The Effectiveness of a Ward-Based Nurse Counselling Service for Mastectomy Patients
Cancer of the breast is nowadays the commonest malignancy in women, over 20.000 new cases occuring each year in England and Wales alone1. Many of these women will still be treated initially by undergoing a mastectomy. Recent controlled studies2,3 have confirmed earlier beliefs, that 20–40% of women following mastectomy will suffer significant psychiatric morbidity in the form of an affective disorder (depression and/or anxiety). With such high numbers of women being psychiatrically disturbed a variety of approaches have been used to see whether intervention might relieve the distress. These have included prosthesis clinics4, mastectomy nurses5,6, post-mastectomy rehabilitation groups7, ex-patient volunteer counsellors8 and voluntary advice services such as the Mastectomy Association. Many of these interventions have been reviewed by Morris9 who has shown that whereas most believe they are effective, definite proof from properly controlled studies is still lacking. One study15 has shown that a specially trained mastectomy nurse who counselled patients in surgical clinics and in their own homes played a part in the lower incidence of psychiatric symptoms 18 months after surgery compared to the women who just received the normal surgical follow-up.
KeywordsCounselling Service General Health Questionnaire Crisp Index Mastectomy Patient Intensive Counselling
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- 1.Cancer Statistics Registration: England and Wales (1981).Google Scholar
- 5.G. P. Maguire, M. Tait, M. Brooke, C. J. Thomas, R. Sellwood, Effect of counselling on the psychiatric morbidity associated with mastectomy, Br. med. J. 281: U54--U56 (1980).Google Scholar
- 6.M. Baum, E. M. Jones, Mastectomy: Counselling removes patients’ fear, Nursing Mirror 148: 38–40 (1979).Google Scholar
- 7.L. Winick, G. F. bobbins, Physical and psychologic re-adjustment after mastectomy, Cancer 39: 478–4.86 (1977).Google Scholar
- 8.C. M. Reach to Recovery, Chapter 1, in: “Breast Cancer — Psychosocial aspects of early detection and treatment” P. Brand, P. VanKeep, ed. MTP Press Ltd, Lancaster (1978).Google Scholar
- 11.C. D. Spielberger, R. L. Gorsuch, R. E. Lushene, “Manual for the state-trait anxiety”, Consulting Psychologists Press, Palo Alto, California (1970).Google Scholar
- 12.S. Crown, A. H. Crisp, “Manual of the Crown Crisp Index”, Hodder and Stoughton, Sevenoaks, (1979).Google Scholar
- 13.D. P. Goldberg, “Manual of the General Health Questionnaire”, NFER Publishing Co, Windsor (1979).Google Scholar
- 14.H. J. Eysenck, S. P. G. Eysenck, “Manual of the Eysenck Personality Inventory” University of London Press, London (1974).Google Scholar