Components of social support among Japanese women with breast cancer

To describe social support from the perspective of Japanese women with breast cancer.

Qualitative, descriptive, and interpretive.

Outpatient breast clinic at a cancer center in a metropolitan area in Japan.

Sixteen Japanese women diagnosed with stage I and II breast cancer who underwent either modified radical or radical mastectomy and were receiving outpatient follow-up care. The majority were in their 50s, married, and employed.

Narrative data were collected through individual interviews using a semistructured interview guide. Responses were analyzed using qualitative, inductive content analysis.

Social support experiences.

"Simply Do It!," "Doing With/Being With," and "Doing For" were three situations in which Japanese women described social support. Doing For was the provision of instrumental aid and was most consistent with Western findings. Each of the three situations was perceived as emotional support. Cultural norms of reciprocity and social obligation entailed strong social imperatives that were sources of conflict. Verbalizations of personal feelings and emotions often did not occur, even among closest family and friends, but were communicated by behavior.

The influence of Japanese culture on interpersonal relationships is strong and guided by cultural norms that include social obligation, maintaining harmonious relationships, and reciprocity. Provision of instrumental aid and areas of conflict were most consistent with Western findings, but differences in sources and forms of social support were pronounced. Continued exploration of social support in Japanese women with breast cancer is warranted.

Understanding and valuing cultural diversity is vital to developing more effective and individualized nursing care consonant with patients' and families' desires and comfort.