Specialist nurse counsellor interventions at the time of diagnosis of breast cancer: comparing 'advocacy' with a conventional approach

Over recent years, specialist breast care nurses have become increasingly r ecognized as core members of any breast care team within the UK, Part of th e role is to support patients at the highly stressful stage of receiving a diagnosis. This paper describes an 'advocacy' style of nurse counsellor int ervention which aims to improve patients' preparation for, and involvement int the diagnostic consultation and provides a framework for future counsel ling support. One hundred and three women undergoing surgery following diag nosis of breast cancer or a benign breast lump were supported using either this advocacy intervention or a more conventional model of care. The aim wa s to identify the most effective and appropriate method of intervening at t his important stage. Assessment took place before surgery, with 2-week and 6-month follow-ups, and included the Hospital Anxiety and Depression Scale, Rotterdam Symptom Check List and semi-structured interviews addressing per ceived quality of care, involvement in decision-making and psyche-social fu nctioning. Whilst the results of many measures were similar for women in th e two intervention groups, qualitative data support the implementation of t he advocacy method by the breast care nurse.