Social Support and Adjustment