Collegian
Volume 17, Issue 3 , Pages 143-149, September 2010

How do Specialist Breast Nurses help breast cancer patients at follow-up?

  • Moyez Jiwa, MA, MD, MRCGP, FRACGP

      Affiliations

    • Curtin Health Innovation Research Institute, Curtin University of Technology, Perth, Western Australia, Australia
    • Corresponding Author InformationCorresponding author. Tel.: +61 8 92661768; fax: +61 8 9266 2608.
    • ,
  • Georgia Halkett, PhD, FIR

      Affiliations

    • WA Centre for Cancer and Palliative Care/Curtin Health Innovation Research Institute, Curtin University of Technology, Perth, Western Australia, Australia
    • ,
  • Kathleen Deas, PGrad Nurs, RN

      Affiliations

    • WA Centre for Cancer and Palliative Care/Curtin Health Innovation Research Institute, Curtin University of Technology, Perth, Western Australia, Australia
    • ,
  • Paul Ward, PhD, MA, BA

      Affiliations

    • Discipline of Public Health, Flinders University, Australia
    • ,
  • Moira O’Connor, PhD, MSc, BA(Hons)

      Affiliations

    • WA Centre for Cancer and Palliative Care/Curtin Health Innovation Research Institute, Curtin University of Technology, Perth, Western Australia, Australia
    • ,
  • Catherine O’Driscoll, PhD, MHM, BSc (Health Prom), RN

      Affiliations

    • Breast Centre, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
    • ,
  • Elizabeth O’Brien, RN, BSocSc, Dip Adv. Counselling

      Affiliations

    • Breast Centre, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
    • ,
  • Lisa Wilson, RN, Dip Pall Care

      Affiliations

    • Breast Centre, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
    • ,
  • Sholeh Boyle, RN, BNSc, MPH, TM

      Affiliations

    • Breast Centre, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
    • ,
  • Jody Weir, MBBS, Dip AppSc

      Affiliations

    • Breast Centre, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia

Received 28 October 2009; received in revised form 1 April 2010; accepted 6 April 2010. published online 03 June 2010.

Summary 

Background

As the proportion of survivors from breast cancer increases it is possible that follow-up care could be delivered wholly by generalists to relieve over subscribed hospital clinics. However, guidelines seldom take into account the nature of interactions between patients and health care professionals involved in hospital-based follow-up.

Methods

Consultations between four Specialist Breast Nurses (SBNs) and 21 consecutive women attending a hospital-based breast cancer follow-up clinic in Western Australia were audio recorded and subjected to a thematic analysis. Recording of consultations ceased with saturation of themes. We analysed the data with reference to theoretical frameworks which postulate that social support is a powerful factor in determining positive health outcomes. We also drew on theories focusing on biographical disruption, biographical reinforcement and biographical reinvention.

Results

The majority of participants were Australian born, married women in their sixties. The mean duration of the consultations was 19min (SD=7.5, min=8, max=43.5). A core theme was the established relationship between the woman and her SBN. Overall, the SBNs played an important role in facilitating the transition of patients by supporting the woman in adjustment to a new self-image and bodily functioning. The SBN accompanies each woman through this phase in her life, while supporting a new narrative, promoting her ‘rebirth’ as someone with ideas, concerns and expectations that have altered significantly after the diagnosis of cancer. Five key themes emerged to demonstrate this supportive role: normalising; facilitating access to services; prevention; promoting self-esteem and promoting a proactive approach.

Conclusions

Many women with breast cancer claimed a new perspective on what was now possible, acceptable or desirable in a host of life domains. Our data suggest that the follow-up care of cancer patients is more than just dealing with a checklist of symptoms but requires an understanding of the biographical disruption occasioned by a diagnosis of breast cancer.

Keywords: Breast cancer, Breast Cancer Nurse, Follow-up, Biographical disruption

 

PII: S1322-7696(10)00022-3

doi:10.1016/j.colegn.2010.04.003

Collegian
Volume 17, Issue 3 , Pages 143-149, September 2010

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