Effect of peer support intervention on quality of life among breast cancer patients on chemotherapy: intervention and control group study

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Min Thu Naung
Alessio Panza
Pramon Viwattanakulvanid
Yin Yin Htun


The tragedy caused by having breast cancer can lead to many challenges for women.  The physical and psychological reactions occurring after the diagnosis of breast cancer and during chemotherapy, can have a negative impact on the quality of life (QOL) of patients. This study was conducted to evaluate the effect of a peer support intervention on QOL of breast cancer patients in Yangon, Myanmar. An interventional study was conducted at Shwe Yaung Hnin Si Cancer Foundation clinic in Yangon in 2019. A total of 74 patients participated and were randomly assigned to an intervention or a control group. The intervention group received peer support during chemotherapy. QOL was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire(s)-Core30 (EORTC QLQ-C30). Independent t-test, chi-square test and analysis of covariance test were used in data analysis. There was no significant difference between the intervention and control groups in socio-demographic characteristics, medical history, global health status/QOL, physical, emotional, cognitive and social functioning scores and symptoms scores, except for role functioning (p=0.019) at baseline.  The intervention group had significantly higher mean scores in global health status/QOL (mean difference/md=10.8, p=0.017), physical functioning (md=7.6, p<0.001), role functioning (md=23, p<0.001), emotional functioning (md=15.9, p<0.001), cognitive functioning (md=10.1, p=0.002) and social functioning (md=17, p=0.002), and significantly lower mean scores in fatigue (md=-9.1, p=0.009), and nausea & vomiting (md=-9.3, p=0.022) than the control group. The results showed that peer support intervention was effective in improving QOL among female breast cancer patients by promoting global health status/QOL and functioning, and diminishing fatigue and nausea & vomiting symptoms. Therefore, peer support intervention should be considered for breast cancer patients to improve their physical and emotional wellbeing.


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Original Articles
Author Biographies

Min Thu Naung, College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand

College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand

Alessio Panza, College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand

College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand

Pramon Viwattanakulvanid, College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand

