In spite of good intentions: patients' perspectives on problematic social support interactions

BACKGROUND: In the setting of an acute coronary syndrome, the natural inclination of friends and family members is to provide social support. However, their efforts may be perceived as being problematic or unhelpful. The objective of this study was to identify the characteristics of problematic social support interactions from the perspectives of patients. METHODS: This was a qualitative study among a purposive sample of 59 patients who had been hospitalized for an acute coronary syndrome. Patients were asked: "Can you describe the types of things that your family members, close friends, and health care providers did during this period to try to be helpful or supportive but you felt was unhelpful or felt that it caused you more stress." Responses were analyzed using qualitative techniques and reviewed by two independent corroborators. RESULTS: The types of behaviors performed by social network members that were perceived as being unhelpful were grouped under 5 themes: (1) excessive telephone contact, (2) high expression of emotions, (3) unsolicited advice, (4) information without means for implementation, and (5) taking over. CONCLUSION: Patients in this study described actions of their social network members that were intended to be supportive but instead were perceived as problematic because they were in excess of what was needed, they were incongruous with what was desired, or they contributed to negative feelings. Helping social networks to understand the potential problematic aspects of social support can aid in tailoring effective social support interventions.