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Importance of Social Support in Cancer Patients
Abstract
Social support is regarded as a complex construct which has long been suggested to have direct and buffering effects on patients' wellbeing and emotional adjustment to cancer. Cross-sectional and prospective studies show a positive association between perceived social support and psychological adjustment following cancer treatment. Research findings suggest that the evidence for the relationship between social support and cancer progression is sufficiently strong. This report points out the importance of social support in cancer and provides recommendations for health care professionals.
... Being married is associated with decreased mortality [66,67], most likely due to the support partners can provide to their loved ones living with cancer. Those patients who are divorced or separated may feel alone due to this support being lost, which can negatively affect their mental health [68]. Patients are thus unable to sufficiently adapt to cancer or cope with their diagnosis [68,69], placing them at risk for suicidal behaviors such as ideation and attempt [47,70,71]. ...
... Those patients who are divorced or separated may feel alone due to this support being lost, which can negatively affect their mental health [68]. Patients are thus unable to sufficiently adapt to cancer or cope with their diagnosis [68,69], placing them at risk for suicidal behaviors such as ideation and attempt [47,70,71]. Cancer support groups may fill this gap for unmarried patients, allowing patients to benefit from the shared experiences, support, and coping provided in these settings [72]. ...
Purpose
A cancer diagnosis results in significant distress and adverse psychosocial sequelae, including suicide, the 10th leading cause of death in the USA. Primary risks for death by suicide include depression and opioid abuse, which are prevalent among cancer survivors. Yet, it remains unclear whether they are also associated with other suicidal outcomes, such as ideation, planning, and suicidal attempt.
Methods
We used cross-sectional data from the National Survey on Drug Use and Health (2015–2019, N = 214,271), a nationwide study in the USA that provides data on mental health and other health concerns. Outcome of interest was suicidality (suicidal ideation, planning, and attempt). Main exposures were history of depression and non-medical use of pain prescriptions. Using weighted logistic regression analyses adjusted for sociodemographic factors and substance use, we estimated odds of suicidal ideation, planning, and attempt.
Results
There were 7635 cancer survivors in our study, which was our analytic sample. We found an associations between a history of cancer and suicidal ideation (aOR = 1.32, 95% CI 1.10, 1.58). Among cancer survivors, depression and non-medical use of pain prescriptions were consistently associated with suicidal ideation (aORdepression = 7.37, 95% CI 4.52, 12.03; aORpain prescriptions = 3.36, 95% CI 1.27, 8.91, planning (aORdepression = 10.31, 95% CI 5.79, 18.34; and aORpain prescriptions = 3.77, 95% CI 1.20, 11.85), and attempt (aORdepression = 4.29, 95% CI 1.41, 13.06).
Conclusion
Both depression and non-medical pain prescriptions are independently associated with increased odds of suicidal behavior among cancer survivors. Routinely assessing for depression and history of non-medical use of pain prescriptions could be an important suicide prevention strategy in oncology.
Implications for Cancer Survivors
Given the increased risk of suicide mortality among cancer survivors, it is critical that risk factors for suicidal behavior, such as depression and use of non-medical pain prescriptions, are routinely screened for as part of cancer care.
... These groups provide a structured environment where participants can share experiences, receive emotional support, and access information. While many patients benefit from the support of friends and family, these groups offer a unique opportunity to connect with peers who have similar experiences, fostering a sense of community and reducing feelings of isolation [36]. ...
... Social support is an integral part of cancer support modes, as it addresses needs related to family relationships, social acceptance, and involvement in relationships with others [16]. Through the MSPSS scale, the present study highlighted a moderate perception of social support among the participants (4.9 ± 1.5). ...
Breast cancer is a major global problem affecting women, leading to changes in their physical and mental health and affecting their quality of life. Social and spiritual support can provide strength and resilience to improve their well-being. A cross-sectional study was conducted among breast cancer patients in Marrakech, Morocco. Data were collected via an interviewer-administered questionnaire by covering (a) sociodemographic, economic, and clinical data, (b) quality of life with the “EORTC Core Quality of Life Questionnaire”, (c) social support with the “Multidimensional Scale of Perceived Social Support”, and (d) beliefs with the “System of Beliefs Inventory.” Descriptive and correlational analyses were performed. The study included 220 breast cancer patients, with a mean age of 49.7 ± 10 years, who were mostly married (69.5%). The assessment revealed moderate perceptions of social support (4.9 ± 1.45) and beliefs (40.7 ± 5.9). Significant associations were found between the level of education and religious beliefs/social support (β = − 0.235, p = 0.023; β = 0.217, p = 0.035), living alone and social support (β = 0.282, p = 0.001), time since diagnosis and social support/SBI (β = − 0.183, p = 0.031; β − 0.248, p = 0.004), chemotherapy treatment and hormone therapy with SBI (β − 0.223, p = 0.005; β = − 0.168, p = 0.031), and comorbidities and social support (β = 0.170, p = 0.024). Although social support and spirituality are important, they are not directly related to quality of life, suggesting the influence of other factors on patients’ perceptions of quality of life. Promoting social support for breast cancer patients is crucial for healthcare professionals, emphasizing the importance of assessing patients’ social support systems and integrating resources into treatment plans. Future research should explore the types of beneficial social support, influences on QoL, the role of digital support networks, and the conduct of longitudinal studies for more meaningful results.
... Patients with low SEP may have worse overall health and may have more difficulties adjusting to their diagnosis [31]. Also, patients with low SEP are more prone to psychological distress and more often lack a social support network compared to patients with high SEP [27,32], which is also associated with a worse mental health status and worse physical and psychological adjustment to cancer [33]. Moreover, patients with low SEP often have lower health literacy. ...
Purpose
To examine socioeconomic disparities in health-related quality of life (HRQoL) and healthcare use during the last year of life of patients with advanced cancer.
Methods
Data was used from a prospective, longitudinal, multicenter, observational study of patients with advanced cancer in forty Dutch hospitals (eQuiPe). Adult patients with stage IV cancer completed 3-monthly questionnaires until death. Socioeconomic position (SEP) was defined as estimated income on street-level. Mixed-effects regression analysis was used to identify associated factors.
Results
A total of 639 patients were included, 14% with a lower SEP, 59% medium SEP and 28% higher SEP. Patients with a lower SEP were more often lower educated (40% vs. 18%, p < 0.001) and less often reported to have a partner (61% vs. 90%, p < 0.001) than those with a higher SEP. In the last year of life, patients with lower SEP were more likely to experience disease-related financial difficulties than those with higher SEP (28% vs. 12%, p = 0.001; β 8.2, 95%CI 2.9–13.3). No significant associations were found between SEP and HRQoL, hospital admissions or emergency department admissions. Although, patients with lower SEP had more frequent (≥ 5 per month) interactions with healthcare professionals than patients with higher SEP in the last year of life (OR 1.9, 95%CI 1.0–3.5).
Conclusion
Some socioeconomic disparities are present during the last year of life of patients with advanced cancer. It is important for clinicians to be aware of the greater financial impact and higher healthcare utilization in patients with a lower SEP to ensure equitable end-of-life care.
... However, as this population is often unprepared to performing cancer-care specific duties or taking on additional responsibilities [28], may develop depression, anxiety disorders or burden [29]. The measurement of social support interactions between cancer patients and their caregivers is critical to researchers and professionals in examining the role of support in the cancer trajectory [30,31]. Most of the social support measurements focuses on different functional or structural aspects of social support [32], however, there is still a lack of common tools available to assess social support for the cancer patients and informal caregivers population. ...
INTRODUCTION: Social support is an important mediator between disease and psychological adjustment, both for the patient, as well as for the family members. The aim of the study was to develop the self-reported Patient-Caregiver Social Support Questionnaire (KWPO) and assess the initial reliability and validity of this tool. MATERIAL AND METHODS: A total of 102 cancer-caregiver dyads completed the KWPO. The reliability and validity of the questionnaire were analyzed. RESULTS: Reliability of the KWPO can be considered satisfactory with a Cronbach’s alpha ranging from 0.89 to 0.923. The mean Content Validity Ratio ranged between 0.85 to 0.92. A four-factor model with the multidimensional aspect of the construct in social support was supported. The fit indices of CFA non-hierarchical model for a flat model was eligible in the goodness of fit index (GFI) (0.943–0.982), the adjusted goodness of fit index (AGFI) (0.921–0.975), the comparative fit index (CFI) (0.703–0.968) and Tucker-Lewis Index (TLI) (0.656–0.963) for received social support, with exception of the root mean square error for caregivers demanded (RMSE) (0.112). CONCLUSIONS: The KWPO can be considered as suitable for measuring social support in cancer-caregivers dyads. It can be used to help Healthcare professionals to assess the patient’s need for social support and caregiver’s competences to provide it.
... Cancer diagnosis and treatment bring about changes in patients' paths of life, in their daily activities, work, relationships, and family roles, and it is associated with a high level of patient psychosocial stress. Usta [20] indicates that social support consists of people we can count on to provide ongoing emotional support, affirmation, information, and assistance, especially in times of crisis. Kyriazidou et al. [21] indicate that patients with strong social support develop more optimistic feelings, which enable them to increase their confidence and hope to fight and cure cancer successfully. ...
Background: The diagnosis and treatment of cancer are associated with substantial physical, psychological, and social morbidity for most patients. Distress can be seen as an unpleasant experience of an emotional, psychological, social, or spiritual nature that interferes with the ability to cope with cancer treatment. Purpose: The aim was to understand patients’ experiences of distress in their context and to analyze and interpret the findings. Method: An explorative, descriptive qualitative study was conducted among cancer patients receiving treatment and care at rural hospitals in Limpopo. A face-to-face individual interview was conducted to determine the participants’ cancer-related experiences and quality of life. Thematic analysis was conducted following Tesch’s method, and the themes developed were subjected to a triangulation process to ensure the validity and rigor of the findings. Findings: The participants revealed experiences of symptomatic distress resulting in biopsychosocial distress such as pain, fatigue, emotional distress related to prognosis and uncertainty about the future, psychosocial distress related to a lack or absence of support, financial instability, and poor self-esteem. Conclusions: Cancer patients face many challenges during their treatment journey. Participants were drained by anxiety and uncertainty of the cancer trajectory and required psychosocial support. The oncology team must provide supportive preventive measures for side effects management and culture-sensitive psychotherapy at an early stage to improve their quality of life.
... La diminución del malestar emocional y la apertura para aceptar el diagnóstico oncológico ocurren por el optimismo, la fe, la esperanza y el apoyo social y familiar percibido y recibido. Tales hallazgos se corresponden con la literatura empírica y teórica que ha resaltado la relevancia que tienen el optimismo y la esperanza (Ciria et al., 2021;Finck et al., 2018;Pamuk, 2018;Scheier y Carver, 2001;Schiavon et al., 2017), el afrontamiento religioso (Ciria et al., 2021;Jenkins y Pargament, 1995) y el apoyo social y familiar (Krishnasamy, 1996;Muhamad et al., 2011;Pamuk, 2018;Usta, 2012) en la salud y calidad de vida de los sobrevivientes de cáncer. ...
El objetivo de este estudio cualitativo, con diseño emergente y proyectado de la teoría fundamentada, fue comprender, mediante la construcción de una teoría sustantiva, la experiencia de las pérdidas vividas por pacientes venezolanos sobrevivientes de cáncer. Participaron diez pacientes sobrevivientes de cáncer, hombres y mujeres con diferentes edades y diagnósticos. Para la producción de la información se empleó la entrevista a profundidad, y para el análisis las estrategias del método de las comparaciones constantes. Los pacientes sobrevivientes vivieron diferentes pérdidas, no limitadas a las relacionadas con la salud. El malestar emocional, la aceptación y la resignificación delinearon la experiencia de dichas pérdidas. La aceptación, promovida por el optimismo, la esperanza y el apoyo social/familiar, facilitaron el ajuste a la cotidianidad, el manejo del temor a la recurrencia del cáncer y la culpa y la resignificación de esta enfermedad y de sus pérdidas. El estudio permitió conocer los recursos psicosociales que promueven la adaptación a la pérdida durante la sobrevivencia al cáncer. Recibido: 17/10/2023Aceptado: 12/01/2024
... Alongside the financial context, social support, defined as the constellation of individuals available to provide psychological, physical, and financial help to a patient, also plays a vital role in oncologic outcomes [144]. More specifically, existing evidence suggests support is closely associated with physical health, psychological adjustment, hospital readmission, and overall survival [145][146][147][148][149][150][151][152]. As aging occurs, social networks may be narrowed by death and illness, while concurrently, medical and supportive care needs may increase. ...
