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Family members experiencing critical illness and intensive care (ICU) may lose hope and have reduced health-related quality of life (Alfheim et al., 2019; Griffith et al., 2018; Heylandetal., 2018; Orwelius, [...], Introduction: When a family member has been critically ill and cared for at an intensive care unit the individual family member as well as the family system are affected and in need of support. The aim of this study was to compare and contrast the responses from 2 different types of follow-up interventions for families of critically ill persons, focusing on individual hopes, health-related quality of life, family functioning and ability to cope with challenges. Method: Adult family members from 3 hospitals attended 1 of 2 interventions 2 months after intensive care. The family health conversation included the family. The support group conversation included just family members and not the patient who had experienced intensive care. Data were collected via self-reported questionnaires and followup interviews with family members. Quantitative and qualitative data were first analyzed separately, and the results were then integrated through mixed methods analysis. Results: A total of 38 family members took part in the interventions. Family members in the 2 intervention groups talked about how they had more hope for the future, and about how talking within the family and the group had helped them justify their feelings, which empowered them in the transition toward a healthier quality of life. Comparisons of the interventions show a higher significance of family function and hope in the family health conversation. Discussion: The article illustrates a disparity between how family members function and the needs they have for follow-up. We discuss what kind of follow-up these persons need. Public Significance Statement The results point at a disparity in outcomes between the two groups that possibly could be explained by whether the family or individual family members were targeted in the intervention. The study provides insight into how the follow-up clinic could benefit from family-focused nursing and from an opportunity for the health care professionals to suggest different strategies for the family and/or individual family members. Keywords: family members, family nursing, family relations, intensive care, mixed methods

INTRODUCTION A tenacious driver of the higher rates of morbidity and mortality amongst adolescents living with HIV (ALHIV) is suboptimal adherence to HIV treatment [1?4] Although the global target is [...], : Introduction: Low rates of viral suppression among adolescents living with HIV (ALHIV) indicate that more effective support is urgently required at scale. The provision of peer support has generated considerable enthusiasm because it has the potential to ameliorate the complex social and relational challenges which underpin suboptimal adherence. Little is known about the impact on young peer supporters themselves, which is the focus of this paper. Methods: We present qualitative findings from the Zvandiri trial investigating the impact of a peer support intervention on the viral load for beneficiaries (ALHIV, aged 13 to 19 years) in Zimbabwe. The Zvandiri peer supporters aged 18 to 24 years, known as community adolescent treatment supporters (CATS), are themselves living with HIV. Individual in?depth interviews were conducted in late 2018 with 17 CATS exploring their experiences of delivering peer support and their own support needs. Interviews were analysed iteratively using thematic analysis. Results: The CATS reported that being peer supporters improved their own adherence behaviour and contributed to an improved sense of self?worth. The social connections between the CATS were a source of comfort and enabled them to develop skills to manage the challenging aspects of their work. Two substantial challenges were identified. First, their work may reveal their HIV status. Second, managing the emotional labour of this caring work; given how commonly the complexity of the beneficiaries? needs mirrored the circumstances of their own difficult lives. Both challenges were ameliorated by the support the CATS provided to each other and ongoing supervision from the adult mentor. There was variation in whether they felt their roles were appropriately valued through the remuneration they received and within the health system. There was a consensus that their experience meant that they would graduate from being a CATS with transferable skills that could enhance their employability. Conclusions: Their experiences illustrate the advantages and opportunities of being a CATS. To minimize potential harms, it is vital to ensure that they feel valued in their role, which can be demonstrated by the provision of appropriate remuneration, recognition and respect, and that there is continued investment in ongoing support through ongoing training and mentoring.

There are more than 100 prostate cancer support groups (PCSGs) in Canada, most of which meet on a monthly basis--yet little attention has been paid to the role of women at these groups. As part of an ongoing ethnographic study of PCSGs, we examined women's motivations for attending the groups, their ways of functioning in PCSGs and the benefits they accrued. Participant observations conducted at 13 British Columbian-based PCSGs and individual interview data from 20 women who regularly attended PCSG meetings were analyzed. Although the groups did not overtly limit women's attendance, the women's decisions to attend and their participation at group meetings were subject to much self-reflection, uncertainty and tension. Motivations to access a PCSG included a desire to support their partners, develop understandings about the illness and disease, and to manage their own experience of prostate cancer. Our analyses revealed that women assume three roles in PCSGs: social facilitator, background supporter and cancer co-survivor. The women reported many interrelated benefits as a result of attending, including information, hope and reassurance, and connecting with other women in similar circumstances. The results from this study reveal how traditional feminine ideals, such as nurturing and caring for the men in their lives, facilitating social connections and the desire to share emotional experiences guided the behaviors. Based on the study findings, we suggest that efforts to support women's involvement in PCSGs are critical to enhancing the effectiveness of the groups for both men and women. Keywords: Prostate cancer; Support groups; Health promotion; Gender roles; Women; Spouses

