This study explored the relationship between perceived social support and PTG among couples coping with GC. The actor effects of perceived social support on couples’ PTG are supported, while, the parnter effects are not supported. Furthermore, there is a statistically significant correlation of perceived social support between women diagnosed with GC and their spouses. In addition, women have lower score of perceived social support than spouses, and spouses have lower score of PTG than their partners. All of these findings provide a broader understanding of the influence that women’s and spouses’ perceived social support has on their own PTG and their partners’ PTG.
The actor effects of perceived social support on PTG (i.e., effects of individuals’ perceived social support on their own PTG) are supported in the present study. A potential explanation for this finding is that the need for receiving appropriate social support in adversity is an intrinsic part of human nature that contributes to health and well-being [32]. Another potential explanation for this finding is that increased relationships with others is often reported in spouses of women diagnosed with GC [4]. However, the partner effects of perceived social support on PTG (i.e., effects of individuals’ perceived social support on their partners’ PTG) are not supported in the present study. This finding is similar to those found in several previous studies that have not shown a significant partner effects between cancer patients and their spouses [20, 22].
In the present study, spouses’ perceived social support was positively correlated with women’s perceived social support and women’s PTG, which supports the evidence that there is a mutual dependency among couples coping with cancer [33]. For example, support received from spouse is woman’s most important source for enhancing their coping capacity after a diagnosis of GC [4, 34]. This finding is consistent with Tedeschi et al. [17], who proposed that positive changes in relationships between dyads and groups (e.g., social support networks, and getting involved with a peer support group) after experiencing the crisis could influence individual PTG. This finding is also aligned with GC being a “we-disease” for couples [4, 13] because support provided in the context of the couple relationship often influences each other partner in the dyad [26].
In the present study, support from family received the highest score for both women and their spouses, which was consistent with Qu et al. [35]. Although social support is a distinct cultural phenomenon [36], similar findings have emerged in other studies [26, 27]. A potential explanation is that the assistance received from other family members (e.g., visiting, offering food, and psychological and emotional support) was a critical resource for helping women diagnosed with GC to effectively balance their own needs, make decisions during uncertainty, cope with the situation, and manage emotions [6, 8, 9]. Another potential explanation is that the assistance received from other family members can help spouses of women diagnosed with GC effectively manage emotions, balance their own needs, make decisions during uncertainty, cope with the situation, and alleviate caregiving burden [4].
In the present study, women had lower score of perceived social support than spouses. The possible reason is that women diagnosed with GC needed help and support from their spouses in multiple ways [13]. These women also needed specific information about their diseases well as support from health care professionals [5, 6, 34]. Nevertheless, asking questions of health professionals is difficult, because women are afraid of being considered incompetent if they ask for clarification about important information [6]. Previous studies have shown that more than 35% of women diagnosed with GC have unmet supportive care needs [34] and are not satisfied with the perceived information during and after their cancer treatment [37]. Thus, more research is required to explore the unmet supportive care needs in these women. Further studies of identifing the sources of perceived support, promoting the maintenance and enhancing the beneficial support in different samples are still needed [23].
In addition, spouses had lower score of PTG than their partners in the present sample, in contrast to the work of Lim [27]. A possible reason may be due to a lack of systematic support being provided to spouses of cancer patients, as previously reported by Andersen et al. [33]. Another possible reason is that men may be less susceptible than women to sharing their experiences with others when confronted with adversity [24]. This assumption was supported by the results of a study by Ge et al. [4], where spouses of women with GC seldom disclosed their feelings/needs and were less likely to ask for help, thus, their supportive care needs were not well recognized or addressed by health care professionals. According to Tedeschi et al. [17], disclosure (e.g., talking to others about stressful or traumatic events), is relevant to PTG as it alleviates the initial emotional distress related with the experience, and fosters cognitive processing, etc. Therefore, it is suggested that, by encouraging spouses to increase disclosure and communication with other family members, health care professionals could help spouses effectively manage emotions, balance their needs, cope with the situation, and alleviate the caregiving burden.
Limitations
There are several limitations. First, this study was performed by recruiting a convenience sample and the majority of the women participants had only undergone surgery, which limits the generalizability of the results to other couples who are coping with GC, including all stages of the disease. A larger sample of more diverse couples may provide a more robust view of perceived social support and how it predicts women’s and their spouses’ PTG. Second, this study verified the actor effects of perceived social support on PTG by using cross-sectional data, thus, the explanation of causal relationships cannot be presented. Given that couples may experience different perceived social support and PTG over time, a longitudinal study, designed to fully explore causal models and determine how to enhance existing perceived social support in couples and ultimately improve couples’ PTG, is needed in future research.