Exploring the Role of Social Support in Promoting Patient Participation in Health Care among Women with Breast Cancer

Abstract: Scholars have adopted Street’s (2003) ecological model of medical communication to investigate the factors promoting patient participation in health care.  However, factors demonstrated in the ecological model were bounded in the context of medical care between physicians and patients. Social factors, such as patients’ relationships and supportive communication with others outside the context of health care have yet to be explored. Recognizing this gap, this research integrated social support literature into the research on patient participation in health care, and proposed health information competence and emotional management competence as the underlying mechanism that explains the relationship between social support and health care participation. The data analyzed in this study were a part of two larger clinical trials in which 661 women with breast cancer were recruited from three cancer institutions in the United States.  Overall, the results from structural equation modeling analysis provided strong evidence for the hypotheses predicting that perceived social support was positively associated with both health information competence and emotional management competence, which in turn fully mediated the association between social support and patient participation in health care.  Theoretical and practical implications for social support, competence, and healthcare participation are discussed.