The perception of support received from breast care nurses by depressed patients following a diagnosis of breast cancer

INTRODUCTION Due to their specialist training, breast care nurses (BCNs) should be able to detect emotional distress and offer support to breast cancer patients. However, patients who are most distressed after diagnosis generally experience least support from care staff. To test whether BCNs overcome this potential barrier, we compared the support experienced by depressed and non-depressed patients from their BCNs and the other main professionals involved in their care: surgeons and ward nurses. PATIENTS AND METHODS Women with primary breast cancer (n = 355) 2–4 days after mastectomy or wide local excision, self-reported perceived professional support and current depression. Analysis of variance compared support ratings of depressed and non-depressed patients across staff types. RESULTS There was evidence of depression in 31 (9%) patients. Depressed patients recorded less surgeon and ward nurse support than those who were not depressed but the support received by patients from the BCN was high, whether or not patients were depressed. CONCLUSIONS BCNs were able to provide as much support to depressed patients as to non-depressed patients, whereas depressed patients felt less supported by surgeons and ward nurses than did non-depressed patients. Future research should examine the basis of BCNs' ability to overcome barriers to support in depressed patients. Our findings confirm the importance of maintaining the special role of the BCN.

Training drama teachers: a perspective from England

In England, drama is embedded into the National Curriculum as a part of the programmes of study for the subject of English. This means that all children aged between 5 - 16 in state funded schools have an entitlement to be taught some aspects of the subject. While the manifestation of drama in primary schools is diverse, in a great many schools for students aged between 11 – 19, drama and theatre art is taught as a discrete subject in the same way that the visual arts and music are. Students may opt for public examination courses in the subject at ages 16 and 18. In order to satisfy the specifications laid down for such examinations many schools recognise the need for specialist teachers and indeed specialist teaching rooms and equipment. This chapter outlines how drama is taught in secondary schools in England (there being subtle variations in the education systems in the other countries that make up the United Kingdom) and the theories that underpin drama’s place in the curriculum as a subject in its own right and as a vehicle for delivering other aspects of the prescribed curriculum are discussed. The paper goes on to review the way in which drama is taught articulates with the requirements and current initiatives laid down by the government. Given this context, the chapter moves on to explore what specialist subject and pedagogical knowledge secondary school drama teachers need. Furthermore, consideration is made of the tensions that may be seen to exist between the way drama teachers perceive their own identity as subject specialists and the restrictions and demands placed upon them by the education system within which they work. An insight into the backgrounds of those who become drama teachers in England is provided and the reasons for choosing such a career and the expectations and concerns that underpin their training are identified and analysed.