Cancer support groups, psychological adjustment, and health-promoting behaviors

The purpose of this quasi-experimental study was to compare the effectiveness of a thematically structured format to an open discussion format in professionally-led cancer support groups for adults with cancer. The theoretical perspectives guiding the research were a blend of the Health Promotion and Learned Hopefulness models. A pre-test, post-test, follow-up quasi-experimental design was utilized to assess the outcome variables of psychosocial adjustment (mental adjustment, general mental health, hope, and social support) and health-promoting behaviors. Forty-three adults with cancer of any type were assigned as small groups to one of two eight week interventions: (1) an open discussion format, or (2) a thematically structured format (Renewing Life$\sp{\rm TM}$) which follows a set of ordered themes. Instruments with established reliability and validity were utilized: Mental Adjustment to Cancer, Herth Hope Index, Medical Outcomes Studies Social Support Survey, the SF-12 Mental Health Summary Scale and the Health-Promoting Lifestyle Profile II (HPLP II). Process evaluations and fidelity to treatment checks were included for the independent measures. Repeated measures ANOVAs indicated significant positive changes ($\rm p \le .05$) across time for both interventions for the Mental Health Summary, Herth Hope Index, Positive Social Interaction Social Support subscale and the total HPLP II and each of its six subscales. There were significant differences ($\rm p \le .05$) between the two intervention groups for the subscales of Health Responsibility, Nutrition, and Mental Health Summary. Utilizing exploratory simultaneous multiple regression analysis it was determined that age, gender, marital status, prognosis, and type of support group significantly explained 18% to 46% of the variance on all the dependent measures except hope. Moderate to strong correlations were found between mental adjustment and hope, between perceived social support and interpersonal relations and between health-promoting behaviors and hope, fighting spirit and helplessness/hopelessness. The findings of this study indicate that cancer support groups may be effective as wellness-focused interventions which enhance health-promoting behaviors, hope, general mental health and positive social interaction in the population studied. The correlation and regression analyses revealed potential areas for future research