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 19 min (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
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Article Info
Publication History
Published online: June 03, 2010
Accepted:
April 6,
2010
Received in revised form:
April 1,
2010
Received:
October 28,
2009
Identification
Copyright
© 2010 Royal College of Nursing, Australia. Published by Elsevier Inc. All rights reserved.
