Past studies have shown that breast cancer patients require social support from family members and friends, as well as their medical providers. Although much research has focused on the types of social support that cancer patients desire, considerably less research has focused on what types of social support are received by cancer patients, within the medical setting from medical providers, as well as from accompanying family members and friends, termed companions. This need for social support can be explained by the stress and coping perspective. According to the stress and coping perspective, it is important for individuals under stress to seek methods to manage stress in order to avoid negative consequences concerning one's physical and mental health. Social support has been found to be an effective coping method, particularly for those experiencing stress due to a breast cancer diagnosis.This study reports an analysis of verbal social support utterances transmitted by nurses, breast cancer surgeons and patient companions to breast cancer patients in a medical setting. Specifically, 46 videotapes featuring nurses, breast cancer surgeons, breast cancer patients, and patient companions discussing treatment options were analyzed alongside pre and post-test survey measures of patient mental adjustment to cancer, satisfaction with her surgeon and intended adherence to her treatment regimen. The social support behavior code (SSBC) was used to examine verbal social support. Relationships between social support provided and patient mental adjustment to cancer, satisfaction with surgeon and intended adherence to one's treatment regimen were investigated. Relationships between provider and companion social support, as well as provided social support and cancer stage were also analyzed. Finally, a nonverbal behavior code was developed for this study to perform an exploratory examination of nonverbal social support given by providers and companions. Results demonstrated the majority of units spoken by surgeons and nurses were coded as verbal social support, mostly in the form of informational social support, while companion social support was significantly lower in nearly every category of social support assessed. Findings did not support a relationship between verbal social support and patient mental adjustment to cancer, satisfaction with one's surgeon, or intended adherence to one's treatment regimen. Additionally, companion presence was linked to the receipt of more network support from the patient's surgeon, whereas no links were found between patient cancer stage and received social support. The application of the nonverbal coding scheme developed for this project for exploratory purposes revealed the challenges of measuring a wide range of nonverbal behavior in this context, particularly due to the low instances of nonverbal social support exhibited by all three sources. Overall, the verbal results point to low emotional support for patients during these appointments, which calls for changes to be made in empathy trainings for medical providers. Additionally, future work should seek to validate the nonverbal social support measurement used in this research by conducting studies with a diverse array of audiences, and most importantly through interacting with patients. This work could lead to a greater understanding of the stress and coping perspective in the provider-patient setting.
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