Likely to Be Effective

Peer Counseling

for Depression

Peer counseling is support and guidance provided by a trained nonprofessional who has a similar symptom or health problem (Schover et al., 2006). Peer counseling was examined as an intervention for hot flashes and depression. Aspects of peer counseling may also be incorporated into a broader range of supportive and psychoeducational interventions that have been tested in multiple topic areas.

Schover, L.R., Jenkins, R., Sui, D., Adams, J.H., Marion, M.S., & Jackson, K.E. (2006). Randomized trial of peer counseling on reproductive health in African American breast cancer survivors. Journal of Clinical Oncology, 24, 1620–1626. doi:10.1200/JCO.2005.04.7159

Research Evidence Summaries

Weber, B.A., Roberts, L., Yarandi, H., Mills, T.L., Chumbler, N.R., & Wajsman, Z. (2007). The impact of dyadic social support on self-efficacy and depression after radical prostatectomy. Journal of Aging & Health, 19(4), 630–645.

Study Purpose

To assess the effect of one-on-one peer support on enhancing self-efficacy and decreasing depression in men undergoing radical prostatectomy for prostate cancer

Intervention Characteristics/Basic Study Process

A core group of support partners who were prostate cancer survivors were recruited for the study protocol and trained to recognize signs and symptoms of clinical depression, communicate with active listening skills, and record reactions of study participants in a weekly log. One-on-one sessions were held in a private location, without involvement of patient's significant others. Men were randomly assigned to the support intervention or usual care. Support sessions were to be done eight times over an eight-week period. Data were collected at baseline and at four and eight weeks.

Sample Characteristics

  • The sample was composed of 72 participants.
  • Mean patient age was 60 years, with an age range of 47–74 years.
  • All participants were male.
  • All participants had undergone prostatectomy at least six weeks prior to the study and had been diagnosed within three months of the study.
  • Of participants in the intervention group, 80% were married; in the control group, 67.6% were married. Of all participants, 83% were white and 35% had at least a high school or technical school education.
     

Setting

  • Single site
  • Outpatient
  • Florida, United States

Phase of Care and Clinical Applications

  • Phase of care: active antitumor treatment
  • Clinical application: eldercare

 

Study Design

Randomized controlled trial

Measurement Instruments/Methods

  • Geriatric Depression Scale
  • Stanford Inventory of Cancer Patient Adjustment
  • Modified Inventory of Socially Supportive Behaviors
  • UCLA Prostate Cancer Index
     

Results

The number of sessions was 1–8.  Those in the treatment group had significantly higher self-efficacy (p = 0.005) and lower depression (p = 0.032) at eight weeks. All patients had low depression scores at baseline. There was an 8.6% drop-out rate.

Conclusions

The support intervention provided by trained prostate cancer survivors demonstrated a positive effect on patient self-efficacy and depression scores.

Limitations

  • The study had a small sample size, with fewer than 100 participants.    
  • The study shows baseline sample and group differences of import.
  • The study had a risk of bias due to no appropriate attentional control condition.
  • Findings are not generalizable because
    • The study was limited to specific prostate cancer patients. 
    • At baseline, between groups there were substantial differences in depression scores and urinary and sexual functioning.
    • A larger proportion of control patients were married, which could have contributed to greater concerns regarding impotency and relationships than might have occurred in the intervention group.

Nursing Implications

Study findings show a positive effect of one-on-one support among men with prostate cancer when support was provided by prostate cancer survivors who had the same treatments, side effects, and experiences. It has been suggested that men do not tend to participate in support groups, being less inclined to share concerns in a support-group setting. One-on-one pairing, one patient with one individual who has had similar experiences and adjusted well, may be very beneficial to patients.

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