Professional Support for

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Professional Support for Specialist Breast
Nurses Issues and response Professor Suzanne
Chambers, PhD Cancer Council Queensland Griffith
University
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Context

• Role to facilitate better continuity of care and
  psychosocial support for women with breast cancer
• Increasing complexity of breast cancer care
• Up to one third of women with breast cancer
  experience clinically high distress
• Distress higher in some groups (e.g. younger
  women)

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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• The SBN provides patient support, education,
  psychological support, a liaison person many,
  many roles. SBN
• They provide wonderful support and advocacy
  for the client and her support people that helps
  them, the client and their family, to cope with
  their diagnosis and to understand whats
  happening and where to go ... its the SBN who
  can help to make that pathway of their diagnosis
  and treatment easier. HP

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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• Her role as that of patient advocate, in a
  coordinating fashion in many ways and keeping
  an eye on how the patient is coping and fairing
  and information they are receivingbeing a
  conduit for the concerns of the patient so that
  she is able to feed back to the appropriate
  people if theres a problem HP

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Challenges

• Caring work and specific stressors related to
  working with cancer patients leads to risk of
  compassion fatigue
• Poorly defined role
• Ambiguity about breadth and depth or identity
• Role ambiguity contributes to stress and burnout

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Influencing Factors

• Peer, supervisor and organisational support may
  mediate the relationship between work-related
  stress and burnout
• Role commitment, perceived job control and job
  autonomy can buffer against burnout
• Staffing levels, administrative support and
  doctor-nurse relationships also play a role

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Queensland Issues

• geographic dispersion
• difficult to support each other

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Peer Mentoring as a solution?

• Partnership between Cancer Australia, Queensland
  Health, Cancer Council QLD and Griffith
  University
• Phase 1 Scoping and Needs Analysis
• Phase 2 Intervention

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Phase 1 Scoping and needs analysis

• Aim to explore the scope and practice of SBNs
  and the factors that facilitate or hinder their
  work and preferred sources of support
• In depth interviews with eleven SBNs and seven HP
  stake holders

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Table 1. The SBN position Major themes endorsed
by participants
Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Table 2. Enactment of the SBN role
Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Three Main Role Challenges

• time constraints
• isolation
• compassion fatigue

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Table 3. Practical support needs
Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Table 4. Psychosocial support needs as met at
present
Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Compassion Fatigue

• I did a survey at a conference which showed I
  was heading for burnout. We all talk about
  burnoutbut I hadnt thought of compassion
  fatigue as something that we were at risk ofwe
  often dont give ourselves permission to
  acknowledge the risk we need to recognise the
  need to look after ourselves SBN
• I hope I hit the right noteI do say to the
  women right from the beginning I never lie to
  you. If its bad, Im going to tell you its
  bad, if its good Im going to tell you its
  good. That can be really hard. SBN

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Isolation

• I dont like to burden others with the problems
  that I have. SBN
• I speak to other breast care nurses now and then
  and have a chat but I think its not fair to
  load things onto to breast nurses who were
  already dealing with their own patients... SBN

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Table 5. Common suggestions for SBN professional
peer support network
Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Phase 2 Intervene

• Website
• Seminar
• Teleconferences

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Web-site review

• SBNs perceived web-site to be useful tool for
  information sharing and peer support
• SBNs motivated to use web-site
• Web-site login difficult/ deterred participation

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Introductory Seminar

• Stress management
• Time management
• Introduction to web-site

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Teleconferences

• Six held in August, October and December
• Professionally facilitated
• Feedback positively
• Quantitative measures (e.g., perceived stress and
  psychosocial well-being) and in depth interviews
  will look at effectiveness

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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How does it help?

• Peer support
• SBN role discussion
• Case discussion
• Information sharing, e.g., upcoming seminars
• Peer/ HP referrals for other information
• Role enactment advice

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Future Considerations

• Regular teleconferences (monthly) to maintain
  network for support needs, both professional and
  psychosocial
• Supervision and counselling particular to the SBN
  needs
• Bi-annual seminar/ workshop for PD
• Discussion of SBN role and TX updates
• Interpersonal skills workshops to maintain/
  develop skills needed to develop and maintain
  appropriate relationships and contact with
  patients
• Web-site useful but needs easier and consistent
  access

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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• Often Im not sure what Ive done thats
• been so helpful, but people give you this
• great big smile and go You helped me so
• much, and I havent done much but its what
• they needed. SBN

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Benefit Finding Just for patients?

• In the face of adversity individuals may
• experience enhanced personal relationships a
• change in the perception of the self and
  finally,
• an altered philosophy of life

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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15th UICC Reach to Recovery International Breast
Cancer Support Conference
Brisbane, Australia May 12 15,
2009 www.reachtorecovery2009.org
www.reachtorecovery2009.org
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World Class Program

• Annette Stanton, PhD, Professor UCLAs Jonsson
  Comprehensive Cancer Center
• Sue Murray, CEO National Breast Cancer Foundation
• Mollie Williams, Director of Community Programs,
  Susan G. Komen for the Cure
• Stella Kyriakides, President Europa Donna Cyprus
• Mary Onyango, Executive Director, Kenya Breast
  Health Programme
• Marion Morra, M.A. Sc.D., Chair of the Board of
  Directors for the American Cancer Society
• Andy Miller, V.P. Programs and Policy, Lance
  Armstrong Foundation

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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Celebration of Hope
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Message Stick Relay Journey of Hope
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Additional Highlights

• Over 400 delegates already registered
  representing 39 countries
• Full day Specialist breast care nurses symposium
• Welcome reception at Parliament House
• Gala Conference dinner at City Hall
• Adventure Benefit Finding workshop on the
  Brisbane River

Professor Suzanne Chambers, PhDGeneral Manager,
ResearchCancer Council Queensland
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