Peer-led blended peer support program improves psychosocial adjustment in young- to middle-aged breast cancer patients
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Key Takeaway
Consider that an 8-week peer-led blended support program may improve psychosocial adjustment and coping in young- to middle-aged breast cancer patients, but evidence is limited to 12 weeks and a single-center setting.
This cluster randomized controlled trial evaluated an 8-week peer-led, nurse-involved blended online and offline peer support program (PNO2PSP) added to routine care for young- to middle-aged breast cancer patients. The study enrolled 70 participants (n=35 per group) at a single center, with assessments presurgery and at 4, 8, and 12 weeks post-surgery. Primary outcome was psychosocial adjustment; secondary outcomes included self-efficacy, social support, and coping modes.
Psychosocial adjustment scores were significantly lower in the intervention group versus control at 8 weeks (Wald χ²1=14.96; P<.001) and 12 weeks (Wald χ²1=7.49; P=.006), indicating improved adjustment. Social support was higher in the intervention group at 8 weeks (Wald χ²1=7.65; P=.006). Confrontation coping scores were higher in the intervention group at 8 weeks (Wald χ²1=5.46; P=.02) and 12 weeks (Wald χ²1=10.04; P=.002). Avoidance coping scores were lower in the intervention group at 4 weeks (Wald χ²1=8.24; P=.004), 8 weeks (Wald χ²1=7.45; P=.006), and 12 weeks (Wald χ²1=5.70; P=.02). Absolute numbers and confidence intervals were not reported.
Adverse events, serious adverse events, discontinuations, and overall tolerability were not reported. The authors described the program as feasible and patient-centered, supporting potential clinical implementation with sustained training and delivery. Key limitations include the single-center setting, small sample (n=70), and a qualitative component based on only 9 participants. Results are based on statistical significance and effect sizes; absolute values and confidence intervals are not provided. The program has not been tested beyond 12 weeks or in other age groups or cancer types.
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View Original Abstract ↓
BACKGROUND: Young- to middle-aged patients with breast cancer face significant psychosocial challenges. Existing interventions often lack comprehensiveness, timely initiation, and tailoring specific to this population's unique needs.
OBJECTIVE: This study aimed to evaluate the impact of a peer-led, nurse-involved, blended online and offline peer support intervention program (PNO2PSP) on psychosocial adjustment in young- to middle-aged patients with breast cancer.
METHODS: The effectiveness of PNO2PSP was evaluated through a single-center cluster randomized controlled trial involving 70 newly diagnosed young- to middle-aged patients with breast cancer (35 in each group). The intervention group received an 8-week PNO2PSP in addition to routine care. Psychosocial adjustment, self-efficacy, social support, and coping modes were assessed presurgery and at 4, 8, and 12 weeks post surgery. Generalized estimating equations were used for intention-to-treat analyses. In-depth interviews with 9 participants explored their experiences.
RESULTS: Compared to the control group, the intervention group demonstrated significantly lower psychosocial adjustment scores at 8 weeks (T2; Wald χ²1=14.96; P<.001) and 12 weeks (T3; Wald χ²1=7.49; P=.006); social support was higher at 8 weeks (T2; Wald χ²1=7.65; P=.006). Confrontation coping scores were higher at T2 (Wald χ²1=5.46; P=.02), T3 (Wald χ²1=10.04; P=.002), while avoidance coping scores were lower at T1 (Wald χ²1=8.24; P=.004), T2 (Wald χ²1=7.45; P=.006), and T3 (Wald χ²1=5.70; P=.02). Qualitative findings supported these quantitative results, highlighting the program's role in facilitating psychosocial adjustment, providing vital support, boosting treatment confidence, and fostering positive coping.
CONCLUSIONS: The PNO2PSP effectively improved psychosocial adjustment, social support, and positive coping in young- to middle-aged patients with breast cancer. Its scientifically validated, feasible, and patient-centered design supports its recommendation for wider clinical implementation, with continued training for peer supporters and sustained delivery of peer support.
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