Who utilises cancer support groups

1
Who utilises cancer support groups?

• Gunn Grande SNMSW, The University of Manchester
• Lynn Myers Unit of Health Psychology, University
  College London
• Stephen Sutton GPPCRU, University of Cambridge

2
Benefits of support groups

• Literature reviews of benefits of self-help
  groups and non-directive professionally led
  groups
• Participation associated with improved
  quality of life and, possibly, survival (van den
  Borne et al, 1986, Hogan et al, 2002, Spiegel et
  al, 1989)
• Literature review of RCTs of psychosocial
  interventions, including support groups
• Participation associated with improved
  emotional and functional adjustment, symptoms and
  global health (Meyer and Mark, 1995)

3

• Very few patients utilise support groups
• (Taylor et al, 1986, Luke et al, 1993)
• Many patients who may benefit from participation
  may currently not access groups
• By understanding the factors associated with
  support group participation, we may be able to
  increase appropriate support group utilisation

4

• Literature review
• 11 studies found since 1980 investigating
  differences between participants and
  non-participants of non-directive cancer support
  groups

5
Findings from review (I)

• Support group participants
• Female
• Higher socio-economic status
• Younger
• Clinical variables unclear
• Informal support unclear

6
Findings from review (II)

• Support group participants
• More likely to use other formal support
• More anxiety and non-physical problems
• More fighting spirit/low helplessness and
  information seeking

7
Leventhals self regulatory model of illness
behaviour

• Perceived control over illness or symptoms
• Problem focused coping, support seeking and
  cognitive reappraisal
• Emotional response to illness
• Support seeking

8
Theory of planned behaviour

• Positive beliefs about the outcomes of the
  behaviour
• Significant others hold positive views of the
  behaviour
• Beliefs about ability to carry out the behaviour

9
Hypotheses

• Support group participants
• Female, younger, higher SES
• Different in terms of informal support
• More formal support
• Greater perceived control over cancer
• More distress over cancer
• More adaptive coping
• More positive beliefs about support groups
• Beliefs of significant others towards groups more
  positive
• Greater ease of joining a group

10
Design

• Cross-sectional study
• Postal survey

11
Recruitment

• Support group participants
• Cancer patients who were members of the Cambridge
  Cancer Help Centre, a community peer support
  group
• Comparison group
• A random sample of local adult cancer patients
  from the East Anglian Cancer Registry

12
Data collection

• Demographic and clinical variables
• Formal and informal support (Multidimensional
  Scale of Perceived Social Support)
• Perceived control over cancer and emotional
  response (IPQ-R)
• Coping strategies (Brief COPE)
• Theory of Planned Behaviour (designed for study)

13
Response rates

• Support group sample
• 63 (61) of 103 questionnaires returned
• Comparison sample
• 44 (22) of 199 questionnaires returned by GP
  (not forwarded to patient), 44 of 155 (28)
  returned by patients

14
Findings
15
Demographic and clinical variables

• Support group members
• Younger
• Higher education
• More likely to be women
• Less likely to be married
• More likely to have breast cancer
• Used more formal support options

16
Informal support score (MSPSS, medians)

17
Illness perceptions (IPQ-R medians)


18
Adaptive coping (Brief COPE)






19
Beliefs about support groups (7 item scale,
medians)
All plt0.001
20
Beliefs of others and behavioural control (7
point scale, medians)



21
Multivariate logistic regression
Support group members were more likely to have
Positive beliefs about support groups
Beliefs that others held positive beliefs about
groups Active approach to coping Support
group members were less likely to have Support
from special other
22
Limitations and improvements

• Cross sectional design Prospective study
• Improvement of study measures
• Beliefs derived from UK patients
• Personal relevance of support groups
• Access issues
• Format of support groups

23

• Greater Manchester follow up study
• Qualitative interview study of support group
  members and non-members
• Knowledge, beliefs and opinions about support
  groups
• Relevance of support groups to own needs
• Access
• Usefulness of different support group formats

24
Outcomes

• Feedback to cancer support groups and health
  professionals
• Improvement of study measures for prospective
  study
• Collaborative research with the Macmillan
  Research Unit