mean values of received support, but also with regard to the information on the sources of support.     

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

While young women have been found to be at additional risk for psychological morbidity after a breast cancer diagnosis, their specific needs in relation to support are not well described. A community development approach was utilized to develop the Young Women's Network, a peer support programme for young women who have been diagnosed with breast cancer that addresses their specific psychological and social needs. Central to this approach was the key role of the target group in both the definition of the problem and the generation of the solutions. This article describes the steps involved in developing this programme and guidelines for health professionals and community members who may wish to replicate either the Young Women's Network or this particular approach to programme development. Copyright © 2001 John Wiley & Sons, Ltd.     

Peer victimization and social‐emotional outcomes: The role of teacher and peer support

The relation between peer victimization, risk of social, emotional, and behavioral difficulties, and school‐based sources of social support for students in elementary and middle school were examined. Participants included 656 students in third to eighth grade from one school district. Results indicated that peer support mediated the relation between peer victimization and risk of social, emotional, and behavioral difficulties, but teacher support did not mediate this relation. Conditional indirect effects analyses revealed that the indirect effect of peer support varied as a function of school level (i.e., intermediate and middle school). The implications and limitations of the current study are discussed, as well as directions for future research.

     

Hope and social support utilisation among different age groups of women with breast cancer and their spouses

Objective: Social support and hope are considered positive, important contributors to psychological well-being for women with breast cancer and their spouses. Few studies examine the role of age in relation to these variables. The current study compares the relationship between social support, hope and depression among different age groups of women with advanced breast cancer and their healthy spouses.

Design: Cross-sectional sample of 150 women with advanced breast cancer and their spouses.

Main outcome measures: Social support, hope, depression and socio-demographic data. Analysis included comparison of these variables between groups of older and younger patients and their spouses. Structural equation modelling (SEM) was used to examine hope as a mediator of the relationship between social support and depression within each group (older and younger patients and spouses).

Results: Older patients and spouses reported lower levels of depression than younger ones. SEM showed that social support related directly to depression among younger women and older spouses, while hope was directly related to depression among older women and younger spouses and acted as a mediator between social support and depression.

Conclusions: Theoretical, empirical and clinical implications regarding the understanding of the role of age in coping with cancer are discussed.     

Perceived partner support and psychosexual adjustment to breast cancer

Support from a partner can play a key role in a woman's emotional adjustment to breast cancer. However, little is known about the influence of partner behaviours on a woman's sexual adjustment. This study examined the prospective relationship between baseline levels of several types of perceived partner support (instrumental, informational, emotional and negative) and psychosexual adjustment (sexual functioning and relationship satisfaction) over the course of 12 months post-surgery in a sample of 130 women with breast cancer. Results indicated that perceptions of greater emotional and informational support from the partner at baseline were associated with less sexual difficulties among breast cancer patients concurrently and 6 months post-surgery. Baseline perceptions of greater emotional and instrumental support from a partner were associated with greater relationship satisfaction at all time points. Perceptions of informational support at baseline were related to greater concurrent relationship satisfaction. Baseline perceptions of negative partner support were related to less relationship satisfaction, but only concurrently. These findings suggest that the perception of a partner's provision of emotional, instrumental and informational support may each play a role in facilitating sexual adjustment and relationship satisfaction.     

Development and Evaluation of a Decision Aid for BRCA Carriers with Breast Cancer

BRCA+ breast cancer patients face high risk for a second breast cancer and ovarian cancer. Helping these women decide among risk-reducing options requires effectively conveying complex, emotionally-laden, information. To support their decision-making needs, we developed a web-based decision aid (DA) as an adjunct to genetic counseling. Phase 1 used focus groups to determine decision-making needs. These findings and the Ottawa Decision Support Framework guided the DA development. Phase 2 involved nine focus groups of four stakeholder types (BRCA+ breast cancer patients, breast cancer advocates, and genetics and oncology professionals) to evaluate the DA's decision-making utility, information content, visual display, and implementation. Overall, feedback was very favorable about the DA, especially a values and preferences ranking-exercise and an output page displaying personalized responses. Stakeholders were divided as to whether the DA should be offered at-home versus only in a clinical setting. This well-received DA will be further tested to determine accessibility and effectiveness.     

