Perceived stress mediates the effects of social support on health-related quality of life among men treated for localized prostate cancer

Department of Psychology, University of Miami, P.O. Box 248185 Coral Gables, FL 33124, USA.
Journal of psychosomatic research (Impact Factor: 2.74). 12/2010; 69(6):587-90. DOI: 10.1016/j.jpsychores.2010.04.019
Source: PubMed


To examine the longitudinal effect of social support on general health-related quality of life (HRQOL) in men treated for localized prostate cancer, and to evaluate the role of perceived stress as a potential mediator of that relationship, in an ethnically and demographically diverse sample.
Psychosocial assessments were administered to a sample of 175 men at baseline, and 2 years later. Hierarchical regression analyses were conducted to investigate the relationships between social support, perceived stress and HRQOL, while controlling for possible covariates that may affect HRQOL (e.g., age, time since diagnosis, medical comorbidities, etc.).
Higher levels of social support at baseline predicted higher levels of HRQOL at 2-year follow-up after controlling for relevant covariates and baseline levels of HRQOL. This relationship was partially mediated by level of perceived stress at baseline. Furthermore, men perceiving high levels of social support reported significantly higher HRQOL compared with men perceiving low levels of social support.
Results indicate positive social relationships contribute to improved HRQOL in patients who have undergone treatment for localized prostate cancer. One pathway through which social support can benefit HRQOL is through lower perceptions of stress. Enhancing or maintaining social support and reducing perceived stress may be potential targets for future psychosocial interventions aimed at improving HRQOL.

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    • "Perceived social support can be defined as ‘the perception or experience that one is loved and cared for by others, esteemed and valued, and part of a social network of mutual assistance and obligations’ (Wills cited in [15]). Social support is positively correlated with health-related quality of life [16,17] and was identified by Fortin et al. [11] to be one of the most important factors predicting health-related quality of life in multimorbid patients. Therefore, understanding how social support and quality of life are related, can inform primary care interventions addressing multimorbid patients. "
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    ABSTRACT: It is not well established how psychosocial factors like social support and depression affect health-related quality of life in multimorbid and elderly patients. We investigated whether depressive mood mediates the influence of social support on health-related quality of life. Cross-sectional data of 3,189 multimorbid patients from the baseline assessment of the German MultiCare cohort study were used. Mediation was tested using the approach described by Baron and Kenny based on multiple linear regression, and controlling for socioeconomic variables and burden of multimorbidity. Mediation analyses confirmed that depressive mood mediates the influence of social support on health-related quality of life (Sobel's p < 0.001). Multiple linear regression showed that the influence of depressive mood (beta = -0.341, p < 0.01) on health-related quality of life is greater than the influence of multimorbidity (beta = -0.234, p < 0.01). Social support influences health-related quality of life, but this association is strongly mediated by depressive mood. Depression should be taken into consideration in research on multimorbidity, and clinicians should be aware of its importance when caring for multimorbid patients.Trial register: ISRCTN89818205.
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    • "In summary, social support may influence the relationship between coping and HRQoL by main, moderation and mediation effects. There is a pressing need to identifying the mechanisms through which social support operates on coping and HRQoL to facilitate the development of appropriately theoretically driven and targeted interventions (Zhou et al., 2010b) to address the prevalent unmet support needs of these men. "
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    ABSTRACT: Objective: Men affected by prostate cancer can experience profound physical and psychological sequalae; and unmet support needs are prevalent in men affected by this disease. Social support has been linked to improved health-related quality of life (HRQoL) and coping strategies, but little is known about the relationship between social support, coping and HRQoL for prostate cancer survivors. This review aims to identify the mechanism through which social support influences the relationship between coping and HRQoL for prostate cancer survivors. Methods: A literature review was conducted from the earliest date available to January 2013. Medline, CINAHL, PsycInfo, and ASSIA databases were searched using terms relevant to coping, social support and prostate cancer. Studies that explored the relationship between coping, social support and HRQoL were included. Results: 175 studies were assessed for potential inclusion with 11 publications included in this review. Studies predominately reported main effects of perceived social support on HRQoL, and few studies assessed moderation and mediation effects of coping and social support on HRQoL. Perceived social support was frequently assessed, but few studies evaluated the effects of received social support or satisfaction with social support on HRQoL. Conclusions: The evidence base is under-developed at present. Future research should use a multidimensional inventory of the social support constructs to examine how each of the constructs influences the relationship between coping and HRQoL over time. This may facilitate the development of appropriately targeted social support interventions that are theoretically driven to address the unmet support needs of prostate cancer survivors.
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