Simple Summary
Lung cancer is the leading cause of cancer-related mortality among older adults, but older adults experience age-related disparities in treatment outcomes, clinical trial representation, and guideline-concordant care. This review addresses critical factors contributing to these disparities, outlining age-specific considerations to optimize management of medical and supportive care needs and cancer-directed therapy selection. Key recommendations include comprehensive geriatric assessment, individualized treatment planning, and improved resource allocation to ensure older adults receive equitable and effective care.
... On the other hand, social support, the role of which is key in cancer patients (Usta, 2012), has been proposed as a main social pathway (Masters, 2008;Park, 2007;Park et al., 2017). A longitudinal study showed a relationship between gratitude and social support, further concluding that the former leads to the latter (Wood et al., 2008): Grateful patients receive more social support. ...
This study aims to examine the interactions of spiritual well-being with
different psychosocial and behavioral aspects that have been proposed in
the literature as pathways underlying the relationship of religiosity and
spirituality (R/S) with physical health, specifically in cancer patients (N =
351). Using a cross-sectional research design, a series of hierarchical regression
analyses show the predictive power of different elements of R/S (attachment
to God, religious practice, commitment and coping, and spiritual
experiences) on spiritual well-being. In turn, spiritual well-being (meaning/
peace and faith) predicts gratitude and compassion (as psychological pathways).
Thus, finally, spiritual well-being, together with gratitude and compassion,
correlates to the rest of the psychological (positive and negative
emotions), social (social support) and behavioral (healthy behaviors) pathways
to different extents. Spiritual well-being may play an important role in
understanding the relationships between R/S and health, so considering it
along with its associated factors may be key to improving the health and
quality of life of people affected by cancer in Spain.
... Understanding that support must be constructive, encouraging and based on the best available information is fundamental to the success of cancer treatment. May this approach inspire patients and their loved ones to work together, rather than being an emotional burden that negatively affects the path to recovery [42]. ...
This article addresses the bioethical and medico-legal challenges in the multimodal treatment of cancer, emphasizing the growing gap between therapeutic advances and their clinical implementation. Many patients remain uninformed or lack access to advanced therapies, such as immunotherapy or targeted treatments, due to outdated practices in their healthcare centers. This situation often leads to frustration, as patients feel that not all potential treatment options have been explored. The right of patients to receive clear, informed, and transparent guidance on their treatment is highlighted, as well as the necessity for proper documentation of medical decisions to ensure traceability and protect both the patient and the medical professionals involved. The lack of information or bias directly impacts patient autonomy, limiting their ability to make well-founded decisions. The article also highlights the significant benefits of multimodal therapies, such as cytoreductive surgery and personalized immunotherapy, which have been shown to improve outcomes and quality of life in advanced cancer cases. It calls for treating physicians to act as guides or, when necessary, defer to specialized centers with proven expertise, thus avoiding limiting patients to conventional protocols. The need for a multidisciplinary approach is clear, with a committee of clinical oncologists, radiation-oncologists, surgical oncologists, and pathologists, alongside immuno- oncopathology specialists, being essential to the development of personalized, biologically driven therapies. Advances in cancer treatment confirm the importance of this integrated approach, particularly through collaboration between pathologists and clinical oncologists who have specialized in biotechnology and precision medicine.
... Social relationships are integral to cancer survivors due to the importance of family and friends during cancer diagnosis, treatment, and survivorship [14]. Therefore, behavior change may be more sustainable among survivors when support, feedback, and motivation are shared with others. ...
Purpose
Parental or spousal cohabitating relationships are often targeted in behavioral interventions, but the contribution of cohabitation is poorly understood. This study explored whether cohabitation status moderated the impact of social cognitive theory constructs on adiposity, diet, and exercise in a dyadic, web-based weight loss intervention among cancer survivors and their chosen partners.
Methods
The 24-week weight loss intervention was conducted among 56 dyads, comprised of a cancer survivor and their chosen partner (n = 112). Baseline and 6-month data on social cognitive theory constructs (self-efficacy, social support, and perceived barriers), and study outcomes of adiposity (weight and waist circumference), diet (calories and diet quality), and moderate-to-vigorous physical activity (MVPA) were used to perform moderated-mediation analyses among cohabitating (n = 25) versus non-cohabitating (n = 31) dyads.
Results
The intervention was positively associated with dietary social support (path a1: 0.36, 95% CI [0.083, 0.659]) and inversely associated with perceived dietary barriers (path a1: − 10.57, 95% CI [− 19.109, − 3.091]) and perceived exercise barriers (path a1: − 11.29, 95% CI [− 22.098, − 3.500]) among those who did not cohabitate (effects not observed among cohabitating pairs). The intervention’s mediating effects through perceived barriers on weight (indirect effect (ab): − 2.21, 95% CI [− 4.794, − 0.548]), waist circumference (ab: − 1.13, 95% CI [− 2.452, − 0.171]), caloric intake (ab: − 5.09 (2.86), 95% CI [− 12.602, − 0.709]), and self-reported MVPA (ab: 0.29 (0.18), 95% CI [0.019, 0.754]) also were stronger among non-cohabitating pairs.
Conclusions
These findings suggest that social support partners outside the home substantially enhance intervention impact, though relationship quality and gender dynamics warrant further exploration.
Trial registration
ClinicalTrials.gov Identifier: NCT04132219.
... Social support, which encompasses the emotional, informational, and practical assistance provided by one's social network, helps patients cope with their diagnosis and increase hope. Cancer patients with greater social support have been reported to have better quality of life, treatment adherence, and overall survival outcomes (25,26). Bou-Samra et al. found that among patients specifically with GI cancer, low social support was associated with higher incidences of depression and mortality, and identified marital status to be a predictor of social support even after controlling for other sociodemographic and disease factors (27). ...
Background
Hope is correlated with quality of life and overall survivorship among patients with cancer. We aimed to identify sociodemographic and clinical determinants of hope among patients with gastrointestinal (GI) cancer.
Methods
Patients with GI cancer seen in radiation oncology between 10/2022 and 6/2023 were surveyed with the Adult Hope Scale (AHS) questionnaire, which assesses hope based on goal-setting and goal-striving beliefs. Linear regression and Pearson’s/Spearman’s correlation coefficients were used to evaluate associations between AHS scores and demographic or disease variables.
Results
One-hundred and forty-five (71.1% response rate) patients were included in the analysis. Most (75%) patients were symptomatic from disease, and Asian American and Pacific Islander (AAPI) patients accounted for 30.3% of our cohort. Identifying as AAPI or needing an interpreter for clinic visits was significantly associated with lower AHS scores, and more AAPI patients required interpreter assistance compared to non-AAPI patients (P=0.04). Being divorced, unemployed, or female was also linked to less hope. No other differences in hope were found.
Conclusions
Sociodemographic rather than prognostic clinical factors were predictive of hope among patients with GI cancer. Interventions to contextualize psychosocial risk factors have the potential to improve quality of life and oncologic outcomes.
... Depression, anxiety, and somatization are commonly experienced challenges by caregivers [2,12,13], emphasizing the need for robust support systems tailored to caregivers' needs. Despite the challenges, caregivers are vital to patient outcomes, as strong social support can improve patient health and survival [14,15,16]. ...
Background: Chronic diseases are a significant source of physical, emotional, mental, and social distress to patients, caregivers, and healthcare professionals (HCPs). In particular, cancer patients face immense challenges as they navigate their uncertain futures. These difficulties necessitate a collaborative environment where patients, caregivers, and HCPs support each other to improve everyone's quality of life. This study aims to investigate factors that influence a healthy long-term care relationship between patients and HCPs.
Methods: This qualitative study analyzes the experiences of the HCPs with patients and their caregivers at a large metropolitan academic medical center. Twenty-two de-identified reflective essays written by HCPs as part of the Pacemakers initiative at the medical center, which seeks to empower HCPs, patients, and caregivers in creative ways along the management journey were analyzed. The essays describe meaningful experiences, such as patient/caregiver award ceremonies celebrating resilience and hope. Essays (N = 22) were thematically analyzed by two independent coders to identify key codes and themes (italicized).
Results: The presence of support networks (n = 10) was crucial for patients and caregivers. Conveying solidarity (n = 21) helped patients experience companionship with their medical team, family, and friends. Small acts of kindness (n = 10) led to meaningful interactions that encouraged patients. Compassion (n = 19) and patient-centeredness (n = 17) fostered a receptive environment where patients and caregivers felt heard. Celebrating and honoring the resilience (n = 10) of the patients made them feel recognized, and this process of celebration was also found to bolster a renewed sense of purpose for the HCPs (n = 11).
Conclusion: The results highlight the importance of holistic support for patients and their caregivers. Creative encouragement empowers both patients and HCPs, building trust and strengthening the pursuit of their health. This mutual care fosters an environment conducive to healing and recovery. This study offers insights into effectively supporting patients and HCPs in long-term care relationships.
... Özellikle bu süreçte hastaların sosyal desteğe olan gereksinimleri daha çok görülmektedir (5). Yapılan çalışmalarda; aile üyelerinden alınan duygusal ve sosyal destek sonrasında, bireyin fiziksel ve psikolojik uyum derecesi arasında olumlu bir ilişki görüldüğü ve kanser hastaları için sosyal desteğin faydalı olduğu belirtilmiştir (6)(7)(8)(9). Kanser tedavi sürecinde sosyal destek, tedavi sonrası uyumu kolaylaştırmakta, fiziksel ve psikolojik iyileşmeyi desteklemektedir (10). ...
... Bowling (1991), por otro lado, indicó que el AS se trataba de un mecanismo de comunicación y participación en el que el individuo conseguía esa atención afectiva e instrumental de las personas más allegadas a él. Usta (2012) señala que percibir mayor o menor AS se basa en el grado de confianza y seguridad que el individuo tiene de que el resto de personas le ayudarán cuando lo necesite. De esta forma, cuando la persona tenga la suficiente confianza y seguridad de que será arropado y apoyado por las personas más allegadas a ella siempre que lo necesite, el AS percibido será mayor. ...
El presente estudio tiene como objetivo analizar el desgaste laboral en trabajadores de acogimiento residencial de menores, así como las estrategias de afrontamiento y el apoyo social percibido mediante cuestionarios MBI–HSS, COPE–28 y Duke-UNK-11. La muestra total fue de 70 profesionales de residencias de acogida de menores de Valencia, España. Aunque se encontró un bajo porcentaje de desgaste laboral, se establecieron diferencias entre este y el sexo, la rotación laboral, las estrategias de afrontamiento y el apoyo social. De las tres dimensiones del desgaste laboral, el agotamiento y la despersonalización presentaron una correlación inversa y, la realización personal una correlación directa con el apoyo social. Además, la despersonalización presentó diferencias en función del sexo, siendo mayor en hombres. Se concluye destacando la necesidad de seguir investigando para obtener datos más precisos y así poder discutir los resultados de forma más concreta y fiable
... It is generally divided into instrumental support (concrete assistance) and emotional support (psychosocial help). It has been reported that both effective information provision and emotional support can alleviate the psychological burden of cancer patients (66). ...
In the past 40 years, the gradually increasing incidence and mortality rates of malignant tumors have severely impacted the quality of life of patients, bringing significant physical and psychological burdens and becoming an increasingly serious social issue. With the development of medical standards, new methods for cancer detection and treatment have been continuously proposed. Although it has been proven that cancer is related to increased psychological burden and suicidal behaviors in patients, current research on the psychological burden caused by cancer is insufficient. Clinicians often overlook the psychological health issues of patients while treating their physical diseases. Considering the high incidence of cancer, this review will outline the psychological burdens of cancer patients worldwide in recent years and its high-risk factors. Moreover, this review will summarize the common methods for evaluating psychological burdens, present current predictive models and treatment methods for the psychological burden of cancer patients, aiming to provide a research basis and future direction for the timely and accurate assessment of the psychological burden in cancer patients.
... In particular, the role of social support in the development and progression of cancer has been well documented. 31 Previous studies have demonstrated that social support has a beneficial effect on mitigating FCR or progression among patients with cancer. [32][33][34] In a longitudinal study conducted by Ding on 135 patients with advanced gastric cancer undergoing postoperative chemotherapy, social support was found to be negatively correlated with the fear of disease progression in the first, third and sixth stages of chemotherapy. ...
Objectives
The objective of this study is to investigate the relationships between fear of cancer recurrence (FCR), social support and resilience, and further determine whether resilience mediates social support and FCR among Chinese patients with gastric cancer undergoing chemotherapy.
Design
Multicentre cross-sectional survey.
Setting
Four hospitals in Jiangsu Province, China, with grade-A tertiary hospital settings.
Participants
755 patients with gastric cancer on chemotherapy across four hospitals in China were included from March 2021 to September 2022.
