title: Social support and quality of life among Chinese breast cancer survivors: findings from a mixed methods study.
abstract: BACKGROUND
  Social support has been identified as a significant factor positively influencing quality of life (QOL) in breast cancer survivors. However, less is known about whether and how social support remains important among cancer survivors over the course of the survivorship trajectory.
  
  
  OBJECTIVE
  To explore social support and its relationship with QOL in breast cancer survivors in China.
  
  
  METHODS
  This was a sequential mixed methods study. In Phase I, 100 breast cancer survivors were surveyed using standardized questionnaires. A multivariate regression analysis was performed to examine the relationship between social support and QOL after controlling for annual household income and length of survivorship. In Phase II, individual in-depth interviews were conducted to understand social support experience from 29 survivors selected from Phase I. Interview data were transcribed and analyzed using qualitative content analysis.
  
  
  RESULTS
  Survivors reported a median support network size of 2.2 persons (interquartile range = 1.2-3.8) and a median support satisfaction score of 5.5 (interquartile range = 5-6). While support satisfaction was found to be associated with QOL, no association was found between support network size and QOL. Interview findings revealed that close family members and peer survivors constituted the major source of breast cancer survivors' support, especially in emotional and informational support aspects. Cultural factors played a role in the perception and utilization of support of the breast cancer survivors.
  
  
  CONCLUSIONS
  This study has indicated that support satisfaction is more critical than support network size in influencing various aspects of survivors' QOL through the underlying different types of situation-specific support.
authors.affiliation: The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China. Electronic address: newbornee@gmail.com.
authors.forename: Huilin
authors.initials: H
authors.lastname: Cheng
authors.forename: Janet W H
authors.initials: JW
authors.lastname: Sit
authors.forename: Carmen W H
authors.initials: CW
authors.lastname: Chan
authors.forename: Winnie K W
authors.initials: WK
authors.lastname: So
authors.forename: Kai Chow
authors.initials: KC
authors.lastname: Choi
authors.forename: Karis K F
authors.initials: KK
authors.lastname: Cheng
mesh_terms: D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D002681:China; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D015999:Multivariate Analysis; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D018570:Risk Assessment; D018434:Sickness Impact Profile; D012944:Social Support; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data
keywords: Breast cancer; Cancer survivorship; Mixed methods study; Quality of life; Social support