Support-seeking, perceived support, and anxiety in mothers and fathers after children's cancer treatment

The objective was to examine the relationships between anxiety, the seeking of social support as a coping strategy, and perceived social support among mothers (n=103) and fathers (n=81) of children with successfully completed treatment for cancer. Assessments were done using self-report instruments. The mediating effect of perceived support on the relationship between social support-seeking and anxiety was evaluated through path analysis, and comparisons were done in order to evaluate effects of gender. For mothers and fathers alike, a positive relationship of moderate strength between support-seeking and perceived support was found. Anxiety was negatively related to support-seeking (mothers r=-0.22, p=0.025; fathers r=-0.21, p=0.063) as well as perceived support (mothers r=-0.55, p<0.001; fathers r=-0.41, p<0.001), although the relationship for support-seeking was weak. The path analysis showed that perceived support only to a minor extent could strengthen this association. The significance of support-seeking and perceived support was stronger for mothers than for fathers, as regards their association with anxiety. However, the patterns of interrelations were similar for mothers and fathers. In conclusion, parents' subjectively perceived support appears to be more important for anxiety regulation than their support-seeking coping. In clinical practice, individual variation should be acknowledged, and presumptions of general gender differences avoided.     

The role of attachment dimensions and perceived social support in predicting adjustment to cancer

Objective: Several studies carried out over the last years show that patients' adjustment is very important to the past experiences of people with cancer. In our study of 96 subjects with cancer, we examined whether patient's working model of attachment anxiety/avoidance and perceptions of social support predicts adjustment to cancer. Methods: All participants filled in a demographic questionnaire, the Relationship Scale Questionnaire (RSQ), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Mental Adjustment to Cancer (MAC). Results: Anxious attachment predicted psychological adjustment: patients with high levels of anxious attachment showed high levels of helplessness/hopelessness and anxious preoccupation (p<0.01, and p<0.05, respectively). With regard to the function of perceived social support, the patient's perception of social support from friends was predictive of both fighting spirit and stoic acceptance (p=0.01, and p<0.001, respectively). Conversely, the patient's perception of support from family members was not predictive of adjustment to cancer. Patients in the advanced stages of the illness showed higher levels of helplessness/hopelessness (p<0.05). Conclusions: Anxious attachment and perceived social support predicted different domains of psychological adjustment to cancer. Perceived support from friends may predict the patient's tendency to consider cancer as a challenge and to take an active role in therapy and recovery, whereas social support from family was not predictive of various states of adjustment to cancer. Copyright © 2009 John Wiley & Sons, Ltd.     

Coping with parental cancer: web‐based peer support in children

Objective: To investigate the use and content of web‐based peer support in children coping with parental cancer. Methods: In children aged above 12 years, 158 forum discussions on the Dutch website www.kankerspoken.nl in a time‐period of 3 months were investigated. Age, gender, number of discussions, participation and main activities on the website were quantitatively assessed. Contents of the discussions were qualitatively analyzed. Results: In total, 129 children and 8 adults participated on the website with an average age of 15.3 years. The majority was female (80%). On average, a child was on‐line for 3 days and participated in 4 to 5 forum discussions. Main activities on the website were sharing personal experience, providing encouragement/support, providing and seeking information or advice and seeking contact outside of the website. Qualitative content analysis revealed that children regularly faced emotional problems and experienced a lack of understanding and communication in their direct environment. Conclusions: In dealing with parental cancer, children experience a variety of difficulties. This study offers a window into the use of web‐based peer support by children dealing with parental cancer. Copyright © 2009 John Wiley & Sons, Ltd.     

The association between individual attachment patterns,the perceived social support,and the psychological well‐being of Turkish informal caregivers

Background: This study aimed to investigate the relations among the psychological well‐being (i.e. depression and state/trait anxiety levels), attachment patterns (i.e. secure, ambivalent, avoidant), and the perceived social support from family/friends/significant others of caregivers of cancer patients in Turkey. Methods: Fifty‐one caregivers of adult cancer patients were recruited from the oncology outpatient clinic of the Marmara Medical School Hospital in Istanbul. Caregivers were assessed with the Adult Attachment Scale, the Beck Depression Inventory, State–trait Anxiety Inventories, and the Multidimensional Scale of Perceived Social Support. Results: Stepwise multiple regression analysis indicated that depression was predicted by ambivalent attachment and the perceived social support from family. The support from significant others was the significant predictor of trait anxiety and the caregivers' ambivalent attachment score was the significant predictor of state anxiety. Conclusions: We assert that ambivalent attachment pattern could confer a vulnerability to psychological distress in cancer caregivers. Assessing the psychological experiences and needs of caregivers and being aware of possible risk factors (such as attachment patterns) and protective factors (social support network) for depression and anxiety might be helpful for successful programmes and interventions that support the caregivers of cancer patients. Copyright © 2009 John Wiley & Sons, Ltd.     

Social support and survival in young women with breast carcinoma

Purpose: Although previous evidence has shown increased likelihood for survival in cancer patients who have social support, little is known about changes in social support during illness and their impact on survival. This study examines the relationship between social support and survival among women diagnosed with breast carcinoma, specifically assessing the effect of network size and changes in social contact post‐diagnosis. Methods: A population‐based sample of 584 women was followed for up to 12.5 years (median follow‐up = 10.3 years). The mean age at diagnosis was 44 years, 81% were married, and 29% were racial/ethnic minorities. Cox regression analysis was used to estimate survival as a function of social support (changes in social contact and the size of social support), disease severity, treatment, health status, and socio‐demographic factors. Results: Fifty‐four percent of the women had local and 44% had regional stage disease. About 53% underwent mastectomy, 68% received chemotherapy, and 55% had radiation. Regression results showed that disease stage, estrogen receptor status, and mastectomy were associated with greater risk of dying. Although network size was not related to survival, increased contact with friends/family post‐diagnosis was associated with lower risk of death, with a hazard ratio of 0.31 (95% CI, 0.17–0.57). Conclusion: Findings from this study have identified an important aspect of a woman's social network that impacts survival. An increase in the amount of social contact, representing greater social support, may increase the likelihood of the women's survival by enhancing their coping skills, providing emotional support, and expanding opportunities for information‐sharing. Copyright © 2010 John Wiley & Sons, Ltd.     

