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[Qualitative Research in Medicine & Healthcare 2018; 2:7387] [page 113]
Introduction
Breast cancer is the most common type of cancer and a
leading cause of death among women in the U.S.1 Breast
cancer diagnoses vary widely and patients diagnosed with
breast cancer require treatment regimens personalized for
individual needs.2 As such, women diagnosed with breast
cancer have a need for both quality cancer-related informa-
tion3 and social support.4-8 Healthcare professionals, such
as physicians and nurses, often are a primary source of can-
cer-related information3 and social support6 for women di-
agnosed with breast cancer. Research has long indicated
that people diagnosed with cancer have increased support
needs9 and that healthcare providers often help to meet
these support needs.6,8,9 Studies examining the support pro-
vided by healthcare professionals have focused on the
source of the support (e.g., physician, nurse), the function
of the support provided (e.g., informational, emotional),
and the health outcomes related to patients’ use of support.6
Cancer is a complex diagnosis and, as such, people di-
agnosed with cancer receive complex information and ex-
perience a greater number of interactions with healthcare
providers.3 Many research studies have cast cancer-related
information provided to patients by providers as a type of
social support.4,5,8 However, limited research has investi-
gated how the manner used to provide cancer-related in-
formation leads to patients feeling supported rather than
overwhelmed and unsatisfied.6 That is, much of the re-
search on the informational support provided to those di-
agnosed with cancer classifies the cancer-related
information delivered to patients by healthcare providers
as supportive, but does not distinguish whether patients
feel the information they received has met their needs as
opposed to actually considering it delivered in a support-
ive manner. Research suggests that healthcare providers
do not always provide adequate amounts of cancer-related
information to patients and patients may be left with
unmet needs.10 Further, when patients’ information needs
are not fully met, they may have worsened health out-
comes as a result.3 However, patients report more satis-
faction with their medical encounter and experience
various health benefits when they receive informational
support.6,11 Thus, understanding the characteristics of in-
formation delivery patients report as supportive may assist
researchers in ensuring that patient information needs are
met. The present study examines the ways in which
Above and beyond: an exploratory study of breast cancer patient
accounts of healthcare provider information-giving practices
and informational support
Andrea L. Meluch
Department of Communication Studies, Indiana University South Bend, South Bend, Indiana, USA
ABSTRACT
This qualitative study examines breast cancer patients’ accounts of the characteristics of healthcare providers’ supportive informa-
tion-giving practices. Twenty-two women diagnosed with breast cancer participated in semi-structured in-depth interviews designed to
understand their experiences receiving supportive information from healthcare providers (e.g., oncologists, surgeons, nurse practitioners).
Participants’ accounts suggest that providers who spend extensive time discussing cancer-related information and who explain that in-
formation thoroughly so that patients can understand their medical situation, are communicating informational support in contrast to
merely presenting factual information related to cancer diagnosis and treatments. Participant accounts further suggest that the supportive
nature of provider information-giving practices results from message framing, or the provider’s metacommunication.
Correspondence: Andrea L. Meluch, Department of Communica-
tion Studies, Indiana University South Bend, 1700 Mishawaka Av-
enue, South Bend, Indiana 46615, USA.
Tel.: 574.520.5232.
E-mail: ameluch@iusb.edu
Key words: Informational support; Breast cancer; Information-giv-
ing; Healthcare; Metacommunication.
Conflict of interest: the author declares no potential conflict of in-
terest.
Funding: none.
Received for publication: 28 February 2018.
Revision received: 21 July 2018.
Accepted for publication: 21 July 2018.
This work is licensed under a Creative Commons Attribution Non-
Commercial 4.0 License (CC BY-NC 4.0).
©Copyright A.L. Meluch, 2018
Licensee PAGEPress, Italy
Qualitative Research in Medicine & Healthcare 2018; 2:113-120
doi:10.4081/qrmh.2018.7387
Qualitative Research in Medicine & Healthcare 2018; volume 2:113-120
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healthcare professionals convey information in a support-
ive manner to breast cancer patients.
