Health Communication Research Laboratory, Brown School of Social Work, Washington University in St. Louis, United States.
Washington University School of Medicine, Washington University in St. Louis, United States.
Soc Sci Med. 2017 Nov;192:134-142. doi: 10.1016/j.socscimed.2017.09.035. Epub 2017 Sep 22.
Social support plays an important role in quality of life and health outcomes after breast cancer diagnosis and treatment.
To examine changes in perceived social support in African American women during the two years following a new breast cancer diagnosis.
This secondary analysis uses data collected from 2009 to 2015 from 227 newly diagnosed, African American women with breast cancer (mean age 56 [SD = 10], 59% household income < $25,000; 28% married/partnered, 72% early stage) participating in a randomized controlled trial testing the effects of a video-communication intervention on quality-of-life and follow-up care. Participants, all of whom received treatment in one metropolitan area of the Midwestern United States, completed five telephone interviews over 2-year follow-up; demographic, psychosocial, quality of life, and clinical data were collected. Growth curve models were used to examine change in perceived social support (measured by the Medical Outcomes Study Social Support Survey) as well as correlates of baseline levels of social support and predictors of change in individuals' social support. Additional analyses examined whether change in social support over the first year affected depressive symptoms (Center for Epidemiologic Studies Depression Scale) and general health perceptions (RAND SF-36 subscale) at two years.
Being married, reporting greater spirituality, and reporting fewer depressive symptoms at baseline were significantly associated with higher initial levels of perceived social support. Women whose social support declined during the first year after diagnosis reported more severe depressive symptoms and worse general health perceptions at two years.
Clinicians should periodically assess perceived social support among African American women with breast cancer to help find support resources for those who have low initial social support and for those whose support declines in the first year after diagnosis.
社会支持在乳腺癌诊断和治疗后的生活质量和健康结果中起着重要作用。
在新诊断出乳腺癌后的两年内,检查非裔美国女性感知到的社会支持的变化。
这项二次分析使用了 2009 年至 2015 年期间从 227 名新诊断为乳腺癌的非裔美国女性(平均年龄 56 [SD=10],59%的家庭收入<25,000 美元;28%已婚/有伴侣,72%早期阶段)的数据,他们参加了一项随机对照试验,测试了视频交流干预对生活质量和后续护理的影响。参与者均在美国中西部一个大都市区接受治疗,在 2 年的随访期间完成了 5 次电话访谈;收集了人口统计学、心理社会、生活质量和临床数据。增长曲线模型用于检查感知社会支持(通过医疗结局研究社会支持调查测量)的变化,以及社会支持基线水平的相关因素和个体社会支持变化的预测因素。其他分析检查了第一年社会支持的变化是否会影响两年时的抑郁症状(流行病学研究中心抑郁量表)和一般健康认知(RAND SF-36 子量表)。
在基线时,已婚、报告更多的灵性和报告更少的抑郁症状与感知社会支持的初始水平较高显著相关。在诊断后第一年社会支持下降的女性,在两年时报告的抑郁症状更严重,一般健康认知更差。
临床医生应定期评估非裔美国乳腺癌女性的感知社会支持,以帮助为那些初始社会支持水平较低以及在诊断后第一年社会支持下降的患者寻找支持资源。