Outcome measures
The Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Connor-Davidson Resilience Scale (CD-RISC) and Social Support Rating Scale (SSRS) were used to test the model’s constructs. Statistical analyses were conducted by using IBM SPSS V.26.0 software. PROCESS V.3.4 macro was used to analyse the mediating role of resilience in the relationship between social support and FCR.
Results
The mean scores for SSRS, CD-RISC and FoP-Q-SF in patients with gastric cancer receiving chemotherapy were 41.55±7.79, 54.83±18.46 and 30.91±10.11, respectively. 43.3% (n=327) had psychological dysfunction, 56.8% (n=429) had low to medium resilience and 99.1% (n=748) had medium to robust social support. Significant differences exist among three variables, resilience positively correlated with social support, while FCR negatively correlated with resilience and social support (p<0.001). Resilience fully mediated the relationship between social support and FCR (a*b-path=−0.126, 95% CI −0.169 to –0.086).
Conclusions
Mediation analysis shows resilience mediates social support and FCR in patients with gastric cancer as the negative effect of social support on FCR was fully mediated by resilience. Interventions targeting these variables may reduce FCR in patients with gastric cancer undergoing chemotherapy.
... Social support refers to the provision of assistance, care, emotional support, and positive regard by others to an individual in need [14]. Research has suggested that an increased risk of cancer may be associated with inadequate social support [15]. ...
Background: The patients of cervical cancer have more negative emotions and lower quality of life. The aim of this study was to explore the relationships between existential well-being (EWB), social support, resilience, negative emotions in patients with cervical cancer, and to examine whether resilience mediates the associations between EWB or social support and negative emotions.
Material and methods: This study enrolled patients with cervical cancer who were treated at the Tianjin Medical University Cancer Institute and Hospital in China during 2012-2019. The Hospital Anxiety and Depression Scale (HADS), the Resilience Scale of 14 items (RS-14) and the McGill Quality of Life Questionnaire (MQOL) were utilized to assess patient's anxiety, depression, resilience, social support and EWB via telephone. Spearman's correlation analyses were used to assess bivariate correlations, and mediation analyses were applied to examine whether resilience mediated the relationship between social support or EWB and negative emotions.
Results: A total of 150 (92.0%) out of 163 eligible patients completed the questionnaires. EWB and social support were negatively correlated with anxiety (r=-0.560 and r=-0.561) and depression (r=-0.508 and r=-0.526), and positively correlated with resilience (r=0.691 and r=0.652). Resilience was negatively associated with anxiety (r=-0.545) and depression (r=-0.505). Negative direct effects of social support on anxiety and EWB on anxiety and depression were statistically significant (P<0.05). Resilience played a partial mediating role in the relationship between EWB and depression (β=-0.085, 95%CI: -0.150 to -0.020), accounting for 37.12% of the total effect. It also served as a partial mediator in the association between EWB and anxiety (β=-0.061, 95%CI: -0.107 to -0.015), explaining 34.46% of the overall effect. Additionally, resilience partially mediated the connection between social support and depression (β=-0.173, 95%CI: -0.312 to -0.053), explicating 57.48% of the total effect.
Conclusions: A combination of existential, supportive and resilient interventions may help reduce psychological distress and improve quality of life among cervical cancer patients, thereby promoting both physical and psychological health.
... According to the stress-buffering hypothesis, the presence of perceived social support may nullify or diminish the adverse connection between quality of life and perceived stress associated with a chronic condition [26,27]. In addition, higher perceived social support may reduce the speed of the cancer progression [28], prevent the development of infection during chemotherapy [29], and increase survival chances [30] among women. Moreover, Di Giacomo et al. [31] also found a link between increased survival rate after breast cancer diagnosis and the management of emotional weakness in Italian women. ...
Purpose. This study aims to understand the association between emotional intelligence, perceived social support, and psychological distress (i.e., anxiety, depression, stress) in women with cancer at different stages. Specifically, the aims of this study were to investigate: i) the links between emotional intelligence and psychological distress (i.e., symptoms of anxiety, stress and depression); ii) the mediating role of perceived social support provided by family members, friends, and significant others in the relationship between emotional intelligence and psychological distress; iii) the impact of cancer type and cancer stage (I-II vs III-IV) in moderating these relationships, among Italian women.
Methods. The research sample consisted of 206 Italian women (mean age = 49.30 ± 10.98 years; 55% breast cancer patients) who were administered a questionnaire to assess emotional intelligence, perceived social support, and psychological distress. Structural equation model (SEM) analysis was carried out to confirm the hypothetical-theoretical model.
Results. Emotional intelligence had a positive association with perceived social support, which in turn prevented psychological distress only in women with early-stages cancers. The type of cancer has no effect on these relationships.
Conclusions. The findings of this study indicate a pressing need to screen and recognize women with lower emotional intelligence and perceived social support, as they may be more prone to experiencing psychological distress. For such individuals, our results recommend the implementation of psychological interventions aimed at enhancing emotional intelligence and fortifying their social support networks, with consideration for the stage of cancer they are facing.
... The two most important components of the model for physical activity are self-efficacy and perceived barriers; both are influenced by social support, which helps to strengthen interventions and the continuation of the behavior (17,(23)(24)(25)(26)(27). Four dimensions can be used to define, measure, and present social support: emotional (empathy and love), instrumental (tangible assistance), informational (consulting), and evaluation (constructive feedback) (28). HBM and social support structure can be utilized as a framework for designing and implementing educational interventions to promote self-care behaviors of women (29). ...
Introduction
The highest incidence of overweight among adults is found among women, predominantly middle-aged women. While it has been demonstrated that being overweight increases mortality by compromising physical and mental health, it also imposes substantial costs on the healthcare system. Lack of physical activity is a primary contributing factor to becoming overweight. The majority of inactive adults are women, particularly middle-aged women. Consequently, this study investigated the training program for overweight women based on the health belief model (HBM) and social support approach.
Methods
A randomized, controlled trial involving 73 overweight middle-aged women (control group: 37, intervention group: 36) was conducted using simple random sampling. The intervention group participated in six 120-min sessions per week for 6 weeks of a training program based on HBM and social support through physical activity, group discussion, role play, and media. Data were collected using the Physical Activity Questionnaire (IPAQ), Bandura’s Exercise Self-Efficacy Scale (Bandura’s ESE), and a researcher-made questionnaire before and 4 weeks after the training. The collected data were analyzed using descriptive and inferential statistics via SPSS 27 software. p-values <0.05 were considered statistically significant.
Results
A training program based on HBM and social support led to improved perceived benefits (p < 0.001), cues to action (p = 0.03), and self-efficacy (p < 0.001) of physical activity; decreased perceived barriers (p = 0.001); increased social support (p = 0.001); and increased physical activity (p < 0.001). In addition, the BMI of the intervention group decreased after the training program (p = 0.01).
Conclusion
The findings of the study demonstrate the efficacy of the training program based on HBM and the social support approach in improving social support and physical activity of women. In addition, the study evaluates the long-term outcome in populations with varying social, economic, and cultural standings.
Clinical Trials Registration
https://clinicaltrials.gov/, (IRCT201706236261N17).
... The two most important components of the model for physical activity are self-efficacy and perceived barriers; both are influenced by social support, which helps to strengthen interventions and the continuation of the behavior (17,(23)(24)(25)(26)(27). Four dimensions can be used to define, measure, and present social support: emotional (empathy and love), instrumental (tangible assistance), informational (consulting), and evaluation (constructive feedback) (28). HBM and social support structure can be utilized as a framework for designing and implementing educational interventions to promote self-care behaviors of women (29). ...
Introduction: The highest incidence of overweight among adults is found among women, predominantly middle-aged women. While it has been demonstrated that being overweight increases mortality by compromising physical and mental health, it also imposes substantial costs on the healthcare system. Lack of physical activity is a primary contributing factor to becoming overweight. The majority of inactive adults are women, particularly middle-aged women. Consequently, this study investigated the training program for overweight women based on the health belief model (HBM) and social support approach. Methods: A randomized, controlled trial involving 73 overweight middle-aged women (control group: 37, intervention group: 36) was conducted using simple random sampling. The intervention group participated in six 120-min sessions per week for 6 weeks of a training program based on HBM and social support through physical activity, group discussion, role play, and media. Data were collected using the Physical Activity Questionnaire (IPAQ), Bandura's Exercise Self-Efficacy Scale (Bandura's ESE), and a researcher-made questionnaire before and 4 weeks after the training. The collected data were analyzed using descriptive and inferential statistics via SPSS 27 software. p-values <0.05 were considered statistically significant. Results: A training program based on HBM and social support led to improved perceived benefits (p < 0.001), cues to action (p = 0.03), and self-efficacy (p < 0.001) of physical activity; decreased perceived barriers (p = 0.001); increased social support (p = 0.001); and increased physical activity (p < 0.001). In addition, the BMI of the intervention group decreased after the training program (p = 0.01). Conclusion: The findings of the study demonstrate the efficacy of the training program based on HBM and the social support approach in improving social support and physical activity of women. In addition, the study evaluates the long-term outcome in populations with varying social, economic, and cultural standings. Clinical Trials Registration: https://clinicaltrials.gov/, (IRCT201706236261N17). CITATION Faghih M, Kaveh MH, Nazari M, Khademi K and Hasanzadeh J (2024) Effect of health belief model-based training and social support on the physical activity of overweight middle-aged women: a randomized controlled trial.
... The importance of social support in improving positive treatment outcomes for people with chronic diseases and conditions has been confirmed in previous research [11,16,19,23]. Studies have shown that cancer patients who have higher levels of social support have a better quality of life and lower mortality rates [30,31]. Social support has been identified as one of the key factors in the daily lives of cancer patients [32]. ...
Background. The management of breast cancer treatments within the limitations of family, social, and professional life is emotionally burdening and negatively affects physical, psychological, and social well-being, reducing the overall quality of life of patients and their families. Methods: This cross-sectional descriptive–analytical study was conducted from March to August 2023 at the “Dr. Radivoj Simonović” General Hospital in Sombor. A total of 236 breast cancer patients participated in this study. The research was conducted using the following instruments: a questionnaire on sociodemographic and clinical characteristics of patients, the Berlin Social-Support Scales—for assessing social support—and the Connor–Davidson Resilience Scale—for assessing resilience. This study aimed to determine the predictors and levels of social support and resilience of breast cancer patients. We also wanted to examine whether resilience is a mediator between patients’ sociodemographic and clinical characteristics and levels of social support. Results: The total average value of social support was 3.51 ± 0.63, while on the resilience scale, the respondents achieved a total average score of 52.2 ± 9.63. Perceived and actually received social support of breast cancer patients were positively correlated with resilience [p < 0.01], while no statistically significant correlations were found for the need for support and satisfaction. The sets of predictors can significantly predict their effects on all types of perceived social support (emotional social support: 9%; perceived instrumental social support: 9%) and all types of received social support (actually received emotional social support: 8%; actually received instrumental social support: 7%; actually received informational social support: 8%). There is a potential mediating role of resilience in relation to sociodemographic factors, clinical characteristics, and the need for support. Conclusion: This study confirms that a strong connection exists between social support and resilience. However, the analysis did not confirm the mediating role of resilience between the sociodemographic and clinical characteristics on the one hand and social support on the other.
... Under the in uence of family members, patients can also spontaneously develop the habit of actively searching for useful information and improve their self-management ability. Additionally, a signi cant relationship exists between low social support and adverse health behaviors, which can predict increased likelihood of cancer-associated mortality [34]. ...
Background
The research explored the relationship between perceived social support, illness perception, symptom burden, and self-management ability of postoperative elderly patients with lung cancer.
Methods
A cross-sectional survey was administered to 489 eligible participants using Chinese version of the Perceived Social Support Scale, Chinese version of the M.D. Anderson Symptom Inventory-Lung Cancer module, Chinese version of the brief illness perception questionnaire, and Cancer Patient Self-management Assessment Scale.
Results
A significantly positive association was found between perceived social support and self-management ability of postoperative elderly patients with lung cancer,( r = 0.565, and P༜0.001) and a negative relationship between symptom burden, illness perception, and their self-management ability. (r = -0.442, − 0.203, and P༜0.001).
Conclusion
This research emphasizes the importance of perceived social support, illness perception, and symptom burden in exploring self-management ability so that healthcare providers can develop more effective strategies to increase self-management ability.
... Social support can also refer to functional components, such as types of interactions between individuals [36]. In most studies, social support is conceptualized as perceived social support, which is typically measured by psychological scales that cover the components above [37][38][39][40]. ...
