Support Group Setting Research Articles

An Innovative Approach to Partnership in Asthma Care

Control of asthma symptoms is fundamental to asthma management. New asthma guidelines suggest that asthma control, for most patients, can be achieved through education aimed at improving management. This includes providing written asthma management plans from health care providers; instructions on proper inhaler use; education about early signs and symptoms of asthma, and how to respond appropriately; medication regimens that prevent misuse of medications; follow-up medical care for long-term management of asthma after any hospitalization due to asthma; and assistance with assessing and reducing exposure to environmental risk factors in patients’ home, school, and work environments. The Shared Medical Appointment (SMA) is a group appointment model that has the potential to change the management of children with asthma for the better by offering benefits to both the health care provider and the patient. The SMA for children with asthma and their caregivers is an innovative 90-minute medical appointment in which 4 to 9 patients and their parents are seen at the same time in a supportive group setting. In addition to having concerns and questions about asthma addressed, the SMA provides education on medications, monitoring symptoms, and the demonstration and distribution of devices. Supportive materials are provided and discussed and education is emphasized through open group discussion and the participation of both caregiver and child. A brief, focused medical examination is also conducted. In this study, the charts of children with asthma who attended an SMA were reviewed for specific asthma-related clinical outcomes as defined by the National Heart, Lung, and Blood Institute’s, Expert Panel Review-3 (NHLBI-EPR-3) in the 4-month period prior to attending an SMA and during the 4-month period after attending an SMA. The results showed that asthma education provided in an SMA, as compared with a usual appointment, resulted in a significant positive impact on asthma-related outcomes in meeting NHLBI-EPR-3 guidelines for asthma management.

Support Group Processes: Perspectives from HIV-Infected Women in South Africa

This study examined the experiences and perceived benefits of support group participation among HIV-infected women in South Africa. From a qualitative analysis of responses, key psychological processes through which support groups are potentially beneficial were identified. These processes included identification, modeling, acceptance, and empowerment. The participants' consequent life changes were explored in order to associate these processes with the positive outcomes of support group participation. Through understanding the relationship between the psychological processes within a support group setting and the potential benefits, and by targeting these processes in the development and implementation of future support group interventions, a framework is provided for achieving positive outcomes associated with support group participation.

Coping with the Ultimate Deprivation: Narrative Themes in a Parental Bereavement Support Group

Support groups are often used to help individuals cope with challenging and unusual life circumstances through narration. Yet, little is known about specific meta-communication within a support group setting and in what ways these interactions may benefit participants. This study uncovers narrative themes that were expressed during a series of support group meetings specific to bereaved parents. Three central narratives were revealed in the analysis including the death story narrative, coping/negotiating narrative, and connecting through communication with others narrative. This research underscores the vital outlet that the support group serves for participants and the communicative means by which subjective healing can occur.

The Group as a Community Social Change Agent: The Case of the Bedouin

The Bedouin community in the southern Negev desert in Israel is a population in transition. The article describes how deliberate intergroup dialogue enhanced the ability of a group of teachers from the community to discuss the complexities of the transition within a supportive group setting as a starting point to facilitate social change.

Family Roles in Homes With Alcohol-Dependent Parents: An Evidence-Based Review

The behavioral health care field has seen attempts to understand the functioning of families in which a parent is dependent on alcohol as a set of roles into which the other family members fall. The most popular of these classifications taught in the United States includes five roles (enabler, hero, lost child, mascot, and scapegoat) that are used to conceptualize families and individuals in treatment and support group settings, as well as in popular self-help literature. Attempts to operationalize and measure these roles have, however, been fraught with difficulties. The resulting research base has seen conflicting evidence for the support of such roles, as well as little work on diverse families. The evidence against such well-defined family roles, the questions surrounding their development, and the difficulties of applying such constructs in real-life situations (with numerous confounding factors and unknown associated conditions) may indicate that their clinical utility does not win out over the problems inherent with this manner of classification.

