Nattering women? : the psychosocial functions of cancer self help groups
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This work arose from a concern about the psychosocial aspects of health care. Although self help groups are one means by which information and support can be offered and received, there are few studies of health self help groups in Britain. The available literature suggests that self help groups are complex organisations which are difficult to define and categorise. This study adds further confirmation to that. This research follows an ethnomethodological approach and provides an in-depth study of six cancer self help groups. Data were gathered from interviews with group members and associated professionals, and from participant observation of group meetings. Women's experience of the diagnosis and treatment of breast cancer suggests that they are poorly informed and receive little or no support within the formal services. They go to self help groups with little information about them and hold unrealistic expectations of what the group might offer. Participation in groups occurs at a variety of levels and frequently over a long period of time. The groups provide women with practical and social support and act as a means of empowerment to enable them to accommodate their illness into their lives and help to realise their health potential. The interviews with professionals suggest that they were aware of the benefits and possible drawbacks of self help. However, few had fully considered the nature of self help, and professional involvement. Groups were keen to develop good relations with professionals as one means of legitimation yet wished to maintain their own integrity and control. This enabled a shift in the normal, individual social relationship between patient and professional. Several policy issues in relation to both the delivery of health care for people with diagnosed cancer and about the organisation and function of self help groups and their interactions with professionals are discussed. In particular the availability and nature of information and communication during diagnosis and treatment of breast cancer requires review. Self help groups are one way this might be facilitated. They are, on the whole, complementary rather than a direct challenge to mainstream medical services. They maintain a dynamic relationship with formal services, but generally attempt to work alongside local professionals. They provide a cost-effective psychosocial support which is unique. They provide considerable potential to advance a 'whole person' approach as envisaged by the World Health Organisation and it is in the interest of the Health Service to promote their development. Any support from medical and social services will require workers in the field to reassess their own practice and involvement with groups.