Research has shown a protective association between social support and depression, depression among stroke patients, and health impacts of depression. Despite this, not much is known about the effect of social support on depression among stroke patients. This review aims to summarize the current research examining the association between social support and depression among stroke patients. A literature search was performed in PubMed to find original peer-reviewed journal articles from 2016 to 12 March 2023 that examined the association between social support and depression among stroke patients. The search terms were depression and “social support” and stroke, which lead to 172 articles. After abstract review, seven observational studies that studied the target association among stroke patients were selected. One additional study was found using PsycINFO as a complementary source with the same search strategy and criteria. Overall, a negative association was found between social support and depression among stroke patients in eight studies, with more social support leading to lower rates of depression post-stroke. The other study did not find a statistically significant association. Overall, the results of recent studies suggest that social support is negatively associated with depression among stroke patients. In most studies, this association was statistically significant. The findings suggest the importance of improving social support perceived by stroke patients in the prevention of depression after the occurrence of stroke.
... Social support can also refer to functional components such as types of interactions between individuals [32]. In most studies, social support is conceptualized as perceived social support which is typically measured by psychological scales which cover the components above [33][34][35][36]. ...
Research has shown a protective association between social support and depression, depression among stroke patients, and health impacts of depression. Yet not much is known on the effect of social support on depression among stroke patients. This review aims to summarize the current research examining the association between social support and depression among stroke patients. A literature search was performed in PubMed to find original peer-reviewed journal articles from 2016 to Mar. 12, 2023 that examined the association between social support and depression among stroke patients. The search terms were depression and "social support" and stroke, which lead to 172 articles. After abstract review, seven observational studies that studied the target association among stroke patients were selected. One additional study was found using PsycINFO as a complementary source with the same search strategy and criteria. Overall, a negative association was found between social support and depression among stroke patients in seven studies, with more social support leading to lower rates of depression post-stroke. One study found that social support was positively related with depression, but the result was nonsignificant. Overall, the results of recent studies suggest that social support is negatively associated with depression among stroke patients. In most studies, this association was statistically significant. The findings suggest the importance of improving social support perceived by stroke patients in the prevention of depression after the occurrence of stroke.
Background
Anti–programmed death 1/programmed death ligand 1 immunotherapy has greatly advanced lung cancer treatment; however, the symptom clusters experienced by patients during immunotherapy, their influencing factors, and the correlation with social support warrant further attention.
Objectives
The aims of this study were to explore symptom clusters in patients with lung cancer undergoing anti–programmed death 1/programmed death ligand 1 immunotherapy and investigate their relationship with social support.
Methods
We studied 133 patients with lung cancer admitted to a Chinese oncology unit. A cross-sectional survey assessed symptoms using the MD Anderson Symptom Inventory and social support using the Social Support Rating Scale. Sociodemographic and disease data were also collected. Exploratory factor analysis was used to identify symptom clusters, and binary logistic regression analysis was used to analyze the influencing factors.
Results
Patients experienced various symptoms, with fatigue and cough being the most common and severe. Exploratory factor analysis revealed 3 clusters: general, lung cancer–specific, and gastrointestinal symptoms. Logistic regression showed that male sex was associated with general and lung cancer–specific symptom clusters. In contrast, previous radiotherapy was associated with the gastrointestinal cluster ( P < .05). Social support was negatively correlated with the severity of some symptom clusters.
Conclusion
The 3 symptom clusters adversely affected patients undergoing immunotherapy. Low social support exacerbated symptom severity.
Implications for Practice
Male patients should be monitored for general and lung cancer–specific symptoms, and those with a history of radiotherapy should be monitored for gastrointestinal symptoms. We recommend enhancing social support to alleviate symptom severity and tailoring symptom management strategies for individualized patient care.
Introduction: The lack of adequate health information, especially during crises such as COVID-19, creates distrust and misinformation, which negatively impacts public health and medical care. Long COVID patients face scepticism, highlighting the urgency of improved communication and research to support their recovery. Methodology: Structured interviews with 42 Long COVID patients, 10 healthcare professionals, and 11 health communication specialists to obtain a comprehensive picture of the situation and develop recommendations. Results: The need for institutional recognition of Long COVID is emphasized. The creation of official digital platforms and increased awareness among primary care physicians is suggested. The importance of collaboration between government bodies, associations, patient groups, and communication experts is emphasised to provide multidisciplinary and transparent information, considering the evolution of scientific research. Discussion: Improving the communication and recognition of Long COVID can reduce misinformation and distrust. Collaboration between actors is key to ensuring effective and accurate information dissemination. Scientific communication actions, such as conferences and reports, are significant steps to raise awareness among society and health professionals about Long COVID. Conclusions: It is crucial to optimize the dissemination of information about Long COVID via official digital platforms and increase medical awareness. Multidisciplinary collaboration and scientific communication activities are essential to support patients and improve public health.
Background
Bibliotherapy, or reading for therapy, has been shown to help with a variety of mental health conditions, yet reading can be difficult for those undergoing treatment due to cancer-related cognitive impairment (CRCI). Listening is likely to be easier than reading when experiencing CRCI and fatigue. Currently, no studies examine the potential impact of read-aloud programs on the emotional wellbeing of people undergoing cancer treatment.
Methods
To explore a way to introduce or reinstate reading and the benefits it can bring, a new bibliotherapy model was developed and delivered to 38 people who were undergoing or had recently completed treatment. Most participants (97%) were older than 45 years, 34% were palliative, and 13% had incurable but treatable cancer, while 95% self-reported symptoms of CRCI. The bibliotherapy model was personalized in its approach to book selection and delivery (one-on-one in-person or via Zoom). Using a pragmatic, mixed-methods framework, participant wellbeing was measured preintervention to postintervention and qualitative interviews were conducted to explore psychosocial effects from participants' (n = 35) and family members' (n = 17) perspectives and were analyzed using reflexive thematic analysis.
Results
Stress, anxiety, and depression decreased (as measured by DASS-21, P = .004, P = .000 and P = .015, respectively), and wellbeing increased (as measured by Warwick-Edinburgh Mental Wellbeing Scale [WEMWBS], P = .001) preintervention to postintervention. Qualitative analyses highlighted the aspects of the program participants valued: relaxation, mood lift, increased self-efficacy, time out, and feelings of warmth/nurturing. Distraction/escapism was viewed by participants as having benefits to their mood, pain, and nausea. Human interaction was also highly valued: the sense of connection with the reader was important. Family members expressed feelings of comfort and respite.
Conclusions
Findings suggest a tailored bibliotherapy program may be associated with increases in the emotional wellbeing of people undergoing or recently completed cancer treatment, and comfort and respite for their family members. While further research using a randomized controlled trial design is needed, these findings suggest this model is eminently suitable as an offering in integrative cancer centers and palliative settings, with no negative unintended consequences being observed.
Introduction
The estimated number of new cases among older adults with cancer has been increasing. Considering the decrease in social networks as adults age, their need for social support is often unmet. Notably, an increasing number of older adults with cancer have access to social support through online technologies, especially since the COVID-19 pandemic, which heightened the need for online social support. Little is known, however, about the extent to which online social support for older people with cancer has developed. This scoping review aims to explore the developments in online social support for older adults with cancer.
Methods and analysis
We will search PubMed, Elsevier Embase (including Medline) and EBSCO CINAHL Complete to identify eligible studies based on predefined criteria. Screening of articles and data extraction will be carried out independently by two reviewers, with conflicts resolved by a third reviewer. This scoping review will be based on the Arksey and O’Malley methodological framework with the extension proposed by Levac and colleagues. The review findings will be presented in a narrative analysis using tables. This protocol is registered on Open Science Framework at https://doi.org/10.17605/OSF.IO/Z9XJ7.
Ethics and dissemination
No ethical approval is needed. The findings will be published in a peer-reviewed journal and presented at conferences.
Importance
Distress is common among patients with cancer, and evidence of disparities associated with distress has been mixed. Head and neck cancer (HNC) is one of the most emotionally distressing cancers and is also a highly disparate disease. However, it is unknown whether there are disparities associated with patient-reported distress in HNC.
Objective
To examine racial and sociodemographic factors associated with clinically meaningful distress in a cohort of patients with HNC.
Design, Setting, and Participants
This retrospective cohort study analyzed data from a single tertiary institution at a National Cancer Institute–designated comprehensive cancer center in the Southeastern US. Participants included adult patients from January 2017 to December 2022 with confirmed diagnoses of head and neck squamous cell carcinoma who received radiation therapy up to 5 weeks from initial diagnosis.
Main Outcomes and Measures
The outcome of interest was clinically meaningful distress (score of at least 4 on the distress thermometer). The distress thermometer is a single-item, self-reported tool used to measure a person's level of psychological distress over the past week, represented on a scale from 0 (no distress) to 10 (extreme distress). Patients were included in the study if they had visits with clinicians in the radiation oncology department within 5 weeks of diagnosis. Sociodemographic factors were race and ethnicity, age, sex, marital status, and health insurance status. Clinical variables (stage of presentation, anatomical subsites, smoking, and alcohol history) and problem list domain items were included in the adjusted model. Using multivariable logistic regression analysis, odds of meaningful distress by sociodemographic factors were estimated, adjusting for clinical factors and problem list domains.
Results
A total of 507 patients met the inclusion criteria. The study population included 389 male patients (76.7%). The median (IQR) age of participants was 63 (56-71) years, with a racial distribution of 89 Black patients (17.6%), 385 White patients (75.9%), and 33 patients of other categories (6.9%), including Asian, Native American, multiracial, declined to respond, and unknown. Overall, 232 patients (45.8%) had meaningful distress. The median (IQR) DT score for the entire cohort was 3 (0-6). Black patients had the highest rate of physical concerns (n = 31 [34.8%]) compared to the other racial groups (78 White patients [20.3%] and 7 persons of other race [21.2%]). However, in the final multivariable model, race was not significantly associated with clinically meaningful distress (Black compared with White: adjusted odds ratio [aOR], 0.76 [95% CI, 0.45-1.28]; other compared with White: aOR, 0.85 [95% CI, 0.37-1.94]). Compared to those married, unmarried patients were significantly more likely to report distress (aOR, 1.61 [95% CI, 1.05-2.50]). Also, patients with emotional problems had double the odds of reporting clinically meaningful distress (aOR, 2.03 [95% CI, 1.02-4.08]). Other factors associated with significant clinical distress included tobacco use (aOR, 2.14 [95% CI, 1.02-4.50]) and reported practical problems (aOR, 2.08 [95% CI, 1.17-3.69]).
Conclusion and Relevance
Independent of race or sociodemographic factors, the results of this retrospective cohort study underscore the need for social and emotional support in mitigating distress and optimizing mental health care in this patient population. Further studies should explore distress trajectories across the HNC continuum and their impact on HNC outcomes.
Introduction: The incidence of various types of cancers in India are set to increase thereby putting an increased burden on the health system. There is a need for people to know sufficiently about cancer, the various types, the risk factors, the early symptoms and signs etc. so that they can come for professional diagnosis early. However, the fear of cancer prevents screening, early diagnosis and prompt treatment. Methodology: A qualitative study was done about cancer awareness among women in the rural areas using qualitative methods like Focus Group Discussions (FGD), In Depth interviews and Key Informant interviews. Results: Incurability of cancer, stigma, fear of cancer, need for support – physical, emotional & spiritual, lack of discussion in the community, causes of cancer, knowledge about cancer and personal experience with cancer are the themes identified in this study. Discussion: Stigma concerning cancer is a challenge to cancer awareness and control activities in any society. “Cancer fear” is any fear, anxiety, or worry related to cancer, including causes or consequences of cancer such as fear of treatment for cancer. Social support is necessary for physical adaptation, wellbeing and emotional adjustment in people suffering with cancer. Conclusion: This study reveals that knowledge about cancer in rural women is low and there are many misconceptions. There is reluctance to discuss about it due to fear and stigma. Recommendations: Following appropriate cancer education programmes with a stress on rural populations, prevention and screening programmes must be taken up urgently. Healthcare workers and volunteers in rural health care must be given necessary training to be able to give adequate cancer awareness, addressing key misconceptions.
Introduction: The incidence of various types of cancers in India are set to increase thereby putting an increased burden on the health system. There is a need for people to know sufficiently about cancer, the various types, the risk factors, the early symptoms and signs etc. so that they can come for professional diagnosis early. However, the fear of cancer prevents screening, early diagnosis and prompt treatment.
Breast cancer is a leading cause of cancer-related deaths globally, particularly affecting developing countries. In Namibia, it is the most prevalent cancer type, highlighting the need for enhanced awareness and early detection strategies, especially in rural areas. This study evaluated the knowledge and awareness of breast cancer among Namibian women, identifying gaps and exploring the development of an online support group. The research collected qualitative data from randomly selected participants in the Khomas region through questionnaires, as well as secondary data from online archives, which included a comprehensive literature review and observation of the existing structures and systems in place. The study employed interpretive phenomenological analysis and qualitative content analysis to interpret the collected data. It emphasized the importance of psychosocial support for patients and caregivers, suggesting the establishment of an online support group platform to facilitate emotional and moral support, ultimately enhancing the fight against breast cancer in Namibia.
