青年癌症幸存者的社会隔离、抑郁和焦虑：社会联系的中介作用。
Social isolation, depression, and anxiety among young adult cancer survivors: The mediating role of social connectedness.
机构信息
Moffitt Cancer Center, Tampa, Florida, USA.
University of North Carolina Chapel Hill School of Nursing, Chapel Hill, North Carolina, USA.
出版信息
Cancer. 2024 Dec 1;130(23):4127-4137. doi: 10.1002/cncr.35508. Epub 2024 Aug 4.
BACKGROUND
Social isolation and social connectedness are health determinants and aspects of social well-being with strong associations with psychological distress. This study evaluated relationships among social isolation, social connectedness, and psychological distress (i.e., depression, anxiety) over 1 year in young adult (YA) cancer survivors 18-39 years old.
METHODS
Participants were YAs in a large cohort study that completed questionnaires every 2 months for 1 year. Social isolation, aspects of social connectedness (i.e., companionship, emotional support, instrumental support, and informational support), depression, and anxiety were assessed with Patient-Reported Outcomes Measurement Information System short form measures. Mixed-effect models were used to evaluate changes over time. Confirmatory factor analysis and multilevel structural equation modeling were used to define social connectedness as a latent construct and determine whether relationships between social isolation and psychological distress were mediated by social connectedness.
RESULTS
Participants (N = 304) were mean (M) = 33.5 years old (SD = 4.7) and M = 4.5 years (SD = 3.5) post-initial cancer diagnosis. Most participants were female (67.4%) and non-Hispanic White (68.4%). Average scores for social well-being and psychological distress were within normative ranges and did not change (p values >.05). However, large proportions of participants reported at least mild social isolation (27%-30%), depressive symptoms (36%-37%), and symptoms of anxiety (49%-51%) at each time point. Across participants, more social isolation was related to less social connectedness (p values <.001), more depressive symptoms (p < .001), and more symptoms of anxiety (p < .001). Social connectedness mediated the relationship between social isolation and depression (p = .004), but not anxiety (p > .05).
CONCLUSIONS
Social isolation and connectedness could be intervention targets for reducing depression among YA cancer survivors.
背景
社会隔离和社会联系是健康决定因素和社会幸福感的方面，与心理困扰有很强的关联。本研究评估了 18-39 岁年轻癌症幸存者中社会隔离、社会联系和心理困扰（即抑郁、焦虑）在 1 年内的关系。
方法
参与者是参加一项大型队列研究的年轻人，该研究每两个月完成一次问卷调查，为期 1 年。使用患者报告的结果测量信息系统短式量表评估社会隔离、社会联系的各个方面（即陪伴、情感支持、工具支持和信息支持）、抑郁和焦虑。采用混合效应模型评估随时间的变化。验证性因子分析和多层次结构方程模型用于将社会联系定义为潜在结构，并确定社会隔离与心理困扰之间的关系是否通过社会联系中介。
结果
参与者（N=304）的平均年龄（M）为 33.5 岁（SD=4.7），癌症初始诊断后平均（M）为 4.5 年（SD=3.5）。大多数参与者为女性（67.4%）和非西班牙裔白人（68.4%）。社会幸福感和心理困扰的平均得分在正常范围内，没有变化（p 值>.05）。然而，在每个时间点，都有很大比例的参与者报告至少有轻度的社会隔离（27%-30%）、抑郁症状（36%-37%）和焦虑症状（49%-51%）。在所有参与者中，更多的社会隔离与更少的社会联系相关（p 值<.001），更多的抑郁症状（p<.001）和更多的焦虑症状（p<.001）。社会联系中介了社会隔离与抑郁之间的关系（p=.004），但与焦虑无关（p>.05）。
结论
社会隔离和联系可能是减少年轻癌症幸存者抑郁的干预目标。
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