Group-based psychosocial programs provide an effective forum for improving mood and social support for cancer patients. Because some studies show more benefit for patients with initially high psychosocial distress, and little or no benefit for patients with initially low distress, support programs may better address patient needs by only including distressed patients. However, distressed patients may benefit particularly from the presence of nondistressed patients who model effective coping, an idea many researchers and extensions of social comparison theory support. We present a theoretical analysis, based on a social comparison perspective, of how group composition (heterogeneous group of distressed and nondistressed patients versus homogeneous group of distressed patients) may affect the efficacy of cancer support programs. We propose that a heterogeneous group allows distressed patients maximal opportunity for the various social comparison activities they are likely to prefer; a homogeneous group does not. Though the presence of nondistressed patients in a heterogeneous group potentially benefits distressed patients, the benefits for nondistressed patients are unclear. For nondistressed patients, heterogeneous groups may provide limited opportunities for preferred social comparison activity and may create the possibility for no benefit or even negative effects on quality of life. We also discuss ethical issues with enrolling nondistressed patients whose presence may help others, but whose likelihood of personal benefit is questionable. Keywords: Social comparison theory; Theoretical evaluation of cancer support groups; Psychological distress

Despite the growing popularity of self-help groups for people with chronic illness, there has been surprisingly little research into how these may support adjustment to illness. This study investigated the role that social comparison, occurring within a self-help group, may play in adjustment to chronic illness. A model of adjustment based on control process theory and response shift theory was tested to determine whether social comparisons predicted adjustment after controlling for the catalyst for adjustment (disease severity) and antecedents (demographic and psychological factors). A sample of 301 people with Meniere's disease who were members of the Meniere's Society UK completed questionnaires at baseline and 10-month follow-up assessing adjustment, defined for this study as functional and goal-oriented quality of life. At baseline, they also completed measures of the predictor variables i.e. the antecedents (age, sex, living circumstances, duration of self-help group membership, self-esteem, optimism and perceived control over illness), the catalyst (severity of vertigo, tinnitus, hearing loss and fullness in the ear) and mechanisms of social comparison within the self-help group. The social comparison variables included the extent to which self-help group resources were used, and whether reading about other members' experiences induced positive or negative feelings. Cross-sectional results showed that positive social comparison was indeed associated with better adjustment after controlling for all the other baseline variables, while negative social comparison was associated with worse adjustment. However, greater levels of social comparison at baseline were associated with a deteriorating quality of life over the 10-month follow-up period. Alternative explanations for these findings are discussed. Keywords: UK; Adjustment; Quality of life; Chronic illness; Social comparison; Longitudinal design

Although there is a high prevalence of co-occurring mental and substance abuse disorders, and empirical evidence shows the need to integrate multiple treatment services for dually diagnosed persons, service integration is relatively recent and often poorly implemented. Moreover, service providers and clients often hold divergent views of what constitute appropriate and feasible treatment goals. This paper presents interview data from an urban sample of dually diagnosed members of self-help groups (N = 310) concerning the challenges confronting them in their recovery, and discusses the interrelations of these issues. The findings indicate that most clients struggle with emotional and socioeconomic issues, which bear significantly on their ability to handle adequately other aspects of recovery.

The ideal interface between self-help group and professional being of both theoretical and practical interest, this paper reviews the conceptual underpinnings of the interface issue and empirical studies in which the professional or self-help group member perspective on this issue was elicited or comparative analyses were conducted. Empirical studies measuring self-help group members' perceptions and studies of professionals' views indicate that professional interaction with self-help groups is desirable but that professional lack of information concerning self-help groups and lack of preparation for appropriate roles are perceived as barriers to such interaction. These studies clearly show that the indirect, non-authoritarian role of the professional as consultant receives the most support. Consultation and collaboration are recurrent themes in the empirical investigations of the professional interface with self-help groups. Balance and exchange theories could provide useful theoretical foundations for this collaborative practice. Clearly, educational preparation is needed to enable health professionals to embark on the essential transition from provider to partner with self-help groups.

This paper documents the use and interest in support strategies such as telephone support, newsletters, and computer services, among caregivers of all ages. Data obtained from telephone interviews with community living caregivers of persons with dementia (n = 148) showed substantial interest in the use of these types of services. Using a theoretical framework, this paper identifies caregiver and care-receiver characteristics associated with those interested in the utilization of these support strategies. The implications of these findings for program planning and future research are discussed. KEY WORDS: dementia; support; caregiving.

Support groups have the potential to mitigate some of the developmental and condition-specific psychological and social issues common to sickle cell disease (SCD), yet little is known about how adolescents [...]

A multi-modal analysis of over 100 letters to the TMJ Assn found that writers who included some history of their temporomandibular joint syndrome (TMJ) use two basic patterns. The letters were generally either a request for information incorporating a synopsis, or a narrative detailing the writer's problems to the institution or person most like to be sympathetic to their plight. Data show that summarizers relied on their aggregate number to prove the legitimacy of their request, while narrators viewed the association more as a support group.