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Two studies examined the effects of social support and communication on the self-esteem of patients undergoing chemotherapy. In Study 1, a cross-sectional study of 81 patients, the patients perceived high levels of social support, but those who communicated most about cancer had the lowest self-esteem. Although causality cannot be determined in a correlational study, the data suggested that communicating with significant others about the disease may damage a patient's self-esteem even when the others are perceived as generally extremely supportive. In Stud 2, 99 patients were randomly assigned three intervention conditions: (1) standard information (controlled condition), (2) enhanced information, designed to protect self-esteem, and (3) shared information, in which both patient and significant other received the enhanced information. In the first condition, the inverse relationship between communication and self-esteem was replicated. In the second, no relationship was found between self-esteem and communication. In the third, higher levels of communication were associated with greater self-esteem, suggesting that joint viewing of preparatory information by the patient and significant others mobilizes the patient's available support system.
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Ward et al. (1991) studied this question.
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