The influence of breast cancer survivors' Perceived partner social support and need satisfaction on depressive symptoms: A longitudinal analysis

The present study examines the ways in which breast cancer survivors’ perceptions of emotional and instrumental social support from an intimate partner and need satisfaction in their partner role influence depression during and after breast cancer treatment. Our sample was comprised of 163 women who were an average of 57 years old, mostly White/Caucasian, and diagnosed primarily with early-stage breast cancer. Longitudinal data were analysed using both multilevel and structural equation modelling. Results reveal that (a) greater perceived partner emotional support is associated with lowered levels of depression at each wave, (b) partner-role need satisfaction mediates the relationship between perceived partner emotional support and depression at each wave, (c) perceived partner emotional support predicts subsequent changes in depression by way of need satisfaction and (d) depression prospectively predicts lowered perceptions of partner emotional and instrumental support. The findings confirm that basic need satisfaction, within intimate relationships, is an important predictor of lowered depression among breast cancer survivors.     

The role of informal social support in needs assessment: proposal and application of a model to assess immigrants' needs in the south of Spain

Needs assessment models have been generally focused on the identification and prioritization of needs, analysing formal resources available in the community as possible solutions for existing problems. These kinds of models have assumed that formal services are the primary source of support for individuals in need. However, a great deal of the investigations in the field of Social Psychology have shown that the main source of help and support when facing a problem is not formal organizations, but people's own informal networks. In this article, we therefore propose a needs assessment model that emphasizes the importance of analysing both formal and informal social resources. The application of this model to assess Moroccan immigrants' needs in the south of Spain shows the anticipated low level of utilization of formal services and programmes, one that contrasts with the high use of informal networks as an essential source of social support for this group of immigrants. These results reveal the limitations of traditional needs assessment models, and the importance of incorporating the analysis of informal social support as a key resource for need satisfaction, particularly in the case of immigrant populations. Copyright © 2004 John Wiley & Sons, Ltd.     

Social Comparisons Among Women With Breast Cancer: A Longitudinal Investigation1

We examined social comparisons made by women with breast cancer who participated in peer‐support interventions. This setting. in which participants were exposed to similar others, allowed for a longitudinal investigation of the frequency, antecedents. and consequences of social comparison. Consistent with the literature, the majority of comparisons were made to worse‐off others (downward), and the majority of comparisons were associated with positive affect (positive comparisons). Low self‐esteem. low internal locus of control, and high illness uncertainty were associated with making more negative comparisons. In addition, negative comparisons were associated with a decrease in perceived control and an increase in uncertainty over time. whereas positive doanbard comparisons were associated with an increase in self‐esteem. Implications for support groups are discussed.     

‘Them’ and ‘us’: The experiences of women with metastatic disease in mixed-stage versus stage-specific breast cancer support groups

The objective of this study was to explore the experiences of women with metastatic breast cancer (MBC) in mixed-stage and stage-specific groups. Interpretative phenomenological analysis (IPA) was used to examine 15 interviews from eight women with MBC. The interviewees felt that their experiences were very much different from those of women with primary breast cancer (BC), because of their different prognoses. In mixed-stage groups, the interviewees described feeling silenced, marginalised and helpless. They did not receive support in these groups because survivors of primary BC are often afraid to face the idea of metastasis. In stage-specific MBC groups, on the other hand, women were able to talk openly and were understood by others with whom they identified. They became more informed about issues related to their illness. Seeing others living well despite MBC made them feel more hopeful. Although there are some disadvantages of participating in stage-specific groups, the findings suggest that, overall, stage-specific groups are more helpful to women with MBC than mixed-stage groups. These findings have implications for the provision of group support for this population.     

The Prophylactic Mastectomy Dilemma: A Support Group for Women at High Genetic Risk for Breast Cancer

The goal of this pilot study was to test the usefulness of a six session psychoeducational support group for women at high genetic risk for breast cancer who were considering prophylactic mastectomy. The themes of the group sessions included overestimation of and anxiety about risk; desire for hard data; the emotional impact of watching a mother die of breast cancer; concerns about spouse reactions; self- and body image; the decision-making process; and confusion over whom to trust in decision making. Both the participants and the multidisciplinary leaders concluded that as a supplement to individual counseling, a support group is a beneficial and cost-effective treatment modality. Recommendations for the optimal format for such a group are described.     