Access to medical and supportive care services is important for the health and quality of life of cancer survivors; however, services are not always available or accessible to all survivors equally. This study aims to explore the experiences of cancer services among cancer survivors in urban and rural settings to inform social work practice. Authors conducted interviews with 25 cancer survivors (colorectal, n = 13; hematological, n = 12) in the West of Ireland, using a narrative inquiry approach. Thematic analysis was used to analyze the data. Authors found variations in the availability of supportive care services for urban and rural cancer survivors. Often, services designed to maximize survivors’ individualized choices and needs in community care were limited in rural communities, preventing some survivors from having their physical and psychological needs met. Additionally, access to services proved to be a barrier for rural cancer survivors. Rural survivors stated that traveling to appointments required time and planning, and the implications of travel costs were an increased burden. When rural survivors had good social support, access to services became less of an issue. The study confirms geographical disparities and recommends a review of supports that better meet survivors’ needs and informs social work practice.
OBJECTIVE
Neighborhood-level resource disadvantage has been previously shown to predict extent of resection, oncological follow-up, adjuvant treatment, and clinical trial participation for malignancies, including glioblastoma. The authors aimed to characterize the association between neighborhood disadvantage and long-term outcomes after spine tumor surgery.
METHODS
The authors analyzed all patients who underwent surgery for primary or secondary (all metastatic pathologies) spine tumors at a single spinal oncology specialty center in the United States from 2015 to 2022. The Area Deprivation Index (ADI), a validated metric compositing 17 social determinants of health variables that ranges continuously from 0% (higher advantage) to 100% (higher disadvantage), was used to quantify neighborhood disadvantage. Patient addresses were matched to ADI on the basis of the census block of residence. Subsequently, the study population was dichotomized into advantaged (ADI 0%–33%) and disadvantaged (ADI 34%–100%) cohorts. The primary endpoint was functional status, as defined by Eastern Cooperative Oncology Group (ECOG) Performance Status Scale grade, with secondary endpoints including inpatient outcomes, mortality, readmissions, reoperations, and clinical research participation. Multivariable logistic, gamma log-link, and Cox regression adjusted for 14 confounders, including patient and oncological characteristics, general and tumor-related presenting severity, and treatment.
RESULTS
In total, 237 patients underwent spine tumor surgery from 2015 to 2022, with an average age of 53.9 years, and 57.0% had primary tumors whereas 43.0% had secondary tumors; 55.3% (n = 131) were classified by ADI into the disadvantaged cohort. This cohort had higher rates of ambulation deficits on presentation (39.1% vs 23.5%, p = 0.015) and nonelective surgery (35.1% vs 23.6%, p = 0.030). Postoperatively, disadvantaged patients exhibited higher odds of residual tumor (OR 2.55, p = 0.026), especially for secondary tumors (OR 4.92, p = 0.045). Patients from disadvantaged neighborhoods additionally exhibited significantly higher odds of poor functional status at follow-up (OR 3.94, p = 0.002). Postoperative survival was 74.7% (mean follow-up 17.6 months), with the disadvantaged cohort experiencing significantly shorter survival (HR 1.92, p = 0.049). Moreover, this population had higher odds of readmission (OR 1.92, p = 0.046) and, for primary tumors, reoperation (OR 9.26, p = 0.005). Elective participation in prospective clinical research was lower among the disadvantaged cohort (OR 0.45, p = 0.016).
CONCLUSIONS
Neighborhood disadvantage predicts higher rates of residual tumor, readmission, and reoperation, as well as poorer functional status, shorter postoperative survival, and decreased elective research participation. The ADI may be used to risk stratify spine oncology patients and guide targeted interventions to ameliorate neurosurgical disparities and to reduce barriers to research participation.
OBJECTIVE
Earlier research has demonstrated that social determinants of health (SDoH) impact neurosurgical access and outcomes, but these trends are less characterized for spine tumors relative to intracranial tumors. The authors aimed to elucidate the association between SDoH and outcomes for a nationwide cohort of spine tumor surgery admissions.
METHODS
The authors identified all admissions with a spine tumor diagnosis in the National Inpatient Sample (NIS) from 2002 to 2019. Four SDoH were analyzed: race and ethnicity, insurance, household income, and safety-net hospital (SNH) treatment. Hospitals in the top quartile of safety-net burden (in terms of percentage of patients receiving Medicaid or uninsured) were categorized as SNHs. Multivariable regression queried the association between 22 variables and 5 perioperative outcomes: mortality, discharge disposition, complications, length of stay (LOS), and hospitalization costs. Interaction term analysis with hospitalization year was used to assess longitudinal changes in outcome disparities. Finally, the authors constructed random forest machine learning models to assess the impact of SDoH variables on prognostic accuracy and to quantify the relative importance of predictors for disposition.
RESULTS
Of 6,593,392 total admissions with spine tumors, 219,380 (3.3%) underwent surgery. Non-White race (OR 0.80–0.91, p < 0.001) and nonprivate insurance (OR 0.76–0.83, p < 0.001) were associated with lower odds of receiving surgery. Among surgical admissions, presenting severity, including of myelopathy and plegia, was elevated among non-White, nonprivate insurance, and low-income admissions (all p < 0.001). Black race (OR 0.70, p < 0.001), Medicare (OR 0.70, p < 0.001), Medicaid (OR 0.90, p < 0.001), and lower income (OR 0.88–0.93, all p < 0.001) were associated with decreased odds of favorable discharge disposition. Increased LOS and costs were observed among non-White (+6%–10% in LOS and +5%–9% in costs, both p < 0.001) and Medicaid (+16% in LOS and +6% in costs, both p < 0.001) admissions. SNH treatment was also associated with higher mortality (OR 1.49, p < 0.001) and complication (OR 1.20, p < 0.001) rates. From 2002 to 2019, disposition improved annually for Medicaid patients (OR 1.03 per year, p = 0.022) but worsened for Black patients (OR 0.98 per year, p = 0.046). Random forest models identified household income as the most important predictor of discharge disposition.
CONCLUSIONS
For spine tumor admissions, SDoH predicted surgical intervention, presenting severity, and perioperative outcomes. Over 2 decades, disparities improved for Medicaid patients but worsened for Black patients. Finally, SDoH significantly improve prognostic accuracy for outcomes after spine tumor surgery. Further study toward ameliorating patient disparities for this population is warranted.
Objective: The study mainly aims to determine the current state of psychosocial services offered to cancer patients and the views of nurses regarding the ways to meet patients’ psychosocial needs. Other aims to evaluate barriers to meeting patients’ psychosocial needs and measure nurses' difficulty level of psychosocial assessment and intervention practices. Methods: This multicenter, cross-sectional study was conducted with 1189 nurses providing direct care to adult cancer patients in 32 hospitals in 12 geographical regions of Turkey. The data were collected by a survey prepared in accordance with the aims of the study. Results: Three-quarters of the participants reported that their hospital has psychosocial support services while 67.7% stated that this service was provided by psychiatry consultation. Nearly half (49%) stated that all healthcare professionals are responsible for meeting patients’ psychosocial needs, especially it is an integral part of their nursing duties. However, organizational conditions (48.2%-30.7%) are the most important barriers to meeting the psychosocial needs of the patients. Participants have difficulty mostly in assessing and intervening in psychosocial needs of patients mostly in "sexual problems" and "rejection of treatment", and least in "patients’ reactions to illness". Also, the participants have more difficulty in assessing seven of the 19 psychosocial dimensions and intervening in five (p
Social well-being impacts cancer patients’ health-related quality of life (HRQOL) and coping style. This secondary analysis was conducted to examine whether advanced prostate cancer survivors who had experienced low social well-being would benefit from a web-based cognitive behavioral stress management (CBSM) intervention.
APC survivors (N = 192) who had received androgen deprivation therapy (ADT) were randomized to a 10-week CBSM or a health promotion (HP) control condition. A subsample of participants (n = 61) with low pre-intervention SWB (measured by social support from and relationship satisfaction with family and friends) was included in the study. Multilevel models compared participants’ PC-specific quality of life (sexual, hormonal, urinary), affect-based psychosocial burden (cancer-related anxiety and distress), and coping strategies at baseline, 6 months, and 12 months. Covariates were included in all models as appropriate.
Participants randomized to the CBSM condition showed significantly greater improvements in fear of cancer recurrence and cancer-related intrusive thoughts than those in the HP control condition. A significant condition by time interaction was also found, indicating that CBSM improved participants’ PC-related fear in both short- (6 months) and long-term (12 months). However, the CBSM intervention did not significantly impact APC-related symptom burden. Only for the urinary domain, clinically meaningful changes (CBSM vs HP) were observed. In addition, all participants, regardless of condition, reported less coping (e.g., emotion-, problem- and avoidance-focused) over time.
As predicted, the CBSM intervention improved several affect-based psychosocial outcomes for APC survivors with low baseline SWB.
Aim
To explore the actual experience of psychological distress of adult women of reproductive age at different stages after breast cancer diagnosis.
Design
Qualitative.
Methods
Eighty‐one patients with breast cancer‐related distress thermometer scores >4 were selected using a purposive sampling method. Patients were divided into newly diagnosed and 1‐, 3‐, 6‐, 9‐ and 12‐month groups according to time since diagnosis and then interviewed. A phenomenological approach was adopted to analyse interview content, and different themes were extracted.
Results
Women exhibited different levels of psychological distress depending on the time since diagnosis, with newly diagnosed patients showing the highest distress. Within 1 year post‐diagnosis, different events caused patients distress. Themes extracted at new diagnosis and 1‐, 3‐, 6‐, 9‐ and 12 months post‐diagnosis included sadness and disbelief, loss of control, optimistic but concerned, physical and mental exhaustion, difficulties returning to society and limited sexual intimacy, respectively; all groups expressed reproductive concerns.
Conclusion
Clinical nurses should focus on different psychologically distressing events to provide targeted interventions at distinct phases. For women of childbearing age, clinical nurses should pay particular attention to patients' marriage and reproductive concerns.
Implications for the Profession and/or Patient Care
During the year after a breast cancer diagnosis, patients of childbearing age experience events that cause psychological distress that differ depending on time since diagnosis. Nurses should focus on core stressful events and perform specific nursing interventions.
Impact
To provide holistic care, nurses should consider the psychological and emotional changes patients may undergo. For women of childbearing age, clinical nurses should pay particular attention to patients' marriage and fertility concerns, and be able to provide evidence‐based professional guidance on reproductive preservation techniques.
Reporting Method
The study was reported using the consolidated criteria for reporting qualitative research guidelines.
Patient or Public Contribution
Patients contributed to data collection through interviews.
Objective
As social support has been shown to have beneficial effects on coping with cancer, our study aims to close the research gap on perceived social support in adolescent and young adult (AYA) cancer survivors.
Methods
AYAs evaluated their perceived positive social support (PS) and detrimental interactions (DI) by completing the Illness‐Specific Social Support Scale (ISSS‐8) upon completion of acute treatment (t1) as well as 1 year (t2) and 7 years (t6) later. Temporal changes of social support were examined. Sociodemographic, psychological and medical factors were investigated as predictors for PS and DI by using mixed effects models.
Results
We analyzed data from 319 cancer survivors (74.9% women). At baseline, survivors reported an average score of 13.73 (SD = 2.52) for PS and 3.92 (SD = 2.85) for DI. Average perceived PS changed over time, while DI remained stable. Males, AYAs without a partner and AYAs with clinically meaningful anxiety or depression levels reported fewer PS. Higher effort to cope with the disease and clinically significant anxiety and depression levels were associated with more perceived DI.
Conclusions
Existing social networks and perceived social support should be evaluated regularly in AYA‐cancer survivorship. The identification and discussion of mental health of AYAs should also be a standard component in survivor consultations both during treatment and follow‐up care, as elevated depression and anxiety levels were associated with fewer PS and more perceived DI.
Background
Studies have shown improved survival among individuals with cancer with higher levels of social support. Few studies have investigated social support and overall survival (OS) in individuals with advanced prostate cancer in an international cohort. We investigated the associations of marital status and living arrangements with OS among individuals with advanced prostate cancer in the International Registry for Men with Advanced Prostate Cancer (IRONMAN).
Methods
IRONMAN is enrolling participants diagnosed with advanced prostate cancer (metastatic hormone-sensitive prostate cancer, mHSPC; castration-resistant prostate cancer, CRPC) from 16 countries. Participants in this analysis were recruited between July 2017 and January 2023. Adjusting for demographics and tumor characteristics, the associations were estimated using Cox regression and stratified by disease state (mHSPC, CRPC), age (<70, ≥70 years), and continent of enrollment (North America, Europe, Other).