Social support
Social support is a communicative process that results
in the construction of social networks.12 Albrecht and
Adelman13 defined social support as verbal and nonverbal
communication between recipients and providers that
helps reduce uncertainty about the situation, the self, the
other or the relationship and functions to enhance a per-
ception of personal control in one’s life experience. Al-
brecht and Adelman’s definition argued that social support
reducesuncertainty, or the ambiguity, that one experiences
when one does not have complete information.14 For ex-
ample, one encounters many unknowns when diagnosed
with breast cancer (e.g., duration of illness, outcome of
illness) and these unknowns can create feelings of uncer-
tainty about numerous aspects of the situation. Albrecht
and Adelman13 explained that uncertainty in health crises
leads to stress. They contended that when social support
reduces uncertainty, social support also reduces stress.
Thus, Albrecht and Adelman initially argued that social
support benefited health by reducing stress.
Albrecht and Goldsmith12 later revised their13 defini-
tion of social support to argue that social support helps in-
dividuals manage, instead of reduce, uncertainty. For
example, people diagnosed with cancer can manage un-
certainty related to treatment decisions when they receive
informational support, thereby, improving their decision
making and problem solving.6,15Albrecht and Goldsmith12
also recognized that uncertainty is not necessarily a neg-
ative experience. Although an individual often experi-
ences uncertainty negatively (e.g., concerns over one’s
ability to pay medical expenses or one’s ability to manage
side effects of chemotherapy treatment), uncertainty also
can be a positive experience if it allows an individual to
feel hopeful or optimistic. For example, people diagnosed
with advanced cancer often want their healthcare
providers to communicate some level of ambiguity about
the future so that they can retain a sense of hope and even
optimism regarding length and quality of life.16 Thus, so-
cial support helps individuals better manage the uncer-
tainty accompanying their cancer diagnosis and
experience reduced stress as a result.
The functions served by social support have interested
researchers for several decades.12 Early on, Cobb17 ex-
plained that social support can provide resources (e.g., in-
formation, material aid, encouragement) that help
individuals moderate their stress. Researchers later devel-
oped typologies of the functions that social support
serves.18,19 Today, researchers often focus on three func-
tions of social support (informational, emotional, instru-
mental).20 Researchers interested in the social support
people diagnosed with cancer receive from their health-
care providers commonly examine the informational func-
tion of social support.6
Informational support
Information, explanations, guidance, and advice can
be understood as informational support.20 Sources of in-
formational support for people diagnosed with cancer in-
clude family and friends,4 peers patients interact with
through digital forums,21 and healthcare providers.4,6 Can-
cer patients often indicate an increased desire to receive
informational support from their healthcare providers.5,6,8
Most patients receive substantial information from their
healthcare providers and providing information in itself
is a responsibility associated with healthcare providers’
jobs or organizational roles.3,22 That is, healthcare
providers have the responsibility to provide patients with
the information they need to make informed decisions
about their treatment.3,15,22
For patients, informational support can be a critical re-
source in helping one manage uncertainty, feel a greater
sense of control over the situation, and experience health
benefits.5,6,11 Mills and Sullivan11 reviewed literature re-
garding relationships between informational support of-
fered by nurses to people diagnosed with cancer and those
patients’ health outcomes. They found associations be-
tween the informational support provided by nurses and
reduced anxiety, enhanced sense of personal control,
greater compliance with suggested medical regimens, and
feelings of greater security. However, cancer patients do
not always see information-giving processes as helpful
because the amount or complexity of information can be
overwhelming and contribute to greater stress and uncer-
tainty.16,23 Thus, receiving information from a healthcare
provider in of itself is not necessarily a supportive expe-
rience leading to health benefits.
