The relationship of two dimensions of social support to the psychological well-being and social functioning of women with advanced breast cancer

Cancer stereotypes: a multidimensional scaling analysis

The body of empirical research investigating the structure of stereotypes held by the physically healthy population toward individuals with medically related problems is remarkably small. This is particularly true for stereotypes related to cancer. This study adopted a multidimensional scaling (MDS) strategy in order to identify medically related stereotype dimensions for cancer and other illnesses. Sixty-eight subjects judged the similarity of cancer and eleven other medical conditions and rated each on 7-point attribute scales. A two-dimensional solution of respondents' similarity judgments was found and four distinct clusters of related conditions were perceived: (1) cancer and other illnesses with controllable risk factors, (2) conditions affecting motor function, (3) psychological/functional disorders and (4) communication/sensory functional disorders. Regression of mean attribute ratings onto the MDS disability coordinates labeled the two dimensions Normality and Physical Health. Implications of these dimensions for planning effective programs to change stereotypes and improve attitudes toward individuals with cancer and other medical conditions are discussed.

Factors associated with the psychological well-being of adults with acute leukemia in remission

The relationships among coping responses, social support, personality factors, and psychological well-being in adults with acute leukemia in remission were studied. The psychological well-being measure was related to quality of life. Forty persons (21 male, 19 female), average age 47 years and average time since diagnosis of 24 months, completed demographic questions, the PRF-E, the Symptom Distress Scale, a Coping Responses inventory, the modified Social Support Questionnaire, and the General Behavior Inventory. An R of .80 was obtained between psychological well-being and Endurance, Affiliation, Cognitive Structure, Autonomy, and Nurturance. Findings were related to fighting spirit and confronting coping style, concepts associated with psychological well-being and longevity in cancer patients.

Social support and HIV

This paper reviews research about the relationship between social support and health for people with HIV. Current studies linking social support and HIV are described and the major findings summarized in order to identify gaps in the literature. It is argued that, to date, research in this area has focused primarily upon gay white men in the USA at a symptomatic stage of the illness. There are few studies which have considered the impact of social position on the relationship between social support and health, and few which have included HIV-negative controls. Whilst there is evidence of a link between social support and the psychological well-being of people with HIV, research is still in its infancy. Much information is required about which particular aspects of social support and health are associated, how this association changes over time according to the stage of the disease, and with the socio-economic and cultural characteristics of those with HIV.

Social relations, social support and survival among patients with cancer

This study examined the relationship between social relationships and social support and survival following a first diagnosis of breast, colorectal, or lung cancer. Findings showed different factors related to survival for those with breast vs lung or colorectal cancer and for those with localized vs non-localized cancers. Results provide important evidence that social relations and social support may operate differently depending on cancer site and extent of disease.

Psychosocial adjustment in women with breast cancer

There is a plethora of studies investigating psychosocial adjustment in women with breast cancer, its correlates, clinical course, and prognosis. These studies have been conducted with varying degrees of methodologic rigor. An assessment has been made of the quality of this existing evidence to identify from the best evidence the factors which predict the adjustment status of women with breast cancer. Studies have been reviewed, using methodologic standards for the critical appraisal of studies on prognosis, developed by Sackett and colleagues in the Department of Clinical Epidemiology and Biostatistics at McMaster University (Hamilton, Ontario, Canada). Few of the studies investigating psychosocial adjustment of women with breast cancer meet all of the criteria for reviewing studies of clinical course and prognosis. This review focuses the direction and methodologic rigor required in future investigations. In particular, studies are needed that employ prospective designs and that deliberately measure or control for the extraneous prognostic variables that may affect adjustment. Future investigations need to incorporate adequate precision in measurement so that measures of the psychosocial variables are objective, reliable, and valid.

Racial differences in social support and mental health in men with HIV infection: a pilot study

The mediating role of social support in the mental health and behaviours of persons coping with life-threatening chronic illness is of potentially great importance in determining the quality of life of persons with HIV infection (PWHs). As part of a biracial pilot study of the ways black and white men manage the stresses of sexually acquired HIV infection, we have examined the relationship between social support and mental health and behaviours. Forty homosexual/bisexual men (20 white and 20 black) attending a Detroit hospital-based HIV outpatient clinic were recruited for the study and underwent physical and mental health (HSCL-59 and NIMH DIS interview), behavioural and psychosocial evaluations, and a neuropsychologic screening test battery. The black and white men did not differ in terms of age, education, sexual behaviours, physical or mental health status. However, the black men were less likely to be open about their sexuality to their primary social support network, and to report that their social support was less affirmative than did the white men. When correlations between the six-dimensional social support measures (Wortman & O'Brien, 1987) and HSC-L distress scores were examined, both availability of material social support and affirmation were correlated negatively with distress among the white men but positively among the black men. Similarly, the previously observed positive relationship between perceived adequacy of social support and adoption of safer sexual practices was observed among white but not black participants.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of social relationships on survival for women with breast cancer: a prospective study

In this study we examine the relationship between a woman's social contexts at the time of diagnosis and her chances of having survived breast cancer four years later. A cohort of 133 women were followed prospectively after initial diagnosis and treatment and data were obtained from a questionnaire mailed soon after diagnosis and from hospital charts. Using multivariate methods to examine predictors of survival, two clinical factors, pathologic nodal status and clinical stage of disease, were significantly associated with survival. In addition we found significant and independent effects on survival of: number of supportive friends, number of supportive persons, whether the woman worked, whether she was unmarried, the extent of contact with friends and the size of her social network. Thus, the woman's social context, particularly contexts of friendship and work outside the home, are statistically important for survival. Using existing literature, further data analyses and interviews with some survivors, we speculate on the ways in which social contexts may influence survival and suggest research methods suitable to this question.

