Hannover Medical School, Department of Medical Sociology, Hannover, Germany.
Hannover Medical School, Gynaecological Psychosomatics and Psychooncology Clinic for Gynaecology and Obstetrics, Hannover, Germany.
Support Care Cancer. 2024 Aug 2;32(8):566. doi: 10.1007/s00520-024-08695-w.
This study analyzes levels of social participation in patients with breast cancer on average 5 years following primary surgery as compared to women in the general population. In addition, the role of breast cancer-related complaints and medical data as possible influencing factors on levels of patients' social participation is investigated.
A total of n = 454 patients after primary surgery (t0) were recruited for a third follow-up study, and n = 372 completed this survey (t3), corresponding to a response rate of 82.2%. For measuring breast cancer-related complaints, participants completed a written questionnaire. Social participation was measured by a questionnaire on different leisure activities that was taken from the Socio-Economic Panel Study. Medical information was extracted from medical reports at t0. A principal component analysis was carried out to identify different dimensions of social participation. Chi-tests and logistic regression analyses were applied to analyze social participation as compared to the general population and the role of possible medical and diagnosis-related influencing factors thereby.
Compared to the general population, patients show lower levels of social participation in the domains "socio-cultural participation" and "participation in institutions," while no significant differences for "social participation in the private sphere" and "social participation via social media" were found. Psychological symptoms, pain, and a history of mastectomy were most strongly associated with restrictions in social participation.
Our study suggests that social withdrawal may happen due to disease-related symptoms, preventing some breast cancer patients from participating fully in society. Cancer-related follow-ups should address this issue and support patients' reintegration into society through appropriate therapeutic interventions.
本研究分析了乳腺癌患者在初次手术后平均 5 年后的社会参与水平，并与普通人群进行了比较。此外，还调查了乳腺癌相关症状和医疗数据作为影响患者社会参与水平的可能因素的作用。
共有 n=454 名接受初次手术后的患者（t0）被招募参加第三次随访研究，n=372 名患者完成了该调查（t3），应答率为 82.2%。为了测量乳腺癌相关症状，参与者完成了一份书面问卷。社会参与度通过来自社会经济面板研究的不同休闲活动问卷进行测量。医疗信息是从 t0 的医疗报告中提取的。进行了主成分分析，以确定社会参与的不同维度。采用卡方检验和逻辑回归分析，比较了患者与普通人群的社会参与情况，并分析了可能的医疗和诊断相关影响因素的作用。
与普通人群相比，患者在“社会文化参与”和“机构参与”领域的社会参与度较低，而在“私人领域的社会参与”和“通过社交媒体的社会参与”方面则没有显著差异。心理症状、疼痛和乳房切除术史与社会参与受限最密切相关。
我们的研究表明，由于疾病相关症状，社会退缩可能会发生，这可能会阻止一些乳腺癌患者充分参与社会。癌症相关的随访应该解决这个问题，并通过适当的治疗干预来支持患者重新融入社会。