Numerous research studies have indicated that people
diagnosed with cancer classify the information that they
receive from their healthcare providers as informational
support.4,5,8,15 For example, Nazione et al.5 examined the
verbal informational support surgeons provide to breast
cancer patients. They operationalized informational sup-
port as any suggestion or advice...evaluation of the prob-
lem...[and] form of teaching the patient about the problem
in an effort to problem solve.5 Nazione et al.’s operational-
ization of social support focuses on the content of the
message, or verbal communication of information, and
the outcomes of that information (i.e., making decisions
about treatment). However, this operationalization of in-
formation-giving does not fully explain what it is about
the way providers present information to patients that in-
dicates the supportive nature of the communication (i.e.,
helping them manage uncertainty) in contrast to it being
overwhelming, confusing, and/or unhelpful. Given that
the majority of researchers have focused mainly on the
informational content provided to patients (e.g., as advice,
as a description intended to teach the patient) instead of
whether other characteristics of provider information-giv-
ing (e.g., amount of information given) are indicative of
supportive communication, the present exploratory study
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seeks to fill this gap. Thus, the following research ques-
tion guides this study: What are the characteristics of
healthcare provider information-giving processes that
breast cancer patients report as indicating support?
Materials and Methods
The data used in this study are a subset of a larger ex-
isting dataset gathered to investigate cancer patient expe-
riences of social support in healthcare settings. I
conducted semi-structured in-depth interviews with indi-
viduals diagnosed with various types of cancer and fo-
cused on the interviews with women diagnosed with
breast cancer in the present analysis.
Participant demographics
Participants’ ages ranged from 34-82 years-old
(M=59.59, SD=10.73). Twenty participants self-identified
as white and two participants self-identified as white and
Native American. Participants were at different stages in
their breast cancer treatment. The majority of participants
(14) were married, four participants were divorced, two
participants were widowed, and two participants had
never been married. Three participants did not have chil-
dren, four participants had one child, ten participants had
two children, three participants had three children, one
participant had four children, and one participant had six
children. Five participants had obtained a high school
diploma or GED, three participants had attended some
college, six participants had obtained an associate’s de-
gree, five participants had obtained a bachelor’s degree,
and three participants had earned a graduate degree.
Recruitment and data collection procedures
I recruited participants at a cancer wellness center lo-
cated in a medium-sized Midwestern city. Before the in-
terviews took place, I conducted an informed consent
process with all interviewees. The university Institutional
Review Board approved the interview protocol used. I
audio-recorded all interviews.
I conducted in-depth interviews with all study partic-
ipants. In-depth interviews are the use of interviewing
techniques to gather information and knowledge – usually
deeper information and knowledge than is sought in sur-
veys, informal interviewing, and focus groups.24 Using
Charmaz’s25 intensive interviewing process, I engaged in
a one-sided conversation in which participants shared
with me their personal experiences. Intensive interviews
focus on a particular topic of which the participant has
first-hand experience.25 For example, in the present study
participants shared their first-hand experiences interacting
with healthcare providers throughout their breast cancer
treatment.
To assist in focusing the conversation on the topic of
interest in the present study, I followed an interview proto-
col that focused on patients’ experiences of support and
nonsupport in their personal network (e.g., family friends),
at a cancer wellness center, and with healthcare providers.
Specifically, the interview protocol included questions ask-
ing participants about: i) instances of support and nonsup-
port from family, friends, and colleagues; ii) experiences
interacting with other people diagnosed with cancer and
participating in activities at the cancer wellness center; iii)
their healthcare experiences related to cancer; iv) the extent
to which participants felt supported by healthcare providers
(e.g., physicians, nurses) and specific instances or examples
of support (or nonsupport) during their cancer care; and vi)
their accounts of the role of healthcare organizations and
healthcare providers in society. Interviews ranged in length
from 40 minutes to 118 minutes (M=60.86 minutes;
SD=15.79). Transcripts were encrypted and sent to
Rev.com for transcription. After I received completed tran-
scripts I de-identified them and assigned pseudonyms to
each participant. Pseudonyms are used throughout the find-
ings to refer to participants.
Data analysis
I implemented a constructivist grounded theory ap-
proach in the analysis of transcripts. Constructivist
grounded theory is an interpretive, systematic, and flexi-
ble method of qualitative analysis using comparative
methods.25 A constructivist grounded theory approach to
data analysis acknowledges the socially constructed na-
ture of reality and the researchers’ construction and inter-
pretation of the qualitative data.25 Specifically, this
approach acknowledges the researcher’s role in creating
the context in which the research is conducted and the
process through which it is interpreted. As such, the find-
ings of this qualitative approach are subject to my inter-
pretations of the dataset.
