Evaluating family caregivers\u27 memorable messages of social support in the context of cancer

Caring for a loved one with cancer can be physically and emotionally difficult. Research has established that social support can improve overall mental health (Albrecht & Goldsmith, 2003; Sarason et al., 1994). However, many family caregivers still report having unmet needs (Molassiotis et al., 2011) due to a lack of meaningful supportive interactions with social networks (Keitel et al., 1990). To understand how caregivers make sense of the supportive messages they receive and the links between those messages and caregiver well-being (e.g. stress, depression, and affect), this study used the communicated sense-making model (CSM, Koenig Kellas & Kranstuber Horstman, 2015). Specifically, the current dissertation focuses on memorable messages, as one significant form of CSM, in order to identify the understudied nature of supportive message content and the ways in which message content relates to how caregivers feel in the context of cancer caregiving. In addition to CSM, the study of social support lends insight into how people cope with trauma. Therefore, the current dissertation investigated the links between quality of social support and message content to obtain a richer understanding of sense-making and coping for caregivers. An area of study within social support is verbal person centeredness (VPC), which focuses on characteristics of message delivery and outcomes, such as empathy and concern. However, less work has linked VPC to message content in cancer. Memorable messages help to link VPC to message content because they are short, discursive messages that people recall. VPC is also linked to quality of support; therefore, this study sought to uncover the memorable message content that is most person centered. The purpose was to understand what types of message content was most effective in helping caregivers cope and contributing to overall health. The long-term goal of this project is to develop educational materials (e.g. pamphlets, websites) for family caregivers’ social networks. 156 current or former (e.g. bereaved or remission) self-identified primary family caregivers of patients with cancer were recruited to participate in an anonymous online survey. Family caregivers, in this study, were characterized by their involvement in providing assistance to helping patients cope with and manage cancer care (Hardwick & Lawson, 1995). Participants were asked to share the most positive and negative memorable message they received from their social network as well as additional memorable messages they could recall. Inductive coding resulted in five Supra-types of memorable messages including: welcome contributions, messages of hope, thoughtfulness, dismissive, and unwelcome contributions. After each memorable message, caregivers’ were asked to evaluate the degree of VPC for each message. Findings suggest that dismissive message types significantly and positively predicted caregiver stress. Support type was also found to be significantly related to positive memorable messages. Messages of hope and, interestingly, dismissive messages were most likely to be categorized as emotional support whereas thoughtful messages were most likely to be coded as tangible support. The implications for this study were to provide recommendations for future education and research in the context of cancer care