College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand

Yin Yin Htun, Shwe Yaung Hnin Si Cancer Foundation, Yangon, Myanmar

Shwe Yaung Hnin Si Cancer Foundation, Yangon, Myanmar


1. WHO. Breast cancer: prevention and control: World Health Organization [Internet]. 2019. Available from: https://www.who.int/cancer/detection/breastcancer/en/.
2. IARC. Cancer Fact Sheets: Breast: International Agency for Research on Cancer [Internet]. 2019. Available from: https://gco.iarc.fr/today/data/ factsheets/cancers/20-Breast-fact-sheet.pdf.
3. IARC. Population Fact Sheets: South-Eastern Asia: International Agency for Research on Cancer [Internet]. 2019. Available from: https://gco.iarc.fr/ today/data/factsheets/populations/920-south-eastern-asia-fact-sheets.pdf.
4. IARC. Population Fact Sheets: Myanmar: International Agency for Research on Cancer [Internet]. 2019. Available from: https://gco.iarc.fr/ today/data/factsheets/populations/104-myanmar-fact-sheets.pdf.
5. Wang Q-X, Bai Y, Lu G-F, Zhang C-Y. Perceived health-related stigma among patients with breast cancer. Chin Nurs Res. 2017;4(4):158-61.
6. Zhu J, Ebert L, Xue Z, Shen Q, Chan SW. Development of a mobile application of Breast Cancer e-Support program for women with breast cancer undergoing chemotherapy. Technol Health Care. 2017;25(2):377-82.
7. Ulger O, Yagli NV. Effects of yoga on the quality of life in cancer patients. Complement Ther Clin Pract. 2010;16(2):60-3.
8. Jagsi R, Pottow JA, Griffith KA, Bradley C, Hamilton AS, Graff J, et al. Long-term financial burden of breast cancer: experiences of a diverse cohort of survivors identified through population-based registries. J Clin Oncol. 2014;32(12):1269-76.
9. Gangane N, Khairkar P, Hurtig AK, San Sebastian M. Quality of Life Determinants in Breast Cancer Patients in Central Rural India. Asian Pac J Cancer Prev. 2017;18(12):3325-32.
10. Epplein M, Zheng Y, Zheng W, Chen Z, Gu K, Penson D, et al. Quality of life after breast cancer diagnosis and survival. J Clin Oncol. 2011;29(4):406-12.
11. Quinten C, Coens C, Mauer M, Comte S, Sprangers MA, Cleeland C, et al. Baseline quality of life as a prognostic indicator of survival: a meta-analysis of individual patient data from EORTC clinical trials. Lancet Oncol. 2009;10(9):865-71.
12. Napoles AM, Ortiz C, Santoyo-Olsson J, Stewart AL, Gregorich S, Lee HE, et al. Nuevo Amanecer: results of a randomized controlled trial of a community-based, peer-delivered stress management intervention to improve quality of life in Latinas with breast cancer. Am J Public Health. 2015;105 Suppl 3:e55-63.
13. Giese-Davis J, Bliss-Isberg C, Wittenberg L, White J, Star P, Zhong L, et al. Peer-counseling for women newly diagnosed with breast cancer: A randomized community/research collaboration trial. Cancer. 2016;122 (15):2408-17.
14. Taleghani F, Babazadeh S, Mosavi S, Tavazohi H. The effects of peer support group on promoting quality of life in patients with breast cancer. Iran J Nurs Midwifery Res. 2012;17(2):S125-30.
15. Cho OH, Yoo YS, Kim NC. Efficacy of comprehensive group rehabilitation for women with early breast cancer in South Korea. Nurs Health Sci. 2006;8(3):140-6.
16. Mens MG, Helgeson VS, Lembersky BC, Baum A, Scheier MF. Randomized psychosocial interventions for breast cancer: impact on life purpose. Psycho-oncology. 2016;25(6):618-25.
17. Sharif F, Abshorshori N, Tahmasebi S, Hazrati M, Zare N, Masoumi S. The effect of peer-led education on the life quality of mastectomy patients referred to breast cancer-clinics in Shiraz, Iran 2009. Health Qual Life Outcomes. 2010;8:74.
18. 18.Tehrani AM, Farajzadegan Z, Rajabi FM, Zamani AR. Belonging to a peer support group enhance the quality of life and adherence rate in patients affected by breast cancer: A non-randomized controlled clinical trial. J Res Med Sci. 2011;16(5):658-65.
19. Lu Q, You J, Man J, Loh A, Young L. Evaluating a culturally tailored peer-mentoring and education pilot intervention among Chinese breast cancer survivors using a mixed-methods approach. Oncol Nurs Forum. 2014;41(6):629-37.
20. Montazeri A, Jarvandi S, Haghighat S, Vahdani M, Sajadian A, Ebrahimi M, et al. Anxiety and depression in breast cancer patients before and after participation in a cancer support group. Patient Educ Couns. 2001;45(3):195-8.
21. Haddou Rahou B, El Rhazi K, Ouasmani F, Nejjari C, Bekkali R, Montazeri A, et al. Quality of life in Arab women with breast cancer: a review of the literature. Health Qual Life Outcomes. 2016;14:64.
22. Lee R, Lee KS, Oh EG, Kim SH. A randomized trial of dyadic peer support intervention for newly diagnosed breast cancer patients in Korea. Cancer Nurs. 2013;36(3):E15-22.
23. Ferreira JC, Patino CM. Randomi-zation: beyond tossing a coin. J Bras Pneumol. 2016;42:310-.
24. Geldard D, Geldard K. Basic Personal Counselling: A Training Manual for Counsellors. Australia: Pearson 2012.
25. WHO. Creating peer support groups in mental health and related areas - WHO QualityRights training to act, unite and empower for mental health (pilot version): Geneva: World Health Organization. 2017.
26. EORTC. Quality of Life of Cancer Patients: European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group [Internet]. 2018. Available from: https://qol.eortc.org/questionnaire/eortc-qlq-c30/.
27. Scott NW, Fayers P, Aaronson NK, Bottomley A, de Graeff A, Groenvold M, et al. EORTC QLQ-C30 Reference Values. 2nd ed. Brussels, Belgium: EORTC Quality of Life Group; 2008.
28. Tan ML, Idris DB, Teo LW, Loh SY, Seow GC, Chia YY, et al. Validation of EORTC QLQ-C30 and QLQ-BR23 questionnaires in the measurement of quality of life of breast cancer patients in Singapore. Asia Pac J Oncol Nurs. 2014;1(1):22-32.
29. Akel R, El Darsa H, Anouti B, Mukherji D, Temraz S, Raslan R, et al. Anxiety, Depression and Quality of Life in Breast Cancer Patients in the Levant. Asian Pac J Cancer Prev. 2017;18(10):2809-16.
30. Alawadi SA, Ohaeri JU. Health - related quality of life of Kuwaiti women with breast cancer: a comparative study using the EORTC Quality of Life Questionnaire. BMC Cancer. 2009;9:222.
31. Janz NK, Mujahid MS, Hawley ST, Griggs JJ, Alderman A, Hamilton AS, et al. Racial/ethnic differences in quality of life after diagnosis of breast cancer. J Cancer Surviv. 2009;3(4):212-22.
32. Ghavami H. Effects of a Lifestyle Interventions Program on Quality of Life in Breast Cancer Survivors. International Journal of Hematology and Oncology(UHOD). 2017;27.