Not all women with breast cancer benefit from participation in discussion groups with other breast cancer patients, according to a new study.
For women whose spouses are not supportive, participation in peer-support groups can help improve women's ability to cope and function with their illness on a daily basis. However, for those who have adequate support at home, participation in these groups may actually make things worse.
"In the instance of cancer, as well as other stressful life events, it is likely that a portion of people receive effective support from their social network and may not benefit from a peer-discussion group," said lead author Vicki S. Helgeson, PhD. "In fact, it appears from this study that women who started out satisfied with the level of emotional support received from their partner actually deteriorated over time in physical functioning when assigned to a peer-discussion group."
The researchers from Carnegie Mellon University and the University of Pittsburgh report their findings in the current issue of Health Psychology.
The researchers randomly assigned 230 breast cancer patients to an educational support group, a peer-discussion group, or a control group that received usual medical care. Women in the education group heard weekly presentations on nutrition, chemotherapy side effects, or other topics related to breast cancer. Women in the peer-support groups met weekly and discussed their experiences and feelings about the disease.
Before and after the eight-week program, all the women completed standard psychological inventories designed to measure the level of support they received from their spouses and physicians, their level of self-esteem and sense of control over their symptoms and emotions, and their ability to function physically and mentally on a daily basis.
Women who reported low levels of support and more conflict with their spouses at the start of the study benefited from the education and peer-support groups, according to the researchers. These women functioned better on a daily basis over time, in contrast to those in the control group, who did worse.
However, among women who reported adequate levels of support and little conflict with their spouses at the beginning of the study, the results were quite different. Those who heard the educational lectures functioned no better on a daily basis than did women in the control group, while those who participated in the peer-support group actually did worse over time.
How could participation in a support group lead to poorer daily functioning in some women? The researchers suggest that with exposure to the weekly discussions, women who previously saw their relationships as helpful may have had a chance to re-evaluate them. Alternatively, participation in the discussion groups may have spurred the women to discuss their experiences and feelings more at home, leading to more conflict with their spouses.
The educational groups, in contrast, do no harm and definitely benefit many women whose partner's or physicians are not fully supportive. "The resources provided by the educational group interventions seem to meet the largest portion of women's needs," said Helgeson. "Health care professionals could either offer the educational intervention to all women with breast cancer or minimize costs and resources and only target the group with the lowest personal resources."
Health Psychology is the official, peer-reviewed research journal of the Division of Health Psychology (Division 38), American Psychological Association. For information about the journal, contact David Krantz, PhD, at (301) 295-3273.
Posted by the Center for the Advancement of Health < http://www.cfah.org >. For information about the Center, call Petrina Chong, < pchong@cfah.org > (202) 387-2829.
Journal
Health Psychology