Social support and patterns of adjustment to breast cancer.

The effect of marital support and support from other adults on the emotional and physical adjustment of 128 women with breast cancer was examined. Role function and satisfaction with health care also were evaluated as predictors of adjustment. Intact data series were obtained at 7-10 days, at 1, 2, 3, and 6 months, and 1 year postsurgery. Emotional adjustment could be predicted by satisfaction with a spouse's response to interactional and emotional needs and by support from other adults. The relationships were significant at concurrent times, across contiguous times, and predicting from the 7-10 day postsurgical period to both the 6-month and 1-year end points. Physical adjustment was not predicted by support but satisfaction with health care was predictive of perceived overall health status. Functional status in vocational, domestic, and social roles was significantly related to emotional and physical adjustment at all phases with few exceptions.

Differentiation of self: an examination of the concept.

Differentiation of self is a concept that has been used interchangeably with the similar concepts of individuation and psychological differentiation. The construction of a sound empirical knowledge base for differentiation of self has been hindered by the lack of conceptual-operational fit found in many studies. Using a modification of the concept analysis approach proposed by Walker and Avant (1988), a detailed description of differentiation of self is presented, delineating it from similar concepts. Differentiation of self is defined as the ability to distinguish between thoughts and feelings in an emotional relationship system. As the cornerstone concept in the Bowen theory (1985b), knowledge about differentiation of self has important clinical implications for nurses and other health professionals who strive to improve the assessment and intervention process in their work with individuals and families.