The Perception of Support Received from Breast Care Nurses by Depressed Patients Following a Diagnosis of Breast Cancer

Abstract

Ann R Coll Surg Engl 2009; 91: 43-45 43Maguire et al. 1 were the first to show that a specialist nurse could reduce psychological morbidity following diagnosis of breast cancer, and the role of the breast care nurse (BCN) was developed in response. Further evaluation confirmed that the BCN can identify patients at risk of distress and provide effective emotional support.2-5 As a third or more of patients are clinically depressed or anxious immediately after diagnosis, 6-8 the BCN is now a key member of the breast multidisciplinary team 9,10 and often cited by patients as their most valuable contact. 11The role of the BCN has evolved and now includes many technical clinical roles such as seroma draining, patient follow-up and management of lymphoedema. ABSTRACT INTRODUCTION Due to their specialist training, breast care nurses (BCNs) should be able to detect emotional distress and offer support to breast cancer patients. However, patients who are most distressed after diagnosis generally experience least support from care staff. To test whether BCNs overcome this potential barrier, we compared the support experienced by depressed and non-depressed patients from their BCNs and the other main professionals involved in their care: surgeons and ward nurses. PATIENTS AND METHODS Women with primary breast cancer (n = 355) 2-4 days after mastectomy or wide local excision, selfreported perceived professional support and current depression. Analysis of variance compared support ratings of depressed and non-depressed patients across staff types. RESULTS There was evidence of depression in 31 (9%) patients. Depressed patients recorded less surgeon and ward nurse support than those who were not depressed but the support received by patients from the BCN was high, whether or not patients were depressed. CONCLUSIONS BCNs were able to provide as much support to depressed patients as to non-depressed patients, whereas depressed patients felt less supported by surgeons and ward nurses than did non-depressed patients. Future research should examine the basis of BCNs' ability to overcome barriers to support in depressed patients. Our findings confirm the importance of maintaining the special role of the BCN.

Incurable, invisible and inconclusive: watchful waiting for chronic lymphocytic leukaemia and implications for doctor-patient communication

“…The value of cancer specialist nurses has also been demonstrated in providing emotional support and advocacy (Ambler et al . 1999; The London and South East Lung Cancer Forum for Nurses 2004; Lewis & Anthony 2007; Worster & Holmes 2008), supporting depressed patients (Clark et al . 2009), liaising with other professionals to ensure coordinated care (Amir et al .…”

“…A review of studies of nurse-patient interactions in cancer care found evidence that specialist nurses are very effec-tive information providers for cancer patients and that patients may prefer nurses as information providers at specific stages of their treatment and especially concerning symptom management (Koutsopoulou et al 2010). The value of cancer specialist nurses has also been demonstrated in providing emotional support and advocacy (Ambler et al 1999; The London and South East Lung Cancer Forum for Nurses 2004; Lewis & Anthony 2007;Worster & Holmes 2008), supporting depressed patients (Clark et al 2009), liaising with other professionals to ensure coordinated care (Amir et al 2004;The London and South East Lung Cancer Forum for Nurses 2004;Tarrant et al 2008;Ream et al 2009) and providing continuing support after discharge from hospital (Griffiths et al 2007).…”

Patients’ sense of relationship with breast cancer surgeons: The relative importance of surgeon and patient variability and the influence of patients’ attachment style

“…Reasoning that effective clinical relationships need positive images of both self and other [12], we predicted that, as in mental health care [13], patients reporting the strongest relationships with their surgeons would be those with secure attachment. Clinical relationships in cancer care are compromised by patients' depression [14] which can be associated with attachment style [15] and which we therefore measured as a possible confounding variable.…”

Advanced breast cancer clinical nursing curriculum: review and recommendations

“…Along these lines, the expert panel considered that psychological care should be multidisciplinary (Agreement: 100 %; LE/DR: √). The ABCCN should pay attention to psychological considerations for patients and their families throughout the process, and engage in good communication with them, providing appropriate information at each point in the process (Agreement: 100 %; LE/DR: 4/D) [9, 15, 16]. Also, it is recommended that the ABCCN monitors patients’ anxiety levels, so that psychological abnormalities that must be addressed by mental health professionals could be early detected (Agreement: 100 %; LE/DR: 4/D) [17].…”