Students: Dissertation: Julie Reynolds

Julie Reynolds

ABSTRACT
Advances in medical treatment have improved the rate of survival for women diagnosed with early stage breast cancer, so understanding and assuring their psychological recovery from the trauma of diagnosis and treatment is important. Emotional support from a close personal supporter is known to assist in recovery. However, the form and timing of that support is also important. This study examined the four types of support while women were in-treatment and post-treatment for cancer.

The participants in the study were 101 women who had been treated for breast cancer in the year preceding their participation in the study. The women completed a questionnaire that included medical and demographic questions, a Social Support Survey, and 3 measures of psychosocial adjustment: the Cancer Rehabilitation Evaluation System (CARES), Rosenberg Self-Esteem Scale (RSE) and Profile of Mood States (POMS). Sixty-five women completed a single questionnaire either during adjuvant treatment (chemotherapy or radiation therapy) or following the end of treatment; an additional 36 women completed questionnaires during both phases.

Support was conceptualized as four types that included whether support was wanted and whether it was received: positive congruent support (wanted, received), null support (not wanted, not received), support omission (wanted, not received), and support commission (not wanted, received). Congruent support was defined as matched wanting and receiving of support (positive congruent and null support).

Surprisingly, there was little effect of support on psychosocial outcomes during the in-treatment period, perhaps because medical support available during this phase was a larger proportion of total available support. In contrast, in the post-treatment period, multiple effects of support on psychosocial adjustment (psychosocial functioning, self-esteem, and mood) were found. Over 37% of the variance in CARES and 15% of the variance in POMS was explained by the four types of support. Support commissions had a significant unique effect on CARES with greater amounts of support commissions associated with great psychological distress. Support omissions had a significant unique effect on POMS with greater amounts of support omissions associated with worse mood in the woman. Age was also found to be an important factor. Older women reported fewer support commissions and this enhanced their level of psychosocial functioning. The level of support remained relatively constant from the in-treatment to post –treatment period, although the impact of support was much stronger in the post-treatment period.

The study points to the relevance of considering both support wanted and received by the woman, and the importance of support from the personal supporter in the period following the end of adjuvant treatment compared to the in-treatment period.

Friday, March 16, 2001
DISSERTATION COMMITTEE
Nancy A. Perrin, Chair
Laurie A. Skokan
Cathleen Smith
Martin Zwick
Eileen M. Brennan, Graduate Studies Rep.