Gender Differences in Social Support for Socially Anxious Individuals

Given that social anxiety disorder is a common, chronic, debilitating disorder and socially anxious women appear to have different experiences related to social development and social support than men, it is essential that the gender differences in social anxiety and social support be understood. The present study examined perceived social support quantity and satisfaction in 23 women and 28 men seeking treatment for social anxiety disorder. Contrary to expectations, men and women did not differ on measures of social support. However, younger, unmarried women reported having smaller social support networks and less satisfaction with their social support networks than older, married women. Analyses of socially anxious men did not reveal such a pattern. The current study provides preliminary evidence that younger, single women have social support networks that are less satisfying than the social support networks of older, married women. Inclusion of social support modules within a cognitive behavioral treatment approach for social anxiety disorder may be warranted, particularly for young, unmarried women.     

Quality of life and mental health among women with ovarian cancer: examining the role of emotional and instrumental social support seeking

The purpose of the present study was to examine the role of emotional and instrumental social support seeking in the quality of life (QOL) and mental health of women with ovarian cancer. Participants were recruited through the Pennsylvania Cancer Registry, and one hundred women took part in a mail questionnaire that collected information on their demographics, medical status, social support seeking, QOL and mental health including anxiety, depression and stress. Hierarchical linear regression analyses were conducted to assess the influence of emotional and instrumental social support seeking on QOL and mental health. After controlling for remission status, greater emotional social support seeking was predictive of higher overall QOL, social/family QOL, functional QOL and lower depression scores. Instrumental social support seeking was not significant in the models. The results illustrate that social support seeking as a coping mechanism is an important consideration in the QOL and mental health of women with ovarian cancer. Future studies should examine the psychological and behavioral mediators of the relationship to further understand the QOL and mental health of women with ovarian cancer.     

An Interpretative Phenomenological Examination of Psychosocial Changes among Breast Cancer Survivors in their First Season of Dragon Boating

This study used an interpretative phenomenological perspective to qualitatively examine changes in body image and social support experienced by novice participants in breast cancer survivor dragon boating programs. Fourteen women were interviewed at the beginning and end of their first dragon boating season. The participants typically experienced increased perceptions of strength and fitness, and a shift towards discussing body image with respect to fitness, strength, and musculature rather than weight and appearance. Many women discussed an emerging athletic identity. Social benefits included connecting to women who understood the breast cancer experience and could share first-hand information. Some women also reported struggling with the constant reminder of being a survivor. Overall, breast cancer survivors experienced benefits, but further work should explore how they cope with challenges and how dragon boating could inform other physical activity contexts for this population.     

Successful Use of Peer Educators for Sharing Genetic Information

This study examined the impact of a genetics education module provided by Reach to Recovery peer volunteers. Participants included 113 women with confirmed breast cancer diagnoses. Eighty-eight of these women (78%) completed a baseline survey, participated in a peer-led intervention, and completed a follow-up survey. Approximately half of the women received an education module that included a genetic component, while the other half did not. Results indicated that women who received the genetics module had greater increases in genetics knowledge than the group that did not receive the module. However, follow-up interest in genetic testing was not significantly different between the two groups. Results indicate that a peer-led genetics module can increase knowledge about genetics. However, it does not appear to have a differential effect on genetic testing interest.     

Peer Victimization and Depressive Symptoms: Role of Peers and Parent–Child Relationship

The purpose of this study was to investigate the moderating role of parental and peer support and gender differences in the association between peer victimization forms and depressive symptoms. The sample included 261 youths (ages 10–14). Physical victimization rates were higher for boys, whereas girls reported higher emotional victimization experiences and higher peer support. Regardless of gender, a significant moderation effect indicated that physical victimization was significantly related to depressive symptoms among youths with lower peer support. There were significant main effects of parental and peer support for both genders. The findings contribute to the literature regarding the effects of peer victimization on mental health by illustrating the protective role of peer support against depressive symptoms.