George Warren Brown School of Social Work, Washington University in St Louis, St Louis, MO 63130-4899, USA.
Health Psychol. 2013 Aug;32(8):886-95. doi: 10.1037/a0031894. Epub 2013 Mar 11.
Variables associated with levels of, and change in, social support were identified in a cohort of early stage breast cancer patients and age-matched controls.
Telephone interviews measuring perceived social support and other demographic and psychosocial variables were conducted at 4 to 6 weeks and 6, 12, and 24 months after surgery (patients) or a normal/benign screening mammogram (controls). We modeled the intercept (starting point) and slope (changing) aspects of social support.
Participants included 542 controls and 541 patients (77% White, 23% African American; mean age 57.7 years [SD = 10.6]). Most participants reported high social support. Patients reported significantly higher levels of social support at baseline than controls. For patients, social support had a significant negative slope that significantly varied between individuals; the intercept of social support also varied significantly. Predictors of lower social support intercept in patients included not being married/partnered, being White, having lower perceived general health, and having higher negative affect (a latent variable defined by anxiety and depression symptom severity). Patients who were African American (vs. White) or had mastectomy (vs. lumpectomy) had steeper social support declines, and participants with both these characteristics had lower starting points as well as steeper declines. Social support among controls did not change significantly.
Clinicians might consider psychosocial interventions for patients reporting low social support around the time of diagnosis and surgical treatment, and for patients at risk for steeper declines in support, such as African Americans and women undergoing mastectomy.
在一组早期乳腺癌患者和年龄匹配的对照组中,确定与社会支持水平和变化相关的变量。
在手术后 4 至 6 周以及 6、12 和 24 个月时,通过电话访谈测量感知社会支持以及其他人口统计学和心理社会变量(患者)或正常/良性乳房 X 光筛查(对照组)。我们对社会支持的截距(起始点)和斜率(变化)方面进行建模。
参与者包括 542 名对照组和 541 名患者(77%为白人,23%为非裔美国人;平均年龄为 57.7 岁[SD=10.6])。大多数参与者报告了较高的社会支持。与对照组相比,患者在基线时报告的社会支持水平明显更高。对于患者,社会支持具有显著的负斜率,个体之间差异显著;社会支持的截距也有显著差异。患者社会支持截距较低的预测因素包括未婚/无伴侣、为白人、感知一般健康状况较低以及负面情绪较高(由焦虑和抑郁症状严重程度定义的潜在变量)。与白人相比,非裔美国人(而非白人)或接受乳房切除术(而非乳房切除术)的患者社会支持下降更为陡峭,具有这两个特征的患者起点较低,下降也更为陡峭。对照组的社会支持没有显著变化。
临床医生可能会考虑在诊断和手术治疗前后,为报告社会支持水平较低的患者以及面临支持水平下降风险较高的患者(如非裔美国人和接受乳房切除术的女性)提供心理社会干预措施。