Relationship Distance as Facework Strategy: Family Members’ Account for Non-Support to Cancer Patients

Based on observations and interviews at a comprehensive hospital in China, this study explored how family members engaged in facework to explain their nonsupport to cancer patients. The findings reveal that family members employed relationship distance as a facework strategy in two relationship contexts. In the patient-self dyad, family members used "drawing closer to the patient" (e.g. following the patient's wishes) and "pulling away from the patient" (e.g. putting the nuclear family first) to account for nonsupport. Within the patient-spouse-adult children-siblings multi-ring relationship, family members in outer circles used "staying away from the patient" and highlighting inner circle roles (e.g. the patient's siblings narrowly defined the concept of family); those in inner circles used "pulling outer circle roles close to the patient" (e.g. the spouse values the opinion of the adult children or the patient's siblings); and family members in the same circle highlighted "the same distance with the patient" (e.g. emphasizing the common responsibilities of each child). This study expanded the relationship-centered inquiry into nonsupport from a narrow patient-supporter dyad to a patient-centered, multi-ring relationship network that includes all potential supporters.