Results
We included 2,119 participants with advanced prostate cancer, of whom 427 died during up to 5 years of follow-up (median 6 months). Two-thirds had mHSPC. Most were married/in a civil partnership (79%) and 6% were widowed. Very few married participants were living alone (1%), while most unmarried participants were living alone (70%). Married participants had better OS than unmarried participants [adjusted HR: 1.44; 95% confidence interval (CI): 1.02–2.02]. Widowed participants had the worst survival compared with married individuals (adjusted HR: 1.89; 95% CI: 1.22–2.94).
Conclusions
Among those with advanced prostate cancer, unmarried and widowed participants had worse OS compared with married participants.
Impact
This research highlighted the importance of social support in OS within this vulnerable population.
Mechanisms that explain behavior change within web-based lifestyle interventions are not well-studied. This secondary analysis explores whether the effects of the DUET web-based lifestyle intervention on diet, physical activity, and/or adiposity are mediated through changes in self-efficacy, social support, and perceived barriers (key constructs of social cognitive theory). Data on mediators, diet quality, caloric intake, moderate-to-vigorous physical activity (MVPA), weight, and waist circumference (WC) were analyzed from 112 cancer survivors and their partners enrolled in the DUET intervention. Mediation analyses were performed using Mplus to execute regression analyses and determine associations. Mediation analyses supported an effect of the intervention on caloric intake (−3.52, 95% CI [−8.08 to −0.84]), weight (−1.60, CI [−3.84 to −0.47]), and WC (−0.83, CI [−1.77 to −0.18]), interpreting these negative associations as intervention induced reductions in dietary barriers. Higher social support was significantly and positively associated with, but not a mediator for, improvements in self-reported and accelerometry-measured MVPA (b = 0.69, CI [0.19, 1.24]) and (b = 0.55, CI [0.15, 1.00]), respectively. Self-efficacy did not appear to mediate the intervention’s effects. Findings suggest that the effects of the DUET intervention on diet and adiposity stem from reducing perceived barriers to a healthful, low-calorie diet.
Knowledge about how social support operates under specific circumstances lags behind the amount of research on the relationship between social support and well-being. Therefore, the purpose of our research was to study the mechanisms through which social support influences psychological well-being under stressful circumstances. We distinguished between perceived available support and received support in evaluating a hypothetical model specifying the direct and indirect effects of support on depression of recently diagnosed breast cancer patients. Results from structural equation modeling show that available support has direct beneficial effects on depression and received support has indirect effects (via appraisal and coping). Moreover, dependent on the type of support and coping strategy in the analyses, other effects of available and received support were found.
The concept of social support has been used extensively in both the theoretical and research literature, yet it has not been clearly delineated or operationalized. As a result, numerous other concepts have been subsumed under the heading of social support. In this article, the concept of social support will be analyzed for the purpose of concept clarification using the qualitative research approach of critical analysis of the literature. The present conceptualizations and operationalizations of social support are examined, and the incongruities or fit between the concept and its application are presented. Then, the structural features of social support are identified, and a revised definition of the concept is suggested.
Surveys the literature on social support and cancer and reports results from an empirical investigation of the factors that led cancer patients to join social support groups. Questionnaire data from 666 21–89 yr old cancer patients show that although most Ss received high levels of social support following cancer, some experienced isolated instances of rejection or did not receive the type of support they wanted from family, friends, and medical caregivers. This appeared to be 1 impetus for joining cancer support groups, although Ss reporting a lack of social support were not generally more likely to join support groups than were other Ss. The Profile of Mood States suggested that attenders were somewhat less likely to be depressed than were nonattenders. In addition, cancer support group attenders were more likely to be White middle-class females, to report having more problems, and to use social support resources of all kinds than were nonattenders. Implications for outreach to cancer patients are discussed, and it is concluded that while support groups may be beneficial for many cancer patients, current programs tend to be used largely by the same segment of the population that uses traditional mental health services. (81 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
To obtain a clearer picture of what constitutes social support, we conducted three studies to compare measures of different conceptions of social support. Relations of these instruments to various personality measures were also investigated. Subdividing the construct into discrete functions did not add to the sensitivity of the indices. Measures of received support and support networks were not strongly related to most of the perceived available support measures. Interview and questionnaire approaches were similar in the information they evoked about close supportive relationships. The results suggest that measures of perceived available support, regardless of the way the instruments attempt to break down the construct, generally assess the extent to which an individual is accepted, loved, and involved in relationships in which communication is open. Psychometric characteristics of the measures were associated with differential sensitivity over the range of supportive relationships. The theoretical implications of the findings are discussed with emphasis on the common core underlying social support indices. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The role of social support in functional status to a diagnosis of cancer was examined in 84 patients with breast cancer. Multivariate techniques were used to assess the relationships among the dimensions of social support, as measured by the Multidimensional Scale of Perceived Social Support (MSPSS), and functional status, assessed with the Inventory of the Functional Status Cancer (IFSA-CA). The results indicated significant independent associations between support and functional status outcomes, underscoring the importance of examining social support to evaluate functional status of patients. Nurses cognizant of breast cancer survivors challenges and concerns in areas of social support and are in a unique position to enhance functional status.
Patients with small-cell lung cancer who survive more than 2 years have a significantly increased risk (relative risk of 3.6) of developing a second primary tumour. The cessation of cigarette smoking after successful therapy is associated with a significantly decreased risk of a second primary tumour.
To explore why cancer patients do not want or seek information about their condition beyond that volunteered by their physicians at times during their illness.
Qualitative study based on in-depth interviews.
Outpatient oncology clinics at a London cancer centre.
17 patients with cancer diagnosed in previous 6 months.
Analysis of patients' narratives to identify key themes and categories.
While all patients wanted basic information on diagnosis and treatment, not all wanted further information at all stages of their illness. Three overarching attitudes to their management of cancer limited patients' desire for and subsequent efforts to obtain further information: faith, hope, and charity. Faith in their doctor's medical expertise precluded the need for patients to seek further information themselves. Hope was essential for patients to carry on with life as normal and could be maintained through silence and avoiding information, especially too detailed or "unsafe" information. Charity to fellow patients, especially those seen as more needy than themselves, was expressed in the recognition that scarce resources-including information and explanations-had to be shared and meant that limited information was accepted as inevitable.
Cancer patients' attitudes to cancer and their strategies for coping with their illness can constrain their wish for information and their efforts to obtain it. In developing recommendations, the government's cancer information strategy should attend to variations in patients' desires for information and the reasons for them.
To examine the relationship between women's reported social support and their adherence to recommended breast cancer screening guidelines.
Descriptive, cross-sectional survey.
Community women's organizations throughout the San Francisco Bay Area.
833 mostly low-income women with a mean age of 46.2 years from three racial or ethnic groups (i.e., Latina, Caucasian, and African American) who were not breast cancer survivors.
Social support was measured with a five-item, four-point, Likert scale developed for the study (Cronbach's alpha = 0.7248). Adherence to screening guidelines was measured by asking frequency of performing breast self-examination (BSE) and frequency of obtaining a clinical breast examination (CBE) and a mammogram. Research assistants and leaders of women's organizations conducted the survey in work and community settings.
Social support, performance of BSE, obtaining a CBE and a mammogram, income, education, spoken language, and level of acculturation.
Higher levels of social support were related to higher income and higher education. Lower levels of social support were associated with being Latina, completing the survey in Spanish, and being born abroad. Women who did not adhere to screening guidelines (for BSE or CBE) reported less social support.
Social support is associated with adherence to breast cancer screening guidelines.
Nurses should assess women's levels of social support as a factor when evaluating adherence to breast cancer screening guidelines.
Stress has long been believed to influence carcinogenesis, but little is known about physiological mechanisms that may underlie these effects. We have recently observed lower levels of vascular endothelial growth factor (VEGF) in ovarian cancer patients with greater social support, whereas higher VEGF was found in patients with greater distress. The goal of this study was to examine possible mechanisms underlying these relationships.
The effects of stress-related mediators including norepinephrine (NE), epinephrine, isoproterenol (a nonspecific beta-adrenergic agonist), and cortisol on the production of VEGF by the ovarian cell lines SKOV3 and EG were investigated.
NE and isoproterenol significantly enhanced VEGF production by SKOV3 cells, and all three of the adrenergic agonists enhanced VEGF production by EG cells. These effects were blocked by the beta antagonist propranolol, supporting a role for beta-adrenergic receptors in these effects. Reverse transcriptase-PCR studies indicated constitutive expression of beta-1 and beta-2 adrenergic receptors on both cell lines. Effects of cortisol on VEGF production varied according to the specific cell line and dose, with stimulating effects on SKOV3 at pharmacologic doses (1000 nM) and on EG at physiological stress level doses (10 nM), and inhibitory effects on EG at pharmacologic doses. Although priming with cortisol blunted NE-induced VEGF production from both cell lines at 3 h, significant increases in VEGF were still seen. Priming with cortisol enhanced isoproterenol-induced VEGF production from SKOV3.
These findings provide the first experimental evidence of a pathway by which biobehavioral stress mediators could directly contribute to the progression of ovarian tumors.
Recent analyses based on UK data indicate that people who stop smoking, even well into middle age, avoid most of their subsequent risk of lung cancer. We investigated whether similar absolute risks of lung cancer in men are found in other European countries with different smoking patterns and at different stages of their lung cancer epidemic. Using data for men from a multicentre case-control study of lung cancer in the UK, Germany, Italy and Sweden, and including 6523 lung cancer cases and 9468 controls, we combined odds ratio estimates with estimates of national lung cancer incidence rates to calculate the cumulative risk of lung cancer among men by age 75. Lung cancer cumulative risks by age 75 among continuing smokers were similar for the UK, Germany and Italy at 15.7, 14.3 and 13.8% respectively, whereas the cumulative risk among Swedish male smokers was 6.6%. The proportion of the risk of lung cancer avoided by quitting smoking before the age of 40 was comparable between the four countries, at 80% in Italy and 91% in the UK, Germany and Sweden. Similarly, the proportion of the excess risk avoided by quitting before the age of 50 ranged from 57% in Italy to 69% in Germany. Our results support the important conclusion that for long-term smokers, giving up smoking in middle age avoids most of the subsequent risk of lung cancer, and that lung cancer mortality in European men over the next three decades will be determined by the extent to which current smokers can successfully quit smoking.
We prospectively examined social ties and survival after breast cancer diagnosis.
Participants included 2,835 women from the Nurses' Health Study who were diagnosed with stages 1 to 4 breast cancer between 1992 and 2002. Of these women, 224 deaths (107 of these related to breast cancer) accrued to the year 2004. Social networks were assessed in 1992, 1996, and 2000 with the Berkman-Syme Social Networks Index. Social support was assessed in 1992 and 2000 as the presence and availability of a confidant. Cox proportional hazards models were used in prospective analyses of social networks and support, both before and following diagnosis, and subsequent survival.
In multivariate-adjusted analyses, women who were socially isolated before diagnosis had a subsequent 66% increased risk of all-cause mortality (HR = 1.66; 95% CI, 1.04 to 2.65) and a two-fold increased risk of breast cancer mortality (HR = 2.14; 95% CI, 1.11 to 4.12) compared with women who were socially integrated. Women without close relatives (HR = 2.65; 95% CI, 1.03 to 6.82), friends (HR = 4.06; 95% CI, 1.40 to 11.75), or living children (HR = 5.62; 95% CI, 1.20 to 26.46) had elevated risks of breast cancer mortality and of all-cause mortality compared with those with the most social ties. Neither participation in religious or community activities nor having a confidant was related to outcomes. Effect estimates were similar in analyses of postdiagnosis networks.
Socially isolated women had an elevated risk of mortality after a diagnosis of breast cancer, likely because of a lack of access to care, specifically beneficial caregiving from friends, relatives, and adult children.
The purpose of this study was to describe the characteristics of social support and the influencing factors on social support in nursing home environments. Observations and staff questionnaires from two central Florida nursing homes were used in this grounded theory study to answer the following questions: (1) How is social support manifested? and (2) What are influences on social support? Social support manifestations seemed predominantly superficial and did not appear to involve complex reciprocal relationships, however, when reciprocal resident tasks were observed, they appeared to have significant value and were sources of pride for the residents. Facility behaviors and policies required by governmental mandates appeared to result in significant resident dependency, a situation that mitigates against significant social support.
