Social support and recovery after surgery for breast cancer: Frequency and correlates of supportive behaviours by family, friends and surgeon

In a longitudinal study of recovery after surgery for breast cancer, subjects reported the frequency of, and their satisfaction with, various supportive behaviours on the part of family members, close friends and medical professionals. The reliability of the Multi-Dimensional Support Scale (MDSS) devised for this purpose is described. Measures of psychological, social and physical adjustment approached normality by 3 months post-operation. Frequency of support from all sources decreased as time from surgery passed, whilst satisfaction with support varied with the type of support given and the source from which it was received. Quite different patterns emerged in support needs from professional and non-professional sources, with empathic support being required from all sources, whilst informational support was desired from surgeons, rather than from family and friends. Further, subjects were more discriminating in the amounts of support required from family and friends, such that it was more likely for these sources to give unwanted support than it was for professional sources, from whom many subjects reported inadequate support. Satisfaction with social support was matched with measures of adjustment, and it was found that those satisfied with support from family members were significantly less anxious and depressed in hospital than were those who were not satisfied with support from this source. However, at 1 month post-operation, anxiety and depression levels were significantly related to satisfaction with support from surgeons; and at 3 months post-operation, anxiety and depression measures were significantly related to satisfaction with support from both family members and surgeons. Further research is required to investigate the needs and problems of the lay person who, by virtue of social bonds with the patient is widely expected to fulfil a supportive function, yet who, because of lack of training or experience in such a situation may feel unequal to the task. Approaches which might amplify and/or prolong the support to patients from medical staff are also discussed.