Social support for women during chronic illness: the relationship among sources and types to adjustment

The purpose of this study was to explore who in the network provided what type of support in relation to psychosocial adjustment for women experiencing chronic illness. The Norbeck Social Support Questionnaire was administered to 125 chronically ill women, along with measures of depression (CES-D), family illness demands (Demands of Illness Inventory), marital quality (Spanier Dyadic Adjustment Scale), and family functioning (FACES-II). Repeated-measures ANOVA was used to examine the average amount of support from four main sources: partner, family, friends, and others. Women perceived more support from the partner than from any other source. Family members provided more affective support than friends or others. Friends provided more affirmation than family or others. After the partner, women reported confiding about their illness more to health care providers, counselors, or religious personnel than family or friends. Pearson correlation coefficients were computed for the amount of support from each source and the measures of individual, dyadic, or family adjustment. In general, affect, affirmation, and reciprocity from both the partner and family were associated with less depression, higher marital quality, and better family functioning.

Self-concept and cancer in adults: theoretical and methodological issues

Research and theory development on the self-concept have increased dramatically over the last decade. Investigators of the psychosocial aspects of cancer have utilized the self-concept as both an independent and dependent variable. This article discusses quantitative adult studies from the self-concept and cancer literature in terms of their correspondence with current conceptualizations of the self-concept in psychology. The wide gap between recent empirical work and self-concept theorizing is discussed and strategies for future investigations of the self-concept/cancer relationship are outlined.

The relationship of social support and health

The objective of this research note is to challenge the research community to develop a cumulative body of knowledge on the relationship between social support and health. Fruitful approaches to this end include further explication of the concept of social support and its measurement, studies of the causal pathways between social supports and health, and further understandings of the relationship between the different dimensions of support and mental and physical health.

The social experiences of cancer patients under treatment: a comparative study

As part of a larger study on the quality of life of cancer patients under treatment, the positive and negative experiences in social interaction have been examined as compared to those of a control group (nonpatients, n = 201). Two patient groups were included: 109 patients who had recently undergone surgery and 108 patients receiving chemotherapy. The respondents returned a mailed questionnaire. Contrary to the assumptions based on a review from the literature, cancer patients appear to have more positive and fewer negative social experiences than a random sample from the 'normal' population. Even under more severe medical circumstances (a poor prognosis or heavy chemotherapy, a large number of chemotherapy cycles, poor progress after surgery) the poorer the patients, medically speaking, the more help and support they perceive. The results of this study do not support the idea of stigmatization. The personality characteristics, neuroticism and self-esteem are especially important for the having of positive and negative experiences in social interaction. Positive social experiences show a relationship with self-esteem and negative social experiences show a relationship with neuroticism.

Social support and recovery after surgery for breast cancer: frequency and correlates of supportive behaviours by family, friends and surgeon

In a longitudinal study of recovery after surgery for breast cancer, subjects reported the frequency of, and their satisfaction with, various supportive behaviours on the part of family members, close friends and medical professionals. The reliability of the Multi-Dimensional Support Scale (MDSS) devised for this purpose is described. Measures of psychological, social and physical adjustment approached normality by 3 months post-operation. Frequency of support from all sources decreased as time from surgery passed, whilst satisfaction with support varied with the type of support given and the source from which it was received. Quite different patterns emerged in support needs from professional and non-professional sources, with empathic support being required from all sources, whilst informational support was desired from surgeons, rather than from family and friends. Further, subjects were more discriminating in the amounts of support required from family and friends, such that it was more likely for these sources to give unwanted support than it was for professional sources, from whom many subjects reported inadequate support. Satisfaction with social support was matched with measures of adjustment, and it was found that those satisfied with support from family members were significantly less anxious and depressed in hospital than were those who were not satisfied with support from this source. However, at 1 month post-operation, anxiety and depression levels were significantly related to satisfaction with support from surgeons; and at 3 months post-operation, anxiety and depression measures were significantly related to satisfaction with support from both family members and surgeons.(ABSTRACT TRUNCATED AT 250 WORDS)

Longitudinal analysis of psychological adaptation among family members of patients with cancer

A growing body of research suggests that a cancer diagnosis reverberates throughout the family system. The majority of studies provide evidence of the psychological distress experienced by family members at the time of diagnosis and during terminal and early bereavement stages. Increasingly, however, patients survive a cancer diagnosis. Therefore, their experience and that of family members more closely approximates living with a chronic illness. In this longitudinal study of 143 pairs of patients and significant others it was found that a substantial minority of significant others experienced psychological distress up to one year after the patient's initial diagnosis. The psychologically vulnerable group of significant others included an initially poor functioning group who remained so over time as well as a group whose mental health status declined over time. Personal and social resources were more important factors in declining mental health than illness-related factors.