The effects of 8‐week cancer support groups (CSGs) with and without coaching on adaptation were tested in a sample of 181 women with newly diagnosed early stage breast cancer. CSG participation with coaching resulted in higher quality of relationship with significant other at CSG conclusion; this effect was not sustained 8 weeks later. CSG participation had no effect on symptom distress, emotional distress, or functional status. On average, symptom distress was low, emotional distress was moderate, and functional status was relatively high. Independent of CSGs, symptom distress decreased and functional status increased over time from entry into the study to 16 weeks later. Further research is needed to determine the optimal starting time and length for CSGs. © 1997 John Wiley & Sons, Inc. Res Nurs Health 20: 15–26, 1997
Social support and assistance with daily life are important elements of the endeavor to reduce and compensate for the disadvantages that result from tumour illnesses and therapies. Social measures to avoid impairments of activities and performance should be given priority because an essential factor affecting quality of life is independence. Activities of daily living dependency is associated with lower quality of life ratings in cancer patients (Cheville, 2005) (tables 1.9, 3.1, 3.2, 3.3).
Social support is an important aspect of psychological functioning during diagnosis and treatment of cancer. Gender has been found to influence support preferences, and previous research suggests that women are more likely to seek and utilize support by comparison to men. This qualitative study explores how patients perceive the support they receive. It also examines patient preferences and satisfaction with information and emotional support provided by staff. Eleven melanoma patients (6 men and 5 women) and 5 breast cancer patients participated in a semistructured interview. Thematic analysis suggests that gender is central to patients' satisfaction and preference for support. Whereas women expected staff to provide information and emotional support, men felt that emotional support from staff was inappropriate and perceived information as supportive in helping them deal with their emotions. Men were also more satisfied with support generally, and women perceived staff to have less time to provide support. Breast cancer patients were more satisfied with access to and the nature of support available to them. Findings suggest that female melanoma patients would benefit from similar services. Meeting the support needs of men appears less clear. If support were available as part of a structured care plan, it is possible that men would also utilize support. Future research is required to gain greater understanding of men's support needs.
We assessed the functional status and social support networks of 799 men and women aged 65 years or older newly diagnosed with cancer and living in six New Mexico counties. Functional limitations included depending on others for transportation (33%) and mental incompetence or poor recent memory (42%). The percentage of patients with functional limitation increased sharply with increasing age. In a substantial number of patients there was also evidence for poor social support networks; 26.5% of subjects lived alone and 38.9% had no children living in the vicinity. In a multiple logistic regression analysis, the predictors of having a poor social support network included non-Hispanic white ethnicity, advanced age, low income, and being a recent migrant to the area. Subjects with functional limitations were more likely to have poor social support networks than subjects without such limitations. The deleterious combination of impaired functional status and a limited social support network may explain why elderly cancer patients are at increased risk for not receiving appropriate therapy. Given the potential complexities involving the evaluation and appropriate treatment of cancer, care must be taken to adequately assess functional status and support mechanisms of older patients, and to provide adequate support to ensure compliance with treatment.
(Arch Intern Med. 1991;151:366-370)
Presents a collection of 10 lectures on concepts and issues involved in preventive psychiatry, emphasizing the importance of structuring cognitive and emotional supports for people in crisis situations. Topics include an overview and definition of support systems, detection of mental disorders in children, the role of the nurse in mental hygiene, the contribution of the school to personality development, and conceptual models in community mental health. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
evaluate existing measures of social support, . . . suggest directions for their future use, and . . . propose the development of new measures as needed
social relationships as measures of support / social network measures of support / measures of social support in terms of the functional content of relationships (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Abstract The aims of the present study were to compare the quality of life (QoL), depression and stress between patients with malignant breast cancer and those with benign breast tumors. The present study also examined the factors related to QoL among the patients who were receiving active treatment for breast cancer. Among the 97 patients participating in the study, 73 patients were diagnosed as having malignant breast cancer (malignant group) and 24 as having benign tumors (benign group). All the participants completed the World Health Organization Questionnaire on Quality of Life to determine their QoL. The level of depression, stress, and demographic characteristics were also collected. Quality of life, depression and stress were compared between the malignant and benign groups, and the factors related to QoL were also examined. It was found that the malignant group had poorer physical and psychological QoL and higher life stress. Depression was significantly associated with QoL for both the malignant and benign groups, and the stress from health problem was the most significant predictors for QoL among the malignant group. The breast cancer patients suffered more severe psychological difficulty under active treatment than did the benign group patients. This will have great impact on their QoL, as in Western society. Depression and stress need to be recognized and aggressive psychological and/or medical intervention needs to be carried out in order to diminish the impact on QoL.
The variability in the conceptualization and categorization of social support has resulted in mixed findings regarding its role in cancer progression. This systematic review identifies and summarizes the evidence for the significance of two important indices of social support in progression of different cancers.
We used systematic and replicable methods to search, select, and evaluate findings.
Thirty-one longitudinal prospective findings (in 26 papers) which were selected for inclusion categorized social support into structural and functional support. The types of cancer included in these studies fell into three major categories: breast cancer (16), other cancer (10), and mixed cancers (5). Results suggest that the evidence for the relationship between social support and cancer progression is sufficiently strong for breast cancer as shown by five out of seven methodologically sound studies but consistently unconvincing for other types of cancer or in studies which combined different types of cancer. Structural support indices were found to be more frequently associated with disease progression than the indices of functional support in breast cancer. Disease-related variables such as severity, treatment, nodal status, and site of metastasis were found to be significant predictors of cancer progression, and it is suggested that these variables must be considered when conducting studies on the role of psychosocial factors in cancer-related outcomes including progression.
Methodological limitations of the studies and counterintuitive findings are discussed, and further conclusive research, particularly randomized controlled trials of social support interventions, is warranted to support the findings of this systematic review.
This study aims to investigate the role of social support and coping in explaining health related quality of life (HRQoL) among Turkish breast cancer patients. A cross-sectional sample of 188 women from three hospitals in Turkey completed the Multidimensional Scale of Perceived Social Support, the Ways of Coping Inventory, and the Short Form 36 Health Survey. Socio-demographic and medical information was also collected. Results indicated high HRQoL levels, with 7 of the 10 SF-36 scores being within 1 SD of population mean. Correlations showed that helplessness coping was inversely associated with HRQoL whereas social support, religious coping, optimistic coping and problem focused coping were positively associated with HRQoL. Multiple regressions indicated that time since diagnosis, time since operation, stage of cancer, post-operative treatment, social support and problem solving coping were significant predictors of HRQoL accounting for 54.7% to 46.4% of the variance in physical and emotional HRQoL. Coping and social support have an independent effect on HRQoL over and above sociodemographic and medical variables and should be targeted by appropriate interventions.
Purpose/Objectives: To examine the relationship between perceived social support, uncertainty, and their individual and combined effects on quality of life (QOL) among Latina breast cancer survivors.
Design: Descriptive, correlational study.
Setting: Selected private hospitals in Staten Island, Brooklyn, and Manhattan and the American Cancer Society units of Staten Island, Brooklyn, and Queens, New York.
Sample: 89 Latina breast cancer survivors ages 30-86 years.
Methods: Participants completed a personal data sheet, the Social Support Questionnaire, the Mishel Uncertainty in Illness Scale-Community form, and the Ferrans and Powers Quality of Life Index-Cancer Version III at home and returned the questionnaires to the investigators via postage-paid envelope.
Main Research Variables: Perceived social support, uncertainty, and QOL.
Findings: A significant positive correlation was noted between perceived social support and total QOL. A significant negative correlation was found between uncertainty and QOL. Social support predicted 15.1% of QOL variance, and uncertainty predicted 10.4% of additional QOL variance. Together, these two variables predicted 20.5% of QOL variance.
Conclusions: Perceived social support and uncertainty play a pivotal role in managing or maintaining QOL in Latina breast cancer survivors.
Implications for Nursing: Social support, uncertainty, and QOL are essential variables that should be acknowledged when delivering health care to Latina breast cancer survivors. Nurses cognizant of Latina breast cancer survivors' issues and concerns in areas of social support and uncertainty are in a unique position to enhance QOL.
We assessed the functional status and social support networks of 799 men and women aged 65 years or older newly diagnosed with cancer and living in six New Mexico counties. Functional limitations included depending on others for transportation (33%) and mental incompetence or poor recent memory (42%). The percentage of patients with functional limitation increased sharply with increasing age. In a substantial number of patients there was also evidence for poor social support networks; 26.5% of subjects lived alone and 38.9% had no children living in the vicinity. In a multiple logistic regression analysis, the predictors of having a poor social support network included non-Hispanic white ethnicity, advanced age, low income, and being a recent migrant to the area. Subjects with functional limitations were more likely to have poor social support networks than subjects without such limitations. The deleterious combination of impaired functional status and a limited social support network may explain why elderly cancer patients are at increased risk for not receiving appropriate therapy. Given the potential complexities involving the evaluation and appropriate treatment of cancer, care must be taken to adequately assess functional status and support mechanisms of older patients, and to provide adequate support to ensure compliance with treatment.
Twenty-one instruments developed by nurse researchers were reviewed according to dimensions identified in the general social support literature: type, source, direction, drawbacks, disposition, description or evaluation, duration, and level. The aspects of social support studied, as reflected in the measurement instruments designed by nurse researchers, appropriately emphasize available and enacted emotional and instrumental support from family (including spouse) and friends. However, informational and appraisal support, community sources of support, duration of support, mutual receipt and provision of support, costs associated with negative support, perceived and received support, and evaluation of satisfaction with support are infrequently assessed. Nurses need to evaluate which of these elements are merely desirable supplements and which, if any, are essential to validate the information elicited by instruments. Clearly, nurse investigators have operationalized important typologies in the social-psychological literature. However, the number of diverse measures could be considered superfluous.
Researchers have attempted to clarify the concept of social support by differentiating types of support and relating them to types of stressors. This "specificity" model of support represents an analytical advance over unitary constructs of support, yet an emphasis on such typological studies provides a static view of the phenomenon. Studies of support timing, however, contribute to an understanding of support processes. By integrating these different perspectives, it is possible to (1) answer questions about what support is and how it works and (2) suggest new directions for support research.
Although the nature, meaning and measurement of social support are still being debated in the literature, it has been claimed to have positive effects on a variety of outcomes, including physical health, mental well-being and social functioning. However, an intention to help on the part of the support provider is not sufficient to ensure that one is actually supportive, either as a professional or within one's own personal network. Past research indicates that social support is beneficial to cancer patients in adjusting to the stress of the disease and yet, because of the intense fears and stigma associated with it, those who have cancer may be especially likely to experience problems in obtaining adequate support. Without an appreciation of the complexity of support elicitation and support provision, nurses caring for patients with cancer and for their relatives may, however unintentionally, undermine one of the strongest potential resources people have in coping with the disease-the social relationship.
The effects of 8-week cancer support groups (CSGs) with and without coaching on adaptation were tested in a sample of 181 women with newly diagnosed early stage breast cancer. CSG participation with coaching resulted in higher quality of relationship with significant other at CSG conclusion; this effect was not sustained 8 weeks later. CSG participation had no effect on symptom distress, emotional distress, or functional status. On average, symptom distress was low, emotional distress was moderate, and functional status was relatively high. Independent of CSGs, symptom distress decreased and functional status increased over time from entry into the study to 16 weeks later. Further research is needed to determine the optimal starting time and length for CSGs.
Minority women have higher rates of mortality from breast and cervical cancers and lower rates of utilization of screening tests than white women. Innovative ways to increase screening in these populations are needed urgently. This report examines the effectiveness of screening interventions based on social support for breast and cervical cancers in African American, Hispanic, and Native American women.
Despite the availability of mammography, clinical breast examination, and Papanicolaou smears, many women do not follow recommendations to obtain these tests. Further, many of the traditional approaches to health education have not been effective in minority populations. Additional strategies to promote screening for breast and cervical cancers are needed, particularly for women who, by virtue of language and/or culture, are outside the mainstream. Nontraditional approaches, or social support interventions, may be particularly effective in promoting cancer screening and reducing cancer mortality in high-risk minority women.
Programs that use social support offer the potential to draw on the strengths of a population--the ties between individuals, the importance of the family, and traditional cultural values--to improve screening for breast and cervical cancers in minority groups. In developing a social support intervention, healthcare providers should consider the similarities and differences among populations; collaborate with representatives of the target community; incorporate social support within hospitals and clinics; and include social support as an essential component of the clinical encounter.
Developing approaches to improve the use of scarce health care resources is of increasing importance in cancer care. Being able to target the provision of information to the primary needs of consumers ensures more productive use of expensive teaching time by health care professionals. Researchers and clinicians have used a variety of measurement techniques to assess the information needs of individuals with cancer at various points in their illness trajectory. The two most common types of scaling techniques used by researchers to measure information needs have been summative and differential. The advantages and disadvantages of using these types of measurements are evaluated. This article describes the development and pilot testing of a measure of the information needs in cancer patients that uses one type of differential scaling technique, Thurstone scaling. This measure was subsequently converted into a patient-friendly computerized program capable of helping consumers identify their information priorities before their medical visits. Individualized teaching may be guided by this new measurement technique in the future.