Ke ‘Ano Ola: Moloka‘i's Community-Based Healthy Lifestyle Modification Program

We evaluated a community-based 12-week healthy lifestyle program in Moloka'i, HI, called Ke 'Ano Ola, which was developed to decrease chronic disease risk through health education emphasizing weight loss, exercise, and risk factor reduction. Program leaders' strong commitment and positive role modeling, along with social and group support and community involvement, were key elements. A pre-post evaluation of weight, blood pressure, total cholesterol, and blood sugar showed significant improvements for weight (mean change [Delta] = -7.4 lbs; P < .001), systolic blood pressure (Delta = -3.8 mm Hg; P = .027), diastolic blood pressure (Delta = -4.6 mm Hg; P < .001), and total cholesterol (Delta = -9.7 mg/dL; P < .001). Attrition was low, with 89% of participants attending all 12 sessions. Our findings show that lifestyle improvements in a predominantly Native Hawaiian community are achievable in a support group setting.

Strengthening self-healing—Integrative approaches to cancer therapy with mind/body medicine

Cancer patients often perceive themselves as radically injured in their capacities to self-regulate their health and well being. Their mind literally feels betrayed by their bodies. This condition of hopelessness diminishes their self-efficacy and greatly adds to their suffering. At the Clinic for Naturopathy and Integrative Medicine in Essen we have developed an 11-week outpatient program in Mind/Body Medicine that empowers patients to regain responsibility for their own well being. In addition to their conventional therapies patients learn to use self-help strategies like regular exercise and a healthy diet as well as relaxation and mindfulness techniques. To most of our cancer patients the experience that through applying these measures in their daily lives they can positively influence their condition opens up a new dimension of well being, strength and hope. The mindful reflexion on self-harming cognitive processes and the practice of a more accepting and caring attitude towards themselves and others within a supportive group setting adds to this valuable experience. During the program many patients become able to truly change their lives. The presentation introduces the philosophy, context and content of the intervention and summarizes our research findings.

Amazon Heart: An Exploration of the Role of Challenge Events in Personal Growth After Breast Cancer

High-profile events where in response to the experience of breast cancer women take on adventure activities to raise awareness and/or funds for breast cancer are increasing. These activities offer physical and psychological challenges within a peer support group setting. We investigated the experiences of 21 breast cancer survivors who participated in a 7-day breast cancer awareness motorcycle ride. Assessments included a qualitative pre/postinterview, solicited diary, pre-6-month follow-up survey. Measures included satisfaction with life, distress, happiness, global well being, meaning in life. Motivators were a desire for peer support, to promote breast cancer awareness, enjoyment, and personal growth. The ride incorporated physical and emotional challenge. A positive peer support experience led to feelings of inner peace, accomplishment, self-learning, a positive perspective, and improved social support. For a minority of women peer support or recreational expectations were not met resulting in negative feelings. No significant changes were observed over time in adjustment measures. Adventure events where women undertake emotional and physical challenge in an environment of group peer support provide opportunity for personal growth. In this context, peer support may provide the catalyst for the experience to become transformational and so is critical to generating positive outcomes. Realistic expectations of the ride are also influential.

Storytelling Intervention for Patients With Cancer: Part 2—Pilot Testing

To evaluate symptom reports and the impact of a nurse-led storytelling intervention in a supportive group setting on mood, stress level, coping with stress, pain, self-efficacy, and satisfaction with life in patients with cancer. Descriptive pilot project using a pretest/post-test control group. Local regional medical center in the Pacific Northwest region of the United States. Convenience sample of 10 patients with various cancer diagnoses; 7 completed the intervention. Participants were randomly assigned to a storytelling or control group. Using a tool kit generated for this project, a nurse facilitator guided storytelling group participants in 12 1.5-hour sessions. Six instruments, symptom assessments, and a retrospective physician chart review were completed for each group. Data were analyzed using repeated measures analysis of variance. Mood, stress, coping, pain, self-efficacy, and satisfaction with life. Comparison of changes in group mean scores revealed a significant decrease in anxiety in the storytelling group despite disease progression. Documentation of psychosocial symptomatology by physicians is limited; however, nursing assessments were useful in determining psychosocial status before and after the intervention. Results can be viewed only in context of a feasibility study and are not generalizable because of a limited sample size. A trained oncology nurse was able to use the storytelling intervention. Initial results are promising and warrant further study. After additional testing, the intervention could be used to enhance storytelling groups for patients with cancer or for individuals who are uncomfortable in or do not have access to storytelling groups.

