Social support messages and the management of uncertainty in the experience of breast cancer: An application of problematic integration theory

This article synthesizes past studies of illness, stress, coping, and social support and offers a model of communicative support, based on Problematic integration theory, that emphasizes two major dimensions of meaning in the breast cancer experience. The model suggests that supportive messages are designed to help the breast cancer patient manage both Perceptions of the likelihood (e.g., uncertainty) of various illness experiences and evaluations of those experiences. Support messages are designed to facilitate coping by reducing, maintaining, or increasing the supportee's level of uncertainty; variations in message design are expected to be related to perceptions of the supportee's pre-message uncertainty about and evaluation of the potential experience. These expectations were tested by asking breast cancer patients to formulate supportive messages in response to several hypothetical scenarios. The same patients were then asked to judge the likely function of their messages. These judgments were assessed by means of loglinear analysis. The results generally support the model of social support suggested by problematic integration theory.