Two independent coders (myself and a research assis-
tant) engaged in the initial coding of the transcripts. The
research assistant only participated in the initial coding
phase for the present study. Two independent coders en-
gaged in initial coding to enhance the trustworthiness of
the findings. Initial coding is the process of selecting data
related to the study focus and assigning provisional, com-
parative, and descriptive codes grounded in the data.25 I
used line-by-line coding during this process. Line-by-line
coding is the process of identifying and describing inci-
dents in the data and then comparing the descriptions of
the coded incidents to new datums.26 Short, descriptive
codes were assigned to each line of data analyzed. Exam-
ples of line-by-line codes used include the line “[the
physician] went over everything step by step” was coded
as “in-depth explanation from physician” and the line
“[the physician] was explaining to me what the difference
was and why, what the clinical studies were, and why they
pushed this to be done” was coded by as “medical expla-
nation for treatment.”
I then engaged in Charmaz’s25 process of focused cod-
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ing. Focused coding is the process of categorizing the
most significant and repetitive initial codes.25 I analyzed
sets of similar initial codes and then assigned them to a
focused code or category. Examples of focused codes
used include “in-depth discussions with physicians,”
“complete patient understanding of the information,” “in-
creased time explaining information,” and “information
presented supportively.” Finally, I engaged in theoretical
sampling to determine the properties of each category
identified in the focused coding process and the connec-
tions among them.25 Charmaz25 defines theoretical sam-
pling as the process of refining and elaborating on the
categories identified to construct the key findings of the
analysis. I identified two key themes related to the nature
of informational support provided by healthcare providers
through the theoretical sampling process. Identification
and examination of these themes and their intersections
are in the study findings section.
Results
The research question guiding this study asks what are
the characteristics of healthcare provider information-giv-
ing processes that breast cancer patients report as indicat-
ing support. The analysis of data reveal two related
characteristics of provider information-giving processes
that participants report as supportive: i) extensive time
spent providing cancer-related information, and ii) careful
explanation of complex-cancer related information. I also
examine the intersections between these related charac-
teristics of informational support.
Extensive time spent providing cancer-related
information
The first characteristic of participants’ interactions
with providers that they report as being supportive in na-
ture is healthcare providers spending extensive time dis-
cussing cancer-related information. Prior research
indicates that the duration of an office visit varies widely
among cancer patients and physician reimbursement prac-
tices may also affect duration of offices visits.27Although
it is unclear whether the time providers spend with pa-
tients diagnosed with cancer is associated with better
health outcomes, interviewees did say that when their
physician or other healthcare provider spent extensive
time with them they received an increased amount of can-
cer-related information, that their providers were acting
in supportive ways, and that they were better able to make
treatment decisions. Thus, a clear commonality among
participants’ accounts of labeling healthcare providers’ in-
formation-giving processes as supportive (in contrast to
non-supportive) relates to the extensive amount of time
those providers spent discussing cancer-related informa-
tion with the participants.
Participants repeatedly reported that providers’ exten-
sive time spent delivering information signifies supportive
communication. For example, Dolores (76, Stage 1
Breast) said:
I really like nurse practitioners [because they] re-
ally have more time and give you a lot more informa-
tion. I know they are listening to me and
understanding what I’m saying too because sometimes
you can talk but you can tell [healthcare providers are]
not understanding.
Dolores also said that her doctor was “wonderful” be-
cause “he will sit and talk to me and ask me if I have any
problems too.” Dolores’ account emphasizes that when
healthcare providers are not rushed she can completely
share her concerns, ensure that her concerns are under-
stood, and receive complete informational responses.
Other participants similarly noted that when providers
spend extensive time providing information they feel
cared for and comfortable with their treatment. Julia (50,
Stage 2 Breast) explained that her cancer-care team
“spends as much time as I need them to be there.” Like-
wise, Elaine (58, Stage 3 Breast) reported that her physi-
cian answered all of her questions and “spent that time
with me.” Ramona (56, Stage 1 Breast) said that the
“length of time” her surgeon spent with her going over
cancer-related information was “shocking” because she
was accustomed to her other physicians (e.g., general
practitioners, gynecologists) rushing through the appoint-
ment and not receiving enough information.
