Perceived social support change in patients with early stage breast cancer and controls.

Abstract

Objective To identify variables associated with levels of and change in social support in a cohort of early-stage breast cancer patients and age-matched controls. Methods Telephone interviews measuring perceived social support and other demographic and psychosocial variables were conducted at 4–6 weeks and 6, 12, and 24 months after surgery (patients) or a normal/benign screening mammogram (controls). A latent trajectory model was used to model the intercept (starting point) and slope (changing) aspects of social support. Results Participants included 542 controls and 541 patients (77% White, 23% African American; mean age 57.7 [SD = 10.6]). Most participants reported high social support. Patients reported significantly higher levels of social support at baseline than controls. For patients, social support had a significant negative slope that significantly varied between individuals; the intercept of social support also varied significantly. Predictors of lower social support intercept in patients included not being married/partnered, being White, having lower perceived general health, and having higher negative affect (modeled as a latent variable defined by anxiety and depression symptom severity). Patients who were African American (vs. White) or had mastectomy (vs. lumpectomy) had steeper social support declines, and participants with both these characteristics had lower starting points as well as steeper declines. Social support among controls did not change significantly. Conclusions Clinicians might consider psychosocial interventions for patients reporting low social support around the time of diagnosis and surgical treatment, and for patients at risk for steeper declines in support, such as African Americans and women undergoing mastectomy.

Perceived social support in African American breast cancer patients: Predictors and effects

“…On average, participants reported having high levels of social support, comparable to previous results among African American women with breast cancer (Giedzinska et al, 2004; Thompson et al, 2013). The stability of social support over time was unexpected given previous research (Den Oudsten et al, 2010; Courtens et al, 1996; Bloom and Kessler, 1994), and especially because a recent study of early-stage breast cancer patients in this metropolitan area found that African American patients experienced steeper decline in social support over time compared to White women (Thompson et al, 2013).…”

“…This modeling technique allows researchers to differentiate between a construct's systematic change over time (i.e., the slope) and the estimated initial level of a construct (i.e., the intercept) (Curran and Hussong, 2003). Growth curve models can handle data that are not normally distributed (Curran et al, 2010), which was observed previously for MOS-SSS scores (Thompson et al, 2013). Because the trial involved two study arms, differences between a one-group and a two-group model were examined using a series of difference tests as described by Bollen and Curran (2006, p. 171).…”

“…Variables in the models included those reported to be related to social support in the literature, including marital status (Von Ah et al, 2012), depressive symptoms (Patten et al, 2010), religious/spiritual beliefs and practices (Haynes-Maslow et al, 2016; Holland et al, 1998), income (Mickelson and Kubzansky, 2003), general health (Jeffe et al, 2012), age (Schroevers et al, 2010), and treatment-related variables including surgery type (Thompson et al, 2013). …”

“…Findings from prior research on perceived social support in breast cancer patients are mixed. Prior work has suggested that many women report having increased support around the time of cancer diagnosis, but that this support often decreases over time after treatment (Den Oudsten et al, 2010; Courtens et al, 1996; Bloom and Kessler, 1994), a decrease that may be associated with negative psychosocial outcomes (Thompson et al, 2013). Not all studies have found a decline in social support after diagnosis, however.…”

“…Growth curve analyses in early-stage breast cancer patients (Thompson et al, 2013) demonstrated that, compared with White breast cancer patients, African American patients reported higher initial levels of perceived social support a mean six weeks after definitive surgical treatment and showed a steeper decline in social support over 2-year follow-up. Among African American and White women with early- and late-stage breast cancer, higher perceived emotional support at diagnosis was found to be associated with a moderate decrease in all-cause mortality over the ensuing 10 years (Soler-Vila et al, 2003).…”