women. These both related to trying to find causes or explanations for the cancer.
However, reactions to other types of support varied greatly between women. Using
cluster analysis, a statistical technique that classifies people into groupings according
to specified characteristics, they found four different patterns. Group 1 wanted many
types of support, which focused on reassurance that everything would be OK; group
2 wanted people to act normally and did not want to talk about cancer; group 3 wanted
facts, information and general advice; and group 4 wanted to talk but did not want
advice. The four groups did not differ on measures of adjustment to breast cancer.
However a mismatch of support was associated with poorer adjustment, particularly
where people received support they had not wanted.
Health impact of social support
There is strong evidence for positive effects of social support. For example, a thorough
review of 81 studies (Uchino et al., 1996) indicated that social support was related to
beneficial effects on cardiovascular, endocrine and immune functioning. These
researchers also found that interventions to improve social support had beneficial
impacts on heart disease risk factors such as blood pressure.
The mechanisms whereby social support impacts on health have been discussed at
length. Cohen and Wills (1985) suggested two alternative pathways. First, social support
may have a direct effect on well-being and health, i.e. it is beneficial regardless of the
COPING AND SOCIAL SUPPORT 107FIGURE 5.2Greater social support is associated with better health.