One exception to this pattern is Lily (49, Stage 1
Breast) who said that “at first” her oncologist was “pretty
good” when “explaining” her cancer treatment plan. How-
ever, later when she went to her appointments the doctor
seemed “rushed” and she “did not always get all the in-
formation” she needed or wanted. Lily noticed that she
was more nervous about her condition after these short
interactions and did not feel that her physician spent the
time needed to “explain this to me in a way that I could
understand.” Lily wanted her providers to “sit down and
chat with me for an hour,” but felt that either the providers
were unable to (because of the number of patients they
see) or did not want to spend that kind of time with her.
When her providers rushed, Lily saw them as less com-
mitted to her as a patient making her feel like she was “a
cog” in the “corporate medical giant machine.” Thus,
when healthcare providers do not spend sufficient time
imparting complex cancer-related information, patients
accounted for the interaction as lacking support, and a
mere function of the provider’s job.
Interviewee accounts showed an understanding that
providers have significant time constraints and, thus,
found the extra time spent with them be unexpected and
indicative of support rather than simply as professionals
doing their jobs well. Sloan and Knowles’8 findings sim-
ilarly indicate cancer patients perceive healthcare profes-
sionals as more caring when they spend time at length (or
repeatedly) providing information to them. In addition,
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Sloan and Knowles8 also found that when healthcare
providers rush through information with patients, patients
will feel less satisfied with their interactions and likely
not supported.
Careful explanation of complex cancer-related
information
The second characteristic of participants’ interactions
with providers that they report as being supportive in na-
ture is healthcare providers explaining information care-
fully in order to ensure that patients understand complex
cancer-related information (e.g., diagnosis, side effects,
treatment plans). Participants believe that their providers
carefully explain cancer-related information because
providers want to ensure that they (as patients) are able
to understand complex information related to cancer. For
example, Carrie (34, Stage 4 Breast) said that her cancer
care team was very “caring” and “would explain things
and continue on until I understood.” Tara (58, Stage 1
Breast) reported that her oncologist “comes in and she’s
talked to me through everything.” Tara continued on to
say that because of her oncologist’s careful explanations
she “felt better going into [treatment].” Stephanie (67,
Stage 3 Breast) said, “When they were giving me
chemo...[the physician provided a] very good justifica-
tion, medically...to give me that drug.” As such, this ex-
planation helped Stephanie to better understand the
reasoning for her treatment.
Nora (72, Stage 1 Breast) said that her doctor was “very
good about explaining the radiation, the machines and all
of that” so that she “understood” her treatment fully. Nora
also noted that she “threw a fit” when tests showed that her
“margins were not clear” after her first surgery, but that her
doctor showed “great concern” when explaining why she
needed additional treatments and it helped Nora to “put
things in perspective” and move forward with the treat-
ment. Sandra (55, Stage 1 Breast) reported:
[My oncologist] went out of the way to make sure
I understood what she was talking about... She was ex-
plaining to me what the difference was and why, what
the clinical studies were, and why they pushed this to
be done.
Sandra further explained that she was “grateful” to her
physician for carefully explaining the rationale for her
treatment “because I had a lot of concerns” and “wanted
to know the benefits” before making a decision on the
type of treatment to choose. She felt that her physician
went “above and beyond” her job responsibilities and, as
a result, Sandra felt very supported by her physician. Sim-
ilarly, Lindsay (56, Stage 3 Breast) reported that her sur-
geon was caring because of the depth with which he
presented the information to her. She said, “My sur-
geon...brought me in the office and he had a booklet [on
cancer] there. He went over everything step by step. Ex-
plained everything about it. What my type [of cancer] was
and all this stuff.”
