title: Together and apart: providing psychosocial support for patients and families living with brain tumors.
abstract: OBJECTIVE
  Brain tumors are associated with neurological sequelae and poor survival, contributing to distress in patients and their families. Our institution has conducted separate support groups for brain tumor patients and caregivers since 1999. This retrospective cohort study aimed to identify characteristics of brain tumor group participants in relation to attendance frequency, and compare themes of discussion in patient and caregiver groups.
  
  
  METHODS
  Demographic and medical characteristics were obtained from patient and caregiver group registration sheets and medical chart review. We quantified discussion topics recorded by group facilitators between 1999 and 2006, extracted themes, and examined similarities and differences in the way these themes were expressed.
  
  
  RESULTS
  A total of 137 patients and 238 caregivers attended the groups; about half attended more than one session. The chart review of a randomly selected subset of patient participants revealed that 57.5 % were married, 58.8 % had high-grade gliomas, and 55 % attended their first group within 3 months of diagnosis or at tumor progression. Both groups discussed physical and cognitive consequences, emotional reactions, relationships, coping, end of life, and practical issues. Caregivers discussed difficulties achieving self-care and caregiver burden.
  
  
  CONCLUSIONS
  Brain tumor support group facilitators can expect to encounter a range of medical and psychosocial issues in accommodating patients' and caregivers' diverse concerns. Separate brain tumor patient and caregiver groups may allow participants to explore those concerns without worrying about effects on their friends or family. It remains to be seen whether the groups meet the needs of attendees, and whether those who do not attend the groups have unmet needs.
authors.affiliation: Pencer Brain Tumor Centre, Princess Margaret Cancer Centre, 610 University Ave Room 18-714, Toronto, ON, M5G 2M9, Canada, cheryl.kanter@uhn.ca.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Kanter
authors.forename: Norma Mammone
authors.initials: NM
authors.lastname: D'Agostino
authors.forename: Maureen
authors.initials: M
authors.lastname: Daniels
authors.forename: Alyson
authors.initials: A
authors.lastname: Stone
authors.forename: Kim
authors.initials: K
authors.lastname: Edelstein
mesh_terms: D000293:Adolescent; D000368:Aged; D001932:Brain Neoplasms / Q000523:psychology* / Q000628:therapy*; D017028:Caregivers / Q000523:psychology*; D015331:Cohort Studies; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D020380:Needs Assessment / Q000458:organization & administration; D011613:Psychotherapy / Q000379:methods / Q000458:organization & administration; D012189:Retrospective Studies; D012657:Self-Help Groups; D012944:Social Support