The whole is greater than the sum of its parts: The social support exchange process

Social support is a dyadic exchange process that yields many psychological and physiological health benefits. The goal of this study was to examine the effects of the support exchange process from a dyadic perspective on health outcomes and to investigate the extent that gender and relationship characteristics influence the support process and health outcomes. It was hypothesized that female patients would report seeking more support and male patients would report receiving more support. In addition, it was expected that patient seeking support would be associated with both partner provision and patient receipt of support. It was also hypothesized that patients' receipt of support would be predictive of better health outcomes. Among a sample of 195 cardiac rehabilitation patients and their self-selected support partners, the current study examined three dimensions of health-related social support: patient seeking, partner providing, and patient receiving. In addition, patients' gender, characteristics of their relationship to the support provider, and living with support partners were included as cross-sectional predictors of support and health outcomes. The support variables, gender, and relationship characteristics were examined on the health outcomes of psychological well-being, physical well-being, depressive symptoms, blood pressure, relationship satisfaction, and coping efficacy. A combination of mean differences, correlations, and path analyses were used to examine the hypotheses. Male patients were more likely than female patients to seek social support, receive social support, and live with their support partners. Living with one's support partner was associated with partners' providing more support and patients' receiving more support. Patients with a spousal support partner reported receiving more support than patients with adult children support partners. More support receipt was related to better psychological well-being, greater relationship satisfaction, and better coping efficacy. Gender of patients and living with a support partner were important predictors of the support exchange process and the health outcomes. In addition, seeking support emerged as an important predictor of receiving support. The current study provides psychosocial pathways that may help reduce the health disparities that exist among African American patients with cardiovascular disease. Future research should examine these constructs from a longitudinal perspective and include multiple social support measures. Clinical implications include assessing social support resources to improve well-being during cardiac rehabilitation.