title: Preparing breast cancer patients for survivorship (PREP) - a pilot study of a patient-centred supportive group visit intervention.
abstract: OBJECTIVE
  The process of breast cancer follow-up has psychosocial benefits for patients, notably reassurance, although attending hospital appointments can increase anxiety. Discharge from hospital follow-up can also invoke anxiety as many patients seek reassurance from continued specialist follow-up. Inevitably, due to increased survival and associated resource issues, opportunities for follow-up and support will be reduced. We delivered and evaluated an intervention which supported the transition from cancer patient to cancer survivor, for breast cancer patients being discharged to primary care.
  
  
  METHODS
  We delivered and evaluated a pilot of a patient-centred group intervention 'Preparing Patients for Discharge', aimed at reducing distress. Between January and September 2008, 172 participants were recruited and 74 (43%) expressed an interest in participating in the intervention; 32 of 74 took part, and participated in its evaluation using a semi-structured evaluation questionnaire, standardized measures [Hospital Anxiety and Depression Scale (HADS) and Clinical Outcomes for Routine Evaluation (CORE)] and independent qualitative interviews.
  
  
  RESULTS
  The qualitative analysis of questionnaire data indicated key factors were 1) shared experience, 2) support and reassurance, and 3) positive views about cancer and being discharged. The interview data revealed that the intervention enabled participants to: share experiences, focus on emotional needs, and have open discussions about recurrence, while increasing confidence in being discharged and using alternative support services. However, no significant differences were found in pre-post-interventions scores of HADS and CORE.
  
  
  CONCLUSIONS
  Providing a structured group intervention approach for breast cancer patients offers an early opportunity to support cancer survivors and facilitate and encourage self-management.
authors.affiliation: Academic Unit of Primary Medical Care, University of Sheffield, Sam Fox House, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK. Electronic address: j.thompson1@sheffield.ac.uk.
authors.forename: Joanne
authors.initials: J
authors.lastname: Thompson
authors.affiliation: Academic Unit of Clinical Oncology, University of Sheffield, UK.
authors.forename: Rob
authors.initials: R
authors.lastname: Coleman
authors.affiliation: Academic Unit of Primary Medical Care, University of Sheffield, Sam Fox House, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Colwell
authors.affiliation: School for Health and Related Research, University of Sheffield, UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Freeman
authors.affiliation: Academic Unit of Clinical Oncology, University of Sheffield, UK.
authors.forename: Diana
authors.initials: D
authors.lastname: Greenfield
authors.affiliation: Cancer Support and Information Centre, Sheffield, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Holmes
authors.affiliation: Academic Unit of Primary Medical Care, University of Sheffield, Sam Fox House, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK.
authors.forename: Nigel
authors.initials: N
authors.lastname: Mathers
authors.affiliation: Academic Unit of Surgical Oncology, University of Sheffield, UK.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Reed
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010351:Patient Discharge; D018802:Patient-Centered Care / Q000458:organization & administration; D010865:Pilot Projects; D011584:Psychology; D012648:Self Care / Q000379:methods* / Q000523:psychology; D012944:Social Support; D013315:Stress, Psychological; D017741:Survivors / Q000523:psychology*; D013997:Time Factors
keywords: Breast; Cancer; Follow-up; Group visit intervention; Oncology; Self-management