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Before referring your patients to disease-related support groups, you may want to assess their personal social networks. A study of women with breast cancer indicates that those with strong social networks and a supportive clinician may not benefit from emotional support groups. In fact, some patients actually may deteriorate from this kind of counseling.
Preliminary results of a five-year study of 312 women diagnosed with breast cancer indicate that breast cancer patients receive little benefit from peer support groups and may experience adverse affects. "This holds most true for women with strong social supports from spouses, friends, and family, and a good relationship with their oncologist," says Vicki Helgeson, PhD, associate professor of psychology at Carnegie Mellon University in Pittsburgh, who presented the study findings at the recent Society of Behavioral Medicine meeting in New Orleans.
The women were interviewed when they first started chemotherapy. The assessment tool evaluated overall physical function, social function, and bodily pain. Women were randomly assigned to a health education or a peer discussion group. They were interviewed again when the groups ended, about three months later. Women will be interviewed annually up until their fifth anniversary.
Women in the education group attended informative sessions presented by health care professionals. Speakers discussed the side effects of chemotherapy, taking care of oneself after chemo therapy, nutrition and body image, sexual functioning, and breast cancer follow-up care. "The first thing we found was that people assigned to the education group experienced improved physical function and positive psychological effects that seemed to hold over time," Helgeson says.
The peer discussion group was facilitated by an oncology nurse and an oncology social worker to avoid the spread of misinformation, she says. "We found that women with little support at home benefited from the peer discussion group, but women who reported strong support at home at the beginning of the study were adversely affected by the peer discussion group. Women in the peer discussion group also reported more negative interactions with family and friends.
"We were surprised that women who had happy social networks were unhappy at the end of their support group counseling. It's possible that the support group altered the women's perceptions of their social networks," she says. "This may have happened because support groups tend to exclude a partner or spouse, and this exclusion may make the partner feel isolated and less involved in the recovery process."
Helgeson suggests case managers consider the composition of individual support groups and the individual patient's psychosocial needs before recommending a peer support group. "We monitored several groups and realized quickly that patients could acquire misinformation. Look for groups facilitated by a health care professional who will control the spread of potentially harmful misinformation," she suggests. And look at whether the groups allow family and friends to attend. "We didn't, but some groups do. It is possible that a woman might experience fewer negative interactions with her partner if the partner attends the support group with her."