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Health Status Health Services Health Care Reform Diverse Communities of Women
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"Voices and Faces": A Qualitative Study of Rural Women and a Breast Cancer Self-help Group via an Audio-teleconferencing Network Jon Church and Vernon Curran, Faculty of Medicine, Memorial University of Newfoundland and Shirley Solberg, School of Nursing, Memorial University of Newfoundland
The aim of this research was to develop an explanatory model of the use of audio teleconferencing in the provision of social support to survivors of breast cancer among women living in rural Newfoundland. The specific objectives were:
Eleven women with a history of breast cancer volunteered for the study. They ranged in age from 30 to 78 and came from across the province of Newfoundland. The women were interviewed following their participation in teleconferences. All interviews were audio taped and subsequently transcribed and analyzed using a grounded theory approach. This work demonstrates the potential and limits of contemporary communication technology to facilitate social support for breast cancer survivors. Women who took part in the audio-teleconferencing obtained support both through the local teleconference site and the interactions that occurred there and through the system-wide network and the exchanges over this medium. Participants described the two different forms of support as ‘faces” and “voices” respectively. The process of faces and voices consisted of four distinct but overlapping stages:
In each of these four stages, certain conditions facilitated a woman’s ability to receive social support. Many people assume that women in rural areas, while distanced from formal means of social support, have greater informal means of support through family and friends and community cohesiveness, and the latter compensates for the lack of formal support services. Our study clearly shows this assumption is not supported. The women talked about the effects of the diagnosis on their spouses or other family members. They did not feel that family and friends, no matter how supportive, could understand what they were experiencing because you really had to be there to understand. They believed it was very important to talk with other women who knew what living with breast cancer was like to help them deal with the tremendous emotional upheaval they were experiencing. Others spoke of not wanting their communities "to know all my business", and spoke of how the teleconferencing network was invaluable in lessening both family and community burdens of dealing with the disease process. Empathy is suggested as a strategy for health professionals to use in meeting patient’s emotional needs yet the women in this study challenged how well health professionals can meet patients’ needs for empathy. They felt that the support they received from other women with breast cancer was qualitatively different from that received from individuals without the disease. They wanted to talk to women who have been through a similar experience to themselves but more importantly they wanted to know that other women survived breast cancer. This finding has important program implications not only for health professionals but for how we structure cancer support groups. One of the obvious means of solving formal support in smaller communities is to combine all cancer survivors in one group. The women we interviewed caution against this approach. While they conceded there are some commonalities among all people living with cancer, they also believe that the needs and concerns of breast cancer survivors are unique. Optimal support, therefore, comes from a group of women composed of breast cancer survivors. Moreover, the women appreciated having access to long-term survivors as well as women in active treatment. They also appreciated the presence of a facilitator who was knowledgeable about breast cancer and could discuss with them the latest in treatment options, on-going or up-coming clinical trials, or breast cancer "news" presented in the media. This study contributes to a greater understanding of an innovative social support programme for rural women and how to foster connection among women in diverse areas in need of support. It also contributes to an understanding of how women use technology to improve their well-being. Additionally, it identifies conditions that foster or inhibit the kind of social support that women with breast cancer receive. For further information contact: |
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