Psychological distress in women at risk for hereditary breast cancer: the role of family communication and perceived social support

Background: Hereditary breast cancer has a profound impact on individual family members and on their mutual communication and interactions. The way at‐risk women cope with the threat of hereditary breast cancer may depend on the quality of family communication about hereditary breast cancer and on the perceived social support from family and friends. Objective: To examine the associations of family communication and social support with long‐term psychological distress in a group of women at risk for hereditary breast cancer, who opted either for regular breast surveillance or prophylactic surgery. Methods: The study cohort consisted of 222 women at risk for hereditary breast cancer, who previously participated in a study on the psychological consequences of either regular breast cancer surveillance or prophylactic surgery. General and breast cancer specific distress, hereditary cancer‐related family communication, perceived social support, and demographics were assessed. Results: Using structural equation modelling, we found that open communication about hereditary cancer within the family was associated with less general and breast cancer specific distress. In addition, perceived support from family and friends was indirectly associated with less general and breast cancer‐specific distress through open communication within the family. Discussion: These findings indicate that family communication and perceived social support from friends and family are of paramount importance in the long‐term adaptation to being at risk for hereditary breast cancer. Attention for these issues needs to be incorporated in the care of women at risk for hereditary breast cancer. Copyright © 2010 John Wiley & Sons, Ltd.     

食管癌放化疗患者自我效能感与领悟社会支持相关性研究

目的 探讨食管癌患者放化疗期间自我效能感与领悟社会支持状况及其相关性。方法 选择2017 年 1~5 月首都 医科大学附属北京康复医院口腔科收治的 216 名食管癌住院患者,应用一般自我效能感量表、领悟社会支持量表和一般资 料调查表进行调查。结果 食管癌患者在放化疗期间自我效能感总体得分为（25.94±5.28）分;其中年龄＞35 岁、月收入 在 5000 元以上、有医保、诊断年限在6~10 年、有治疗史的患者自我效能感水平较高（P ＜ 0.05）。领悟社会支持总分为 （61.67±10.86）分,家庭内支持得分为（23.46±3.91）分,家庭外支持得分为（38.09±8.90）分;其中年龄越大、民族为少 数民族、文化程度越高、居住在城市、职业为医务人员、月收入在 5000 元以上、有医保、确诊年限在 6 年以下的患者领悟 社会支持水平较高（P＜0.05）。患者自我效能感得分与领悟社会支持总分及各维度均呈显著正相关（P＜0.01）。另外, 本研究还发现,完全缓解、部分缓解者的自我效能感、领悟社会支持得分、家庭内支持及家庭外支持得分均显著高于部分稳定、 疾病进展者,差异之间存在统计学意义（P＜0.05）。结论 食管癌患者在放化疗期间自我效能感和领悟社会支持水平较高, 患者感知到的社会支持越高,自我效能感越高。同时,自我效能感和领悟社会支持水平对判断该人群的预后具有重要的临 床意义。     

Depressive symptoms after lung cancer surgery: Their relation to coping style and social support

Lung cancer patients may experience greater emotional distress than patients with other cancers. Studies have shown social support to predict adjustment in other cancers, but findings among lung cancer patients have been equivocal. Coping style has been shown to predict distress among lung cancer patients, but has not been examined in the context of social support. We examined coping style and social support as predictors of depressive symptoms one week after surgery among 119 patients with non-small cell lung cancer. The Beck Depression Inventory was the primary outcome measure. Predictors included age, ECOG performance status, stage of disease, and measures of adaptive coping, less adaptive coping, Directive instrumental social support and Nondirective instrumental social support. Results indicated that 29% of lung cancer patients had scores above a standard cutoff for clinically significant depression. Results also showed that depressive symptoms were directly related to use of less adaptive coping methods and Directive instrumental social support, inversely related to age and use of adaptive coping methods, and unrelated to nondirective social support, stage of disease and performance status. Results extend previous findings by showing that adaptive coping methods are related to severity of distress, and that the benefits of social support may depend on the characteristics of that support.     

Support and training needs of cancer support group leaders: a review

This review focuses on the support and training needs of cancer support group leaders. With an increasing popularity of support groups and growing evidence of the crucial role of group leaders in positive patient outcomes, there is an imperative to identify ways of promoting these outcomes and preventing leader burnout, an issue contributing to the demise of some support groups. Despite this, there is a paucity of research in this area. Available research data clearly illustrates that both professional and peer support group leaders recognise their need for better support, training and information. One study of health professionals identified a need for more advanced skills involved in group processes and specific issues such as dealing with the death of members. Specific leader behaviours, in particular active intervention in group interactions and supportive care, have also been associated with improved patient quality of life. To date, there is no clear evidence as to how best to achieve and support these effective group leader skills. While many cancer societies and other associations provide introductory training and information kits about 'how to start a support group,' no advanced training or support interventions are available. Further research is needed to provide an evidence base for group leader training and to evaluate the impact of such training on both leader and patient outcomes.