title: Social networks, social support mechanisms, and quality of life after breast cancer diagnosis.
abstract: We examined mechanisms through which social relationships influence quality of life (QOL) in breast cancer survivors. This study included 3,139 women from the Pathways Study who were diagnosed with breast cancer from 2006 to 2011 and provided data on social networks (the presence of a spouse or intimate partner, religious/social ties, volunteering, and numbers of close friends and relatives), social support (tangible support, emotional/informational support, affection, positive social interaction), and QOL, measured by the FACT-B, approximately 2 months post diagnosis. We used logistic models to evaluate associations between social network size, social support, and lower versus higher than median QOL scores. We further stratified by stage at diagnosis and treatment. In multivariate-adjusted analyses, women who were characterized as socially isolated had significantly lower FACT-B (OR = 2.18, 95 % CI: 1.72-2.77), physical well-being (WB) (OR = 1.61, 95 % CI: 1.27-2.03), functional WB (OR = 2.08, 95 % CI: 1.65-2.63), social WB (OR = 3.46, 95 % CI: 2.73-4.39), and emotional WB (OR = 1.67, 95 % CI: 1.33-2.11) scores and higher breast cancer symptoms (OR = 1.48, 95 % CI: 1.18-1.87) compared with socially integrated women. Each social network member independently predicted higher QOL. Simultaneous adjustment for social networks and social support partially attenuated associations between social networks and QOL. The strongest mediator and type of social support that was most predictive of QOL outcomes was "positive social interaction." However, each type of support was important depending on outcome, stage, and treatment status. Larger social networks and greater social support were related to higher QOL after a diagnosis of breast cancer. Effective social support interventions need to evolve beyond social-emotional interventions and need to account for disease severity and treatment status.
authors: Division of Research, Kaiser Permanente, Oakland, CA 94612, USA. Candyce.h.kroenke@kp.org
authors: Candyce H
authors: CH
authors: Kroenke
authors: Marilyn L
authors: ML
authors: Kwan
authors: Alfred I
authors: AI
authors: Neugut
authors: Isaac J
authors: IJ
authors: Ergas
authors: Jaime D
authors: JD
authors: Wright
authors: Bette J
authors: BJ
authors: Caan
authors: Dawn
authors: D
authors: Hershman
authors: Lawrence H
authors: LH
authors: Kushi
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D060756:Social Networking; D012944:Social Support
references: Psychooncology. 2012 Feb;21(2):125-33
references: 20967848
references: J Clin Oncol. 2005 Dec 20;23(36):9295-303
references: 16361628
references: J Clin Oncol. 1993 Jan;11(1):66-9
references: 8418244
references: Cancer. 2001 Aug 15;92(4):720-9
references: 11550140
references: Arch Surg. 2004 Sep;139(9):954-58; discussion 958-60
references: 15381612
references: J Clin Oncol. 2009 Nov 10;27(32):5312-8
references: 19738113
references: Psychol Rep. 2011 Jun;108(3):923-42
references: 21879639
references: J Adv Nurs. 1991 Jun;16(6):677-88
references: 1869716
references: Soc Work Health Care. 2005;41(1):17-32
references: 16048854
references: Breast Cancer Res Treat. 2012 May;133(1):375-85
references: 22331479
references: Cancer Epidemiol Biomarkers Prev. 2009 May;18(5):1403-9
references: 19366908
references: Eur J Cancer. 1991;27(5):641-6
references: 1828977
references: J Clin Oncol. 2006 Mar 1;24(7):1105-11
references: 16505430
references: Med Sci Sports Exerc. 2001 Nov;33(11):1959-67
references: 11689750
references: N Engl J Med. 2001 Dec 13;345(24):1719-26
references: 11742045
references: Breast Cancer Res Treat. 2013 Jan;137(1):261-71
references: 23143212
references: Int J Cancer. 2008 Nov 1;123(9):2188-94
references: 18711698
references: Crit Rev Oncol Hematol. 2010 Aug;75(2):122-37
references: 19604706
references: Cancer Causes Control. 2008 Dec;19(10):1065-76
references: 18478338
references: Eur J Oncol Nurs. 2013 Aug;17(4):442-8
references: 23238353
references: Soc Sci Med. 1991;33(2):177-83
references: 1887281
references: J Clin Oncol. 1997 Mar;15(3):974-86
references: 9060536
references: Cancer Causes Control. 2008 Dec;19(10):1319-28
references: 18752034
references: J Clin Oncol. 2009 Feb 20;27(6):919-26
references: 19114692
references: J Chronic Dis. 1987;40(5):373-83
references: 3558716
references: Health Psychol. 2000 Mar;19(2):107-14
references: 10762094
references: JAMA. 2005 May 25;293(20):2479-86
references: 15914748
references: Cancer Nurs. 2001 Jun;24(3):212-9
references: 11409065
references: J Gen Intern Med. 1997 Oct;12(10):613-8
references: 9346457
references: Breast J. 2000 Oct;6(5):324-330
references: 11348391
references: J Clin Oncol. 2005 Mar 1;23(7):1370-8
references: 15684320
references: Am J Epidemiol. 1979 Feb;109(2):186-204
references: 425958
references: Int J Cancer. 2007 Jun 15;120(12):2672-7
references: 17278091
references: Cancer Epidemiol Biomarkers Prev. 1994 Apr-May;3(3):253-9
references: 8019376
references: J Behav Med. 2001 Jun;24(3):231-45
references: 11436544
references: BMC Cancer. 2010 Nov 25;10:648
references: 21108799
references: Soc Sci Med. 1991;32(6):705-14
references: 2035047
references: J Psychosom Res. 2002 May;52(5):285-93
references: 12023125
references: Cancer. 2007 Sep 1;110(5):1130-8
references: 17647221
references: Scand J Caring Sci. 2013 Jun;27(2):396-405
references: 22834764
references: Prev Med. 1988 Sep;17(5):634-42
references: 3237661
references: J Cancer Surviv. 2010 Dec;4(4):372-80
references: 20652435