Due to improvements in medical treatment and survival following breast cancer, researchers have turned their attention to investigating the needs of breast cancer survivors. There is disagreement about the extent to which survivors continue to experience psychological morbidity after treatment ends. Whilst the majority of women adjust well to breast cancer, some may have continued psychosocial needs. Available research suggests that younger pre-menopausal women are at increased risk of psychological morbidity following breast cancer. The present study aimed to gather preliminary qualitative data on the psychosocial needs of breast cancer survivors and to identify the shared and unique needs of younger versus older survivors. A qualitative methodology was chosen as this was a relatively unexplored area of enquiry. Patients treated for early-stage breast cancer who had completed their hospital-based treatment 6-24 months prior to participation were recruited. Sampling was discontinued when informational redundancy was achieved. Eighteen telephone interviews were conducted. A wide variety of on-going psychosocial and information needs were reported by breast cancer survivors including support needs, psychological needs, practical needs, physical needs and information needs. Younger women reported more needs than their older counterparts. Several needs reported by younger women were directly related to being of younger age or pre-menopausal at the time of diagnosis. Clinical implications are discussed.

This analysis indicated that further refinement and validation of existing instruments is required. Valid and reliable instruments are needed for both research and clinical care.

This study evaluated the efficacy of a theory of planned behaviour (TPB) based intervention to increase fruit and vegetable consumption. The extent to which fruit and vegetable consumption and change in intake could be explained by the TPB was also examined.Participants were randomly assigned to two levels of intervention frequency matched for intervention content (low frequency n = 92, high frequency n = 102). Participants received TPB-based email messages designed to increase fruit and vegetable consumption, messages targeted attitude, subjective norm and perceived behavioural control (PBC). Baseline and post-intervention measures of TPB variables and behaviour were collected. Across the entire study cohort, fruit and vegetable consumption increased by 0.83 servings/day between baseline and follow-up. Intention, attitude, subjective norm and PBC also increased (p<.05).The TPB successfully modelled fruit and vegetable consumption at both time points but not behaviour change. The increase of fruit and vegetable consumption is a promising preliminary finding for those primarily interested in increasing fruit and vegetable consumption. However, those interested in theory development may have concerns about the use of this model to explain behaviour change in this context. More high quality experimental tests of the theory are needed to confirm this result.Keywords: theory of planned behaviour; fruit and vegetable consumption; behaviour change Like attitude and subjective norm, PBC is thought to influence behaviour through its influence on intention. It is also thought to have a direct influence on behaviour over and above its influence on intention. The extent to which PBC has a direct influence on behaviour is often thought to reflect an individual's actual behavioural control over the target behaviour (Fishbein & Ajzen, 2010). Given the difficulty in directly assessing actual behaviour control for most health related behaviours, PBC is used as a proxy for actual behaviour control the majority of TPB based studies (Armitage & Conner, 2001;Fishbein & Ajzen, 2010;Godin & Kok, 1996).A large number of studies provide support for the utility of the model in the prediction of behaviour (Armitage & Conner, 2001;Godin & Kok, 1996). In the context of fruit and vegetable intake, the model has been reported to account for an average of 41% of the variance in intention and 45% of the variance in behaviour (Guillaumie, Godin, & Vézina-Im, 2010). In their meta-analytic review of psychosocial predictors of fruit and vegetable intake, Guillaumie, Godin, and Vézina-Im argued that the TPB is the most strongly supported model of intention and behaviour (Guillaumie, et al., 2010), and therefore there is sound justification for the use of the model in interventions designed to increase intake of fruit and vegetables (Guillaumie, et al., 2010). TPB and behaviour changeAlthough the predictive utility of the TPB model has been well established, there are relatively few studies which manipulate the cognitions specified in the mod...

Future interventions should motivate and equip health professionals to use PROM data in managing patients, train patients in self-efficacy, use more specific PROMs in clinic, improve the interpretability of feedback for both medical staff and patients, and monitor the use of PROMs to intervene when problems arise. Future trials should use a cluster-randomized design to control for contamination and enable systems-based interventions.

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In recent years Talcott Parsons' work has come under renewed scrutiny by sociologists who argue that his concept of the sick role may have some role to play in current accounts of health and illness. In this paper we describe the ways in which Australian women who have undergone elective risk-reducing breast surgery (+/-ovarian surgery) talk about their convalescence. When describing their experiences women presented two contrasting recovery narratives in which the negative effects of breast surgery were either minimalised or emphasised. In an effort to explain these differences we draw upon the Parsonian concept of the sick role and argue that the extent to which women either embraced or rejected the sick role in their accounts is related to the amount of external legitimation they received from healthcare professionals. We conclude that the concept of the sick role may provide insight into high-risk women's experiences of risk-management.

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