Pain Prevention and Treatment Research Program, Duke University Medical Center, 2200 W. Main Street, Suite 340, Durham, NC, 27705, USA.
Support Care Cancer. 2021 Sep;29(9):5513-5521. doi: 10.1007/s00520-021-06136-6. Epub 2021 Mar 15.
Fatigue and pain are common among women with breast cancer, and often related to depressive symptoms. Social support may influence levels of fatigue, pain interference, and depressive symptoms. We tested a theory-based, structural model examining the relationship between social support (i.e., emotional and instrumental) and depressive symptoms via fatigue and pain interference in women with breast cancer.
Women (N = 327) with stages I-III breast cancer were enrolled in a randomized trial investigating a behavioral pain intervention. Measures of social support, fatigue, pain interference, and depressive symptoms were completed at enrollment. Data were analyzed using structural equation modeling to test direct and indirect pathways relating social support, fatigue, pain interference, and depressive symptoms.
Our model evidenced good fit. Significant direct effects emerged linking higher levels of emotional support with lower levels of fatigue (β = -.30), pain interference (β = -.32), and depressive symptoms (β = -.31). More instrumental support was significantly associated with more depressive symptoms (β = .11), but not fatigue or pain interference. Higher levels of fatigue (β = .30) and pain interference (β = .34) were significantly related to higher levels of depressive symptoms. More emotional support related to less depressive symptoms via lower levels of fatigue (β = -.09) and pain interference (β = -.11).
Women reporting higher levels of emotional support endorsed fewer depressive symptoms, and that relationship was driven by lower levels of fatigue and pain interference. Our results highlight novel pathways that healthcare professionals can leverage to optimize social support topics in psychosocial interventions targeting breast cancer symptoms. This model should be replicated using longitudinal data.
疲劳和疼痛是乳腺癌女性常见的问题，且常与抑郁症状相关。社会支持可能会影响疲劳、疼痛干扰和抑郁症状的水平。我们通过测试一个基于理论的结构模型，检验了社会支持（即情感支持和工具性支持）与乳腺癌女性的疲劳和疼痛干扰之间通过抑郁症状的关系。
患有 I-III 期乳腺癌的女性（N=327）参加了一项随机试验，该试验调查了一种行为疼痛干预措施。在入组时完成了社会支持、疲劳、疼痛干扰和抑郁症状的测量。使用结构方程模型分析数据，以测试社会支持、疲劳、疼痛干扰和抑郁症状之间的直接和间接途径。
我们的模型具有良好的拟合度。有显著的直接效应表明，较高水平的情感支持与较低水平的疲劳（β=-.30）、疼痛干扰（β=-.32）和抑郁症状（β=-.31）相关。更多的工具性支持与更高的抑郁症状（β=.11）显著相关，但与疲劳或疼痛干扰无关。较高水平的疲劳（β=.30）和疼痛干扰（β=.34）与较高水平的抑郁症状显著相关。更高水平的情感支持通过较低水平的疲劳（β=-.09）和疼痛干扰（β=-.11）与较少的抑郁症状相关。
报告较高水平情感支持的女性报告较少的抑郁症状，这种关系是由较低水平的疲劳和疼痛干扰驱动的。我们的结果强调了新的途径，医疗保健专业人员可以利用这些途径在针对乳腺癌症状的心理社会干预中优化社会支持主题。应该使用纵向数据来复制这个模型。
