Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA.
Indiana University School of Medicine, Center for Health Services Research, Regenstrief Institute, 1101 W. 10th Street, RF-226, Indianapolis, IN, 46202, USA.
Support Care Cancer. 2019 Jun;27(6):2077-2086. doi: 10.1007/s00520-018-4467-8. Epub 2018 Sep 17.
The present study examined the degree to which loneliness mediated the influence of negative (social constraints) and positive (emotional support) relationship qualities on the global mental health of advanced gastrointestinal (GI) cancer patients and their family caregivers.
Fifty patient-caregiver dyads completed measures assessing social constraints (e.g., avoidance, criticism) from the other dyad members, emotional support from others, loneliness, and global mental health. Structural equation modeling was used to examine individual models, and Actor-Partner Interdependence Mediation Modeling was used to examine dyadic associations.
Individual path analyses for patients and caregivers demonstrated that emotional support had a significant indirect effect on mental health through loneliness (Bs = 0.32 and 0.30, respectively), but no associations were found between social constraints and mental health. In dyadic analyses, participants' loneliness and mental health were not significantly related to their partner's emotional support, loneliness, or mental health (Bs = - 0.18 to 0.18).
Findings suggest that for advanced GI cancer patients and caregivers, emotional support from others alleviates feelings of loneliness, which may lead to better mental health. However, the benefits of emotional support appear to be primarily intrapersonal rather than interpersonal in nature. Additionally, participants endorsed low levels of social constraints, which might explain their lack of relation to loneliness and mental health. Continued examination of interdependence in social processes between cancer patients and caregivers will inform intervention development.
本研究考察了孤独感在多大程度上中介了负向（社交限制）和正向（情感支持）关系质量对晚期胃肠道（GI）癌症患者及其家庭照顾者的整体心理健康的影响。
50 对患者-照顾者对完成了评估来自其他成员的社交限制（如回避、批评）、他人的情感支持、孤独感和整体心理健康的测量。结构方程模型用于检验个体模型，而 Actor-Partner Interdependence Mediation Modeling 用于检验双元关联。
患者和照顾者的个体路径分析表明，情感支持通过孤独感对心理健康有显著的间接影响（分别为 Bs=0.32 和 0.30），但社交限制与心理健康之间没有关联。在二元分析中，参与者的孤独感和心理健康与他们伴侣的情感支持、孤独感或心理健康没有显著相关（Bs=-0.18 至 0.18）。
研究结果表明，对于晚期胃肠道癌症患者和照顾者来说，来自他人的情感支持可以减轻孤独感，从而改善心理健康。然而，情感支持的好处似乎主要是内在的，而不是人际间的。此外，参与者报告的社交限制水平较低，这可能解释了它们与孤独感和心理健康之间缺乏关系。进一步研究癌症患者和照顾者之间社交过程的相互依存关系将为干预措施的发展提供信息。