The fears of men in a prostate cancer support group: A pilot study

18616 Background: Little is published on prostate cancer patients’ fears and the effectiveness of interventional strategies. Methods: A 20-item questionnaire addressing various potential fears was administered to 30 men in a local prostate cancer support group: 15 had undergone curative therapy and were NED, and 15 had recurrent disease on androgen suppression. Level of fear for each question was rated from 1 to 5. At a later date, a different questionnaire was administered to 10 men with recurrent disease, addressing the predominant fear previously identified—uncontrolled symptoms at the end of life—with 10 specific questions on this subject. This was followed by the intervention: a 90 minute group discussion, led by an MD boarded in Medical Oncology and Hospice and Palliative Medicine. To assess impact, the 10 item questionnaire on end of life symptoms was readministered immediately after the discussion, and again 2 months later. Results: a) Patients with recurrent disease expressed a greater degree of fear than those free of recurrence; b) A major fear of the future is of uncontrollable symptoms at end of life, and was more of a concern than death itself; c) Of the 7 (of 10 total) items that were most significant to the patients (mean score 2.9 or higher, scale 1–5), a mean drop of 0.7 was seen in the level of fear following the intervention; d) This was inconsistently sustained 2 months later, with some concerns lessened but others not. Conclusions: In this small pilot study of men with prostate cancer, there appeared to be some measurable impact on the level of fear following the group discussion, though inconsistently sustained; questionnaires such as this are feasible to administer and appear to encourage productive discussion of difficult issues in the support group setting. No significant financial relationships to disclose.

The Framing Safety Project

This article describes the Framing Safety Project that the author developed to do collaborative, community action/education research with battered women about the meaning of safety in their lives. The project is built on the use of participant-generated photographs and photo-elicitation interviews as methods for exploring with women, in support group settings, the meanings of violence in their lives and their approaches to creating safer spaces. Although visual sociologists have used variations of these methods, particularly to study the experiences of children, the author combines them in a uniquely feminist approach that leads from the women’s photography and interviews to a community education and action component. The author describes the process of developing and implementing this project with Mexican and South Asian immigrant women and discusses the ways in which its methodological approach serves to amplify the voices of silenced women, and to offer opportunities for community education and social action.

A Support Group for Parents of Children with Hyperkinetic Disorder: An Empowerment Model

Parents face significant stresses and problems when their child suffers with a disabling condition, such as the hyperkinetic disorder. Empowering parents, by providing a facilitative social system, can help enhance their competence in coping with their child’s disability. The use of a support group setting format for this purpose is described. Perceived benefits included: (i) emotional support in sharing experiences with a peer group,(ii) reduction of the sense of isolation,(iii) provision of information on the management and services regarding the hyperkinetic disorders and (iv) better relations with their children because of increased knowledge.

Preparing feminist facilitators. Assisting abused women in transitional or support-group settings.

This article has reviewed one approach to the preparation of support group facilitators to enable them to better meet the needs of abused women. Those women may still be in abusive relationships or they may have left one; they may be unsure whether they are abused; or they may be seeking practical suggestions about ways to tackle a particular problem. Whatever their specific situations, they can benefit from a supportive, accepting, and safe environment in which to explore their options.

Bereavement services development in a rural setting.