Other participants similarly reported that their health-
care providers were supportive, in contrast to delivering
facts about cancer as simply part of their work in instances
where providers made sure that patients had fully under-
stood what they said. For example, Tamra (50, Stage 4
Breast) attributed her healthcare providers’ actions as mo-
tivated by a desire for her to understand the information
presented when she said they “make sure I’m understand-
ing everything like my medicines, or if I need anything
explained to me or if I need help with getting something
medical-wise or anything, they help me with that.” Tamra
characterized them as “such a supportive team” because
they consistently ensured that they met her healthcare
needs (informational and otherwise). Ginny’s (62, Stage
1 Breast) experience of her oncologist explaining in-depth
cancer information thoroughly is particularly unique.
Ginny experienced reduced sexual desire as a side effect
of her cancer treatment, which caused frustration for her
and her partner. Ginny reported strong support from her
oncologist when they met to discuss this side effect. She
said, “[The physician] would have him come in [to the of-
fice] because she wanted him to understand what was
going to be happening to me.”
An exception to providers thoroughly explaining com-
plex cancer-related information to meet participants’
needs included Julia’s first conversation with her surgeon.
Julia (50, Stage 2 Breast) reported that her surgeon called
her while she was at work and told her that she had “can-
cerous tissue [that was] probably nothing.” Julia said that
the information was “overwhelming” and that she did not
believe that the surgeon had fully explained what her
medical situation was and what her options were. In ad-
dition, Julia felt the communication of cancer-related in-
formation over the phone in contrast to being in person
further diminished her ability to fully understand her med-
ical situation. Julia’s experience highlights the need for
differentiating between information-giving and offering
information as supportive communication. That is, the
manner providers communicate information may not in
fact be supportive, thus increasing uncertainty.
Participants attested that when providers thoroughly
explained complex cancer-related information they felt
more comfortable making difficult decisions related to
their treatment and felt that their providers showed con-
cern for their wellbeing. This second characteristic of sup-
portive information-giving processes relates to the first
characteristic (i.e., spending extensive time) identified.
Specifically, participants’ reports suggest that they are
acutely aware of the complicated nature of cancer diag-
noses and treatment and have a need for their providers
to fully address their concerns (through spending the ap-
propriate amount of time and thoroughly explaining the
information) in order to feel comfortable. As such, when
providers helped participants to feel at ease with their
treatment plans, they more effectively managed the un-
certainty related to their diagnosis.
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Metacommunication characterizing provider
informational support
Participants characterized some of the information-
giving dynamics they experienced with healthcare
providers (e.g., nurses, physicians) as not only meeting
their needs, but as doing so in a manner that also commu-
nicated concern and, thereby, went above and beyond
what they expected or associated with the healthcare
providers’ formal responsibilities and were interpreted as
supportive. Participants consistently point to the manner
(e.g., spending extensive time, explaining information
completely, demonstrating concern for patients’ informa-
tional needs) in which their healthcare providers carried
out information-giving when characterizing the messages
as being supportive. The intersections between these two
characteristics of provider information-giving processes
stem from the framing of the content of the message in-
stead of from the explicit content itself (i.e., the informa-
tion related to the cancer diagnosis or treatment). Thus, it
is the metacommunication, or manner in which providers
present messages, rather than the content of the messages
(i.e., the informational content), that participants interpret
as support instead of simply fulfilling job-related infor-
mation-giving responsibilities.
Wilmot defines metacommunication as anything that
‘contextualizes’ or ‘frames’ messages to assist the partic-
ipants in understanding the communication event.28 One
could easily argue that providing information in medicine
is simply doing one’s job and nothing more. However, the
study findings suggest that participants draw nuanced dis-
tinctions regarding what they expect as part of a
provider’s information-giving responsibilities in contrast
to the presentation of informational messages that demon-
strate support for the patient. Notably, participants indi-
cate that not all provider information-giving processes are
supportive in nature. Specifically, participant accounts
show that providers who rush through information or pro-
vide information without sufficient detail are not support-
ive. As such, these findings suggest that it is the
presentation of cancer-related information, or the meta-
communication, that informs whether messages are sup-
portive or non-supportive.
Discussion
Although providing information is arguably a job re-
sponsibility for healthcare providers (i.e., providers rou-
tinely give health-related information to patients), while
providing social support is not, patients in the present ex-
ploratory study, and in other studies examining social sup-
port and provider-patient communication,4-6,15 often
characterize providers’ information-giving as supportive.
