Women with the strongest social relationships were most likely to report better physical and emotional well-being and overall quality of life (QOL) during breast cancer treatment compared with such patients who had little or no social support.
The Kaiser Permanente study yielding these findings included 3,139 female members of Kaiser Permanente Northern California, headquartered in Oakland, California. The women, participants in Kaiser Permanente’s Pathways Study of breast cancer survivorship, had received a diagnosis of breast cancer between 2006 and 2011. They provided information on the following:
- 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, such as help with household tasks and errands; emotional/informational support; affection; and positive social interaction, defined as the availability of other persons with whom to have fun)
- QOL (measured approximately 2 months postdiagnosis by means of the Functional Assessment of Cancer Therapy–Breast, or FACT-B, self-report instrument).
A team led by Kaiser Permanente staff scientist Candyce H. Kroenke, ScD, MPH, evaluated associations between social network size, social support, and lower vs higher than median QOL scores. Multivariate-adjusted analyses revealed that compared with socially integrated women, women who were characterized as socially isolated had significantly lower FACT-B and significantly lower physical, functional, social, and emotional well-being scores as well as greater breast cancer symptoms.
The strongest mediator and type of social support that was most predictive of QOL outcomes was that of positive social interaction, which was significantly related to every QOL measure. Women who had people in their lives with whom to have fun and relax were better able than other patients to deal with pain and other physical symptoms. Women who indicated having little or no positive interaction were three times more likely to report a low QOL and greater physical symptoms.
Each type of support, however, was important, depending on patient outcome, stage, and treatment status. For example, tangible support was the most useful to women with late-stage cancer: Those with low levels of tangible support were 2.74 times more likely to report that their QOL was worse than average.
“Larger social networks and greater social support were related to higher QOL after a diagnosis of breast cancer,” concluded Kroenke and fellow investigators in Breast Cancer Research and Treatment. “Effective social support interventions need to evolve beyond social-emotional interventions and need to account for disease severity and treatment status.”