Functioning as a hospital-based hospice program of a large medical center, bereavement services are not limited to hospice families in one location. Bereavement services are offered to those who died within the medical center and to the residents of the three county area the hospice serves. This paper identifies ways to offer bereavement follow-up to hospice and non-hospice families. This will include discussion of mixing together survivors of different types of death in a support group atmosphere. Due to the smaller population of a rural setting, the need to be creative to offer bereavement services to the community is imperative. This paper will discuss how our Bereavement Services have expanded in response to the needs of the communities in the three county area we serve. We will discuss survey results, meeting and support group data used to generate supporting information to allow our services to grow. Learning objectives for this article consist of readers being able to identify ways to develop and expand bereavement services; incorporating various types of death in a support group setting; and ways to better serve non-hospice families in need of bereavement follow-up. Topics include a description of Bereavement Services; Pre-Death Bereavement Intervention; Open and Closed Support groups; Routine Bereavement Follow-up of Hospice families; Quarterly Nursing Home Staff Support groups; Widow/Widower Brunch Social; opportunities to educate the community about Death/Dying; and data collection for Bereavement Needs.

Social support as an intervention withbereaved college students

Abstract The authors report on a social support group intervention to assist bereaved college students. Based on the Moos (1986) model of coping with life crises, the social support intervention was the chief component in a 2-year research project funded by the Prevention Research Branch of the National Institute of Mental Health. Each support group was facilitated by a graduate student in marriage and family therapy. Support groups met eight times over a course of 4 weeks. The authors discuss the structure of the social support intervention in detail and provide extended glimpses into four issues that emerged: (a) individual functioning and group process, (b) leader tolerance for emotional intensity, (c)managing ethical conflicts due to multiple roles, and (d) integrating didactic material in a support group setting oriented toward open expression of thoughts, feelings, and experiences.

Care-givers' support group: One hospice's approach

The Care-givers' Support Group has been a successful intervention in helping hospice family members work through the numerous emotional tasks with which they are faced in the dying process and in bereavement. This paper focuses on the significance of a support group setting as illustrated through case studies of hospice families.

Effects of Upward and Downward Social Comparison on Mood States

The impact of upward and downward social comparison on the mood states of high and low self-esteem persons was examined in a simulated support group setting. Subjects received bogus information indicating that a “group member” was either (a) facing minor problems adjusting to college and having difficulty coping with them (downward comparison condition), (b) facing minor problems and adjusting well (upward comparison), or (c) facing serious problems and coping relatively well with them. Results indicated that the downward comparison information improved the mood states of the low self-esteem subjects, but had little effect on the high self-esteem group. The opposite pattern of results was obtained in the upward comparison condition. In addition, both high and low self-esteem persons were encouraged by the information indicating that another person was coping successfully with rather severe problems. Results are discussed in terms of implications for social comparison theory and support groups.

Family involvement in the treatment of a psychiatric inpatient.

The short-term diagnostic and treatment unit at C. F. Menninger Memorial Hospital emphasizes maximum involvement of the family in the treatment process. Family members are required to accompany the patient to the preadmission interview and remain available for several days after admission. Frequent visits to the hospitalized patient are encouraged; they are followed three days a week by hour-long meetings involving several patients, their families, and staff. The meetings foster increased communication between patients and their families by providing a mutually supportive group setting in which family members can explore their feelings and ventilate their anxieties. Unit staff believe that involvement of the patient's family in treatment helps reduce the likelihood of recurrence of problems that precipitated hospitalization.

HIV/AIDS through the lens of Christianity: Perspectives from a South African urban support group

HIV is one of the most obscure viruses that humankind has had to face in recent times. Compounding this obscurity are often contesting perspectives on what it means to be HIV infected, and these perspectives are largely constituted by people's rationalisation of complex situations or experiences. Using qualitative research methods and ethnography in particular, this paper reflects on a broad understanding of what it means to live with HIV in the context of Christianity, using research participants' perspectives in an urban support group setting. Two fundamental patterns are evident in this paper: (1) as support group members rationalise their HIV infection, they continuously construct and reconstruct their identities; and (2) support group members rationalise their HIV infection to enhance their coping abilities, using Christianity and the Bible in particular, as a reference. Whilst rationalising HIV infection, three viewpoints emerge. The first viewpoint perceives HIV infection as an affliction by Satan; the second viewpoint sees it as originating from God; while the last viewpoint interprets HIV infection as a negotiated settlement between God and Satan. The paper is intended to trigger debate, and hopefully also to seek and provide answers from various sectors of society, and religious communities in particular, in order to help other HIV positive people in similar situations better manage their HIV condition.