However, unlike much of the literature on the informa-
tional support provided by healthcare practitioners, the
present study differentiates between instances of informa-
tional support and information-giving. That is, partici-
pants in the present study only classified information as
supportive when the provider framed the information in
a caring manner.
Participants’ accounts suggest that much of the time
healthcare providers frame informational messages in
ways that indicate that they care about meeting patients’
informational needs. For example, participants interpret
providers spending extensive time discussing complex
cancer-related information with them (instead of feeling
rushed) as implicitly conveying care and consideration of
their concerns. Thus, patients report that the pace at which
the healthcare providers engage in information-giving
conveys support. Participants also interpret healthcare
providers going out of their way (instead of using medical
jargon) to explain cancer-related information in a way that
is clear and understandable as demonstrating that the
provider cares about their wellbeing (e.g., explaining why
a particular medication is used, offering ways to manage
painful side effects). The present study emphasizes that
metacommunication plays a particularly important role in
patients’ ability to manage uncertainty related to their di-
agnosis and treatment. In these specific ways, providers
implicitly convey informational content in ways patients
deem supportive. Robinson and Tian6 assert that the na-
ture of the relationship between provider and recipient
provides the context in which the socially supportive com-
munication occurs and, to some degree, the way the social
support will be perceived by the recipient. Thus, when
providers interact with patients in ways that communicate
concern for the patients’ informational needs, patients
may believe that they have a more personalized and sup-
portive relationship with the provider instead of a merely
formal relationship.
Conclusions
Study limitations and further research
The present study includes limitations to consider
when interpreting the findings. First, this study was ex-
ploratory in nature and, thus, it included a small number
of homogenous participants located in one city in the
United States. Future studies should include a larger sam-
ple size with varied cancer diagnoses, genders, ethnicities,
and socioeconomic statuses gathered from a more com-
prehensive geographical scope. In addition, future re-
search should more closely examine patients’ expectations
of provider information-giving processes. The interview
protocol used in the present study did not explicitly ask
participants about their expectations of providers related
to information-giving (e.g., do patients expect providers
to rush through appointments?). As such, in the future re-
searchers should ask patients diagnosed with cancer
whether they expect their providers to interact with them
in more supportive ways (especially when providing in-
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formation) because of the serious nature of a cancer diag-
nosis when compared to the way they interact with
providers for other medical reasons (e.g., gynecological
needs, yearly check-ups). Finally, future research should
examine provider perspectives related to supportive com-
munication and information-giving processes (e.g., do
they believe information needs to be given in a supportive
manner). Provider perceptions of information-giving
would be useful in understanding the challenges and op-
portunities that healthcare professionals face when meet-
ing patient information needs and performing their
job-related tasks.
Practical implications
Today there are many sources (e.g., healthcare
providers, online support groups) of informational sup-
port for people diagnosed with breast cancer and, as
such, their access to health information has increased
substantially.21 However, patients often regard healthcare
providers as prime source of cancer-related information,
such as prognosis and treatment options.3 Further, re-
searchers have found that when patients perceive that
their providers deliver support they are more likely to
express satisfaction with their encounter and even follow
directives more closely which may result in better health
outcomes.11 Thus, the present study findings have im-
portant implications for practitioners in two ways. First,
they indicate that practitioners can enact specific behav-
iors (i.e., spending extensive time and thoroughly ex-
plaining information) to ensure that they frame
informational messages in a supportive manner. As such,
practitioners should consider incorporating these com-
municative strategies when imparting information to
breast cancer patients. In particular, communicating can-
cer-related information in a supportive manner may be
beneficial to healthcare providers who are digitally in-
teracting with patients and may have difficulty establish-
ing immediacy the same way they would be able to in
face-to-face encounters. Second, practitioners who prac-
tice supportive information-giving behaviors may find
that their patients are more comfortable and receptive to
the information provided and may be more likely to fol-
low provider guidance (e.g., treatment plans, lifestyle
changes). Thus, providers should not discount the im-
portance of acting in supportive ways when communi-
cating cancer-related information and they should work
to enact these behaviors to ensure that they meet pa-
tients’ informational needs.
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