The purpose of this study was to find out what cancer patients' relatives think about the actions of health care professionals in terms of providing informational and emotional support. The sample consisted of 168 relatives of patients from oncological wards all over Finland. The data were collected with a questionnaire specifically developed for this study. Non-parametric tests were used for statistical analysis. The results clearly highlighted the importance of informing relatives about the patient's illness. However, less than one-third of the relatives said they received much information. Relatives' need for emotional support was clearly at a lower level than their need for information. Even so, only very little support was provided in relation to relatives' needs.
The relationship between social support and depressive symptomatology in cancer patients is well established, yet the extent to which patient variables impact this relationship is not well known. The purpose of this study was to examine whether the relationship of social support to the severity of depressive symptoms varies by patient age and gender. DESCRIPTION OF THE STUDY: A sample of 342 cancer outpatients were administered self-report measures of depressive symptoms, perceived adequacy of social support, satisfaction with family functioning, and the size of their social support network.
There were no significant differences by gender or age in the relationship of the social support variables to depressive symptoms. Although not statistically significant, interesting differences did emerge: a larger social support network was associated with less severe depression for female patients and for younger patients but not for male patients or older patients. For the entire sample, greater perceived adequacy of support and more satisfaction with family functioning were related to less severe depression.
The findings of the study suggest that interventions to alleviate depressive symptoms in cancer patients may be designed with consideration of demographic characteristics such as age and gender to maximize the beneficial impact on quality of life.
1) To cross‐sectionally and longitudinally investigate relationships between the availability and adequacy of both close personal attachment and interactional support, and psychiatric morbidity in a sample of early stage breast cancer patients participating in a 6‐week psychoeducational intervention. (2) To address the question of directionality in these longitudinal relationships. (3) To investigate the effects of the intervention on levels of social support.
Eighty‐nine women were enrolled in the study, and randomly assigned to either the treatment or control condition. They were evaluated with the Interview Schedule for Social Interaction (ISSI), the Beck Depression Inventory (BDI), the Global Severity Index (GSI) of the Symptom Checklist (SCL) –90‐R, and the Structured Clinical Interview for DSM‐III‐R (SCID) at three time periods: baseline (pre‐intervention), 1 year post‐intervention and 2 years post‐intervention. Relationships between social support and the psychiatric measures were evaluated both cross‐sectionally and longitudinally.
Cross‐sectionally, there were strong associations at each time period between being diagnosed with a DSM‐III‐R Axis I disorder and having less adequate perceived social support from both close relationships and more distant social ties. Initial levels of psychiatric symptoms on the BDI and GSI were better predictors of later social support than initial social support variables were of later psychiatric symptoms. Participation in the group intervention did not result in changes in social support at 1 or 2 years post‐intervention.
Cross‐sectionally, there was a strong relationship between social support and psychiatric morbidity in these patients with early‐stage breast cancer. Longitudinally, it appeared that although social support influenced psychiatric symptomatology somewhat, the influence of psychiatric symptoms on social support was greater. This illustrates the importance of both working to bolster social support and dealing with psychiatric symptomatology in this population. Copyright © 2002 John Wiley & Sons, Ltd.
In recent years, there has been increasing emphasis on understanding how the cancer experience affects individuals' quality of life (QOL). The goal of this study was to assess the QOL and to identify psychosocial predictors of QOL among a large sample of patients with a variety of cancers. Specifically, we assessed the unique contribution of demographic variables, medical variables, and social support on patients' QOL and psychological adjustment. Three hundred and fifty-one participants completed measures of social support, depression, anxiety, and QOL at their follow-up medical visits. Analyses indicated that patients who were older and had better social support reported less anxiety (p<0.001), and patients who were older, married or who had more social support reported less depressive symptoms (p<0.01). Men, individuals whose cancer had not recurred, and those not undergoing active treatment reported better QOL in the physical health domain (p<0.05). Patients who were older, married, with more formal education, less advanced disease, and better social support reported better QOL in the mental health domain (p<0.05). Demographic variables (age, gender, marital status, education) were generally associated with measures of adjustment and QOL whereas medical variables (time since diagnosis, recurrence status, treatment variables, stage of disease) were not. Patients with more support reported less anxiety and depression and better QOL in the mental health domain, independent of demographic and medical variables. Assessing patients' level of social support may help to identify patients at risk for distress.
The number of deaths per year from hepatocellular carcinoma (HCC) exceeds 250000, placing it sixth as the cause of death from cancer worldwide. The primary etiology of most cases of HCC in the US is hepatitis B and/or C. Extensive research has demonstrated that the relationship between hepatitis B infection and the progression to HCC is mediated by the immune system. A substantial, but unrelated literature, describes the relationship between psychosocial factors (e.g., stress, psychiatric morbidity), immune system reactivity, and disease progression in patients with cancer. However, the role of these factors in the progression of HBV-HCC has not been explored. An understanding of the relationship among virology, immunology, and behavior in the development and recurrence of HCC may provide alternative methods for secondary prevention of HCC (e.g., behavioral) until a vaccine and/or pharmacological treatments are developed, feasible, and affordable.
Breast cancer is the most common form of cancer in American women across most ethnic groups. Although the psychosocial impact of breast cancer is being studied, there is little information on women from diverse ethnic and socioeconomic backgrounds.
We conducted a qualitative study with breast cancer survivors (BCS) of various ethnicities. A total of 102 BCS participated in focus group interviews (24 African Americans, 34 Asians, 26 Latinas and 18 Caucasians); 20 health professionals participated in key informant interviews. Important ethnic differences in type of treatment were noted, Asians and Latinas were more likely to receive mastectomies and African American BCS were least likely to receive adjuvant therapies, including radiation and chemotherapy. These BCS enjoyed a fairly good overall health-related quality of life (HRQOL) with some persistent concerns. The prevailing concerns among all women included overall health, moderate physical concerns, cancer recurrence or metastases, psychosocial concerns related to worry about children and burdening the family, and body image and sexual health concerns. Additional challenges included: lack of knowledge about breast cancer; medical care issues such as insurance, cost and amount of time spent with physician; cultural sensitivity of providers, language barriers, cultural factors related to beliefs about illness, gender role and family obligations (e.g. self-sacrifice). These BCS, particularly the women of color, voiced that their spiritual beliefs and practices are central to their coping. This study accomplishes two goals; it adds to the sparse literature concerning the psychosocial sequelae of breast cancer among women of color, and it increases our knowledge of specific cultural influences (e.g. dietary practices, coping) and socio-ecological factors on HRQOL. More importantly, the study addressed areas that have not been studied before, specifically, an in-depth study on BCS QOL comparing multiple ethnic groups in the US. The results of this investigation will provide preliminary information to survivors and health-care providers about the impact of culture and socio-ecological contexts on survivorship.
Among women of all major ethnic groups, breast cancer is the most common form of cancer and the second leading cause of cancer death (American Cancer Society (ACS), 2002). In 2002, over 203,000 women in the United States will be diagnosed with breast cancer (ACS, 2002). Ethnic disparities exist for cancer stage, diagnosis, survival, morbidity and mortality. In general, ethnic minority women are diagnosed with more advanced disease and experience greater morbidity and mortality (Haynes & Smedley, 1999; Miller et al., 1996; Ries et al., 2000; Shinagawa, 2000).
In general, increases in survival rates have prompted greater interest in the quality of life (QOL) of breast cancer survivors (BCS) over the past two decades. Additionally, the QOL of cancer survivors from diverse ethnic, cultural and socioeconomic backgrounds is an emerging priority area for studies on survivorship research and clinical care (Haynes and Smedley, 1999; National Cancer Institute (NCI), 2002; President's Cancer Panel, 2000). Copyright
The aim of this paper is to review the evidence on the effectiveness of support groups by reporting a meta-analysis of randomized controlled trials evaluating support groups for patients with cancer.
One of the most important nursing aims is to give patients with cancer emotional support and strengthen their adaptation to the disease. According to the literature, support groups for these patients are beneficial.
Original studies from 14 databases published during the past 20 years in peer review journals were selected. Twenty studies with a randomized clinical trial design constituted the final meta-analysis sample. Methodological quality of the selected articles was checked using the Jadad Scale and the Checklist of Consort Statement. Demographic data were analysed using the SPSS program, and the heterogeneity calculation and effect size were analysed using the Rev-Man 4-.1-Metaview program.
The results indicate that participation in a support group is associated with significant improvements in a patient's emotional state (depression and anxiety), illness adaptation, quality of life, and marital relationships.
Support group participation for patients with cancer has a positive impact in various areas. Nurses should promote participation as a crucial part of their care.
Personality, psychosocial, demographic and medical variables have been identified as correlates of adjustment to breast cancer and quality of life (QoL). Most studies have examined relationships between personality, social support and adjustment to cancer in predominantly middle-class Caucasian samples, thus limiting the generalizability of their findings. Eighty-one female outpatients at a medical oncology breast clinic in a county general hospital serving primarily indigent Hispanic and African-American patients completed measures assessing demographic and medical information, health-related QoL, cancer-specific distress, mood disturbance, dispositional optimism and satisfaction with social support. Older age, receipt of treatment and greater optimism accounted for 41% of the variance in emotional well-being (p<0.01). Absence of family history of breast cancer, receipt of treatment and optimism accounted for 43% of the variance in functional well-being (p<0.01). Optimism and satisfaction with social support accounted for 43% of the variance in social/family well-being (p<0.01). Absence of treatment (not yet treated) and pessimism accounted for 31% of the variance in cancer-specific distress (p<0.01). Finally, family history of breast cancer and pessimism accounted for 48% of the variance in mood disturbance (p<0.001). Family history of breast cancer and pessimism were related to mood disturbance (p<0.001). No between-group differences were found for race/ethnicity for any of the variables. Encouraging positive expectations and facilitating social support may help women in public sector medical settings cope with the stressful demands of diagnosis and treatment of breast cancer regardless of race/ethnicity.
Social support is an important aspect of psychological functioning during diagnosis and treatment of cancer. Gender has been found to influence support preferences, and previous research suggests that women are more likely to seek and utilize support by comparison to men. This qualitative study explores how patients perceive the support they receive. It also examines patient preferences and satisfaction with information and emotional support provided by staff. Eleven melanoma patients (6 men and 5 women) and 5 breast cancer patients participated in a semistructured interview. Thematic analysis suggests that gender is central to patients' satisfaction and preference for support. Whereas women expected staff to provide information and emotional support, men felt that emotional support from staff was inappropriate and perceived information as supportive in helping them deal with their emotions. Men were also more satisfied with support generally, and women perceived staff to have less time to provide support. Breast cancer patients were more satisfied with access to and the nature of support available to them. Findings suggest that female melanoma patients would benefit from similar services. Meeting the support needs of men appears less clear. If support were available as part of a structured care plan, it is possible that men would also utilize support. Future research is required to gain greater understanding of men's support needs.
The concept that tumors can be controlled by directly targeting their vascular supply has finally come of age, because clinical trials using a humanized monoclonal antibody that blocks VEGF have demonstrated exciting efficacy in cancer patients, as well as in vascular eye diseases that can lead to blindness. However, data suggest that these current regimens may not provide complete VEGF inhibition and, thus, that the maximum therapeutic potential of VEGF blockade has not yet been achieved. We describe the status of a very potent and high-affinity VEGF blocker, termed the VEGF Trap, that may provide the opportunity to maximize the potential of VEGF blockade in cancer as well as in vascular eye diseases. We also describe use of the VEGF Trap as a research tool, when coupled to high-throughput mouse genetics approaches such as VelociGene that can be exploited in strategies to discover and validate the next generation of angiogenesis targets.
The purpose of this study was to investigate: (1) how social support influences quality of life (QOL) and (2) whether or not the pathways for predicting QOL outcomes differ between Korean American and Korean survivors of breast and gynecological cancer.
To identify multiple dimensions of health status and psychosocial outcomes, two standardized QOL and psychological distress measures were administered to 51 Korean Americans and 110 Koreans. Social support was measured by items assessing functional social support and social network structures. Hierarchical multiple regression and path analyses were employed to investigate the effects of social support on outcomes and to compare between Korean Americans and Koreans.
The findings indicate that functional social support directly influences QOL and psychological distress, and social network structures are directly and/or indirectly associated with outcomes. Moreover, the two groups showed different pathways from social support to outcomes.
This study provides practical research information by illuminating the relationships between social support components influencing QOL for Korean American and Korean survivors. This study may increase the utility and efficacy of the research and interventions to enhance cancer survivors' social participation and to diminish barriers to follow-up care, considering the different living conditions between the United States and Korea.
A Plan for Investment, A Plan for Reform
- Department
- Health
The interpersonal dynamics of cancer: problems in social relationships and their impact on the patients
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