Negative aspects of social support networks among a diverse sample of breast cancer survivors in the San Francisco Bay Area

Background: Although dynamics within social support networks encompass both positive and negative interactions, little attention has been paid to negative aspects which can induce conflict and stress in coping with breast cancer. This qualitative study aimed to identify negative and positive aspects of social support networks which can influence the health and well-being of breast cancer survivors.

Methods: Using a grounded theory approach, we analyzed data from 61 breast cancer survivors from eight different racial/ethnic groups who participated in 7 focus groups (n= 38) and one-on-one interviews (n=23).

Results: Participants reported: (1) family support was not as positive as expected and often cited feeling the social burden of managing other people's emotions and coping difficulties regarding the participant's breast cancer diagnosis; (2) fear and reluctance to disclose their cancer status to other members of their social network, thereby failing to potentially benefit from supportive social interactions. Among ethnic minority groups, cancer support groups were often underutilized as women preferred one-on-one interactions with acquaintance breast cancer survivors. While non-Hispanic white women were generally satisfied with their familial and extended network support (i.e. colleagues, spiritual communities), women from ethnic minority groups reported increased marital strain and negative social interactions following diagnosis.

Conclusions: Themes around negative interactions contradicted the presumption that social support networks offer only positive interactions for breast cancer survivors. Understanding these negative interactions can greatly enhance our understanding of survivorship issues and inform interventions to improve the health and well-being of women in all racial/ethnic groups.