Department of Health Administration and Policy, College of Public Health, University of Oklahoma, Oklahoma City, OK 73104, USA.
Psychooncology. 2012 Feb;21(2):125-33. doi: 10.1002/pon.1863. Epub 2010 Oct 20.
Although previous evidence has shown increased likelihood for survival in cancer patients who have social support, little is known about changes in social support during illness and their impact on survival. This study examines the relationship between social support and survival among women diagnosed with breast carcinoma, specifically assessing the effect of network size and changes in social contact post-diagnosis.
A population-based sample of 584 women was followed for up to 12.5 years (median follow-up = 10.3 years). The mean age at diagnosis was 44 years, 81% were married, and 29% were racial/ethnic minorities. Cox regression analysis was used to estimate survival as a function of social support (changes in social contact and the size of social support), disease severity, treatment, health status, and socio-demographic factors.
Fifty-four percent of the women had local and 44% had regional stage disease. About 53% underwent mastectomy, 68% received chemotherapy, and 55% had radiation. Regression results showed that disease stage, estrogen receptor status, and mastectomy were associated with greater risk of dying. Although network size was not related to survival, increased contact with friends/family post-diagnosis was associated with lower risk of death, with a hazard ratio of 0.31 (95% CI, 0.17-0.57).
Findings from this study have identified an important aspect of a woman's social network that impacts survival. An increase in the amount of social contact, representing greater social support, may increase the likelihood of the women's survival by enhancing their coping skills, providing emotional support, and expanding opportunities for information-sharing.
尽管先前的证据表明，癌症患者获得社会支持的生存率更高，但对于疾病过程中社会支持的变化及其对生存率的影响知之甚少。本研究通过评估网络规模和诊断后社会联系的变化，考察了乳腺癌患者社会支持与生存之间的关系。
对 584 名女性进行了基于人群的随访，随访时间最长达 12.5 年（中位随访时间=10.3 年）。诊断时的平均年龄为 44 岁，81%已婚，29%为少数民族。使用 Cox 回归分析估计了社会支持（社会联系变化和社会支持规模）、疾病严重程度、治疗、健康状况和社会人口因素对生存的影响。
54%的女性患有局部疾病，44%患有区域性疾病。约 53%的女性接受了乳房切除术，68%接受了化疗，55%接受了放疗。回归结果显示，疾病分期、雌激素受体状态和乳房切除术与死亡风险增加相关。尽管网络规模与生存无关，但诊断后与朋友/家人的联系增加与死亡风险降低相关，风险比为 0.31（95%CI，0.17-0.57）。
本研究的结果确定了女性社交网络影响生存的一个重要方面。社会联系量的增加，代表了更大的社会支持，可能通过增强应对技能、提供情感支持和扩大信息共享机会，增加女性生存的可能性。
