title: Social support as a moderator between depressive symptoms and quality of life outcomes of breast cancer survivors.
abstract: OBJECTIVE
  To examine the unique relationships among demographic variables, depressive symptoms scoring ≥16 on the Center for Epidemiological Studies-Depression (CES-D), social support and quality of life (QOL) in breast cancer survivors, and whether social support moderated the effects of depressive symptoms on the outcome of QOL. Specifically, this study aimed to probe more deeply into the nature of causal mechanisms of moderation.
  
  
  METHODS
  A model based, descriptive cross-sectional research design was conducted. A total of 150 breast cancer survivors were recruited from two teaching hospitals in Taiwan. All participants completed the CES-D, Interpersonal Support Evaluation List, and the Medical Outcomes Study 36-Item Short Form Health Questionnaire. The moderation models and moderating hypotheses were tested and confirmed by applying structural equations and hierarchical regression analyses.
  
  
  RESULTS
  Approximately 35% of the participants had depressive symptoms. Findings indicated social support as a moderator of effects of depressive symptoms on QOL. Social support significantly moderated depressive symptoms on QOL.
  
  
  CONCLUSIONS
  Testing for moderating effects provides helpful information regarding the role of social support in buffering the relationship between depressive symptoms and QOL. The moderating effects of social support are adequate in the management of nursing care for breast cancer patients, particularly in the early phase of treatment or in cases of newly diagnosed patients who may not know how to manage their health conditions. These findings may aid in the development of social support interventions to enhance social support for breast cancer survivors.
authors.affiliation: Department of Nursing, I-Shou University, No.8, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City 82445, Taiwan, ROC.
authors.forename: Chiung-Yu
authors.initials: CY
authors.lastname: Huang
authors.forename: Mei-Chi
authors.initials: MC
authors.lastname: Hsu
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000451:nursing*; D005260:Female; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D011788:Quality of Life; D018434:Sickness Impact Profile; D012944:Social Support; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013624:Taiwan; D016896:Treatment Outcome
keywords: Breast cancer survivor; Depressive symptoms; Moderation; Nursing; Quality of life; Social support