This article reports 3 studies in the development of the Patient Reactions Assessment (PRA). The PRA is composed of three 5-item scales designed to measure the perceived quality of the informative (Patient Information Index) and affective (Patient Affective Index) behaviors of the provider and the patient's perceived ability to initiate communication (Patient Communication Index) about the illness. The PRA was constructed according to factor-analytic procedures using cancer patients as subjects. The PRA and its subscales demonstrated high internal consistency. Concurrent validity for the PRA was shown by its ability to differentiate known groups of providers with respect to quality of patient relationships. As predicted, replicated confirmatory factor analyses supported the conceptual model on which the scale was constructed and indicated that the subscales represented related but separate relationship factors.The relationship between patient and medical provider has a profound effect on a variety of health care variables including treatment compliance, patient satisfaction, and problem resolution (e-g., Inui & Carter, 1985;Joos & Hickman, 1990). In a meta-analysis of 41 observational studies of the relation between provider behaviors and patient outcomes, Hall, Roter, and Katz (1988) conceptualized the relationship in terms of two broad dimensions or sets of variables: task and socioemotional.Provider information giving, question asking, and technical competence are task-oriented behaviors designed to serve instrumental goals in the medical visit. The most important of these, information giving, is related to patient post-visit satisfaction, to compliance (e.g., appointment keeping or treatment adherence), and to patients' recall of information and understanding of their condition (Hall et al, 1988). On the socioemotional side, provider interpersonal competence is associated with patient satisfaction, and partnership building or receptivity to patient input is associated with both satisfaction and recall-understanding. In addition, positive talk, which includes understanding and acceptance, is positively related to satisfaction, compliance, and recall-understanding, whereas negative talk is negatively related to compliance. Task-oriented behaviors tend to be reciprocated by patients, as do socioemotional behaviors. Moreover, task-oriented behaviors tend to be interpreted by patients as reflecting caring and other socioemo-

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This descriptive study investigated perceptions of a peer-helper, telephone-based, social support intervention for melanoma patients receiving immunotherapy. Participants were 59 male and female Stage 3 or4 melanoma patients (helpees) at a Comprehensive Cancer Center and 29 former patients (helpers). Helpers were matched with helpees about to begin immunotherapy based on the site of the melanoma, age, and, when possible, biological sex. The intervention consisted of 2 required telephone contacts initiated by the helper before the helpee's first and second immunotherapy treatments. The reactions to this social support intervention were assessed using surveys and telephone interviews with both open- and closed-ended questions. Results indicated that (a) helpees became more sensitive and open to available social support in their environment; (b) helpers and helpees thought the intervention was effective; and (c) the telephone, as a medium for providing support, was a satisfactory substitute for face-to-face interaction. Limitations of the study and future directions for telephone-based support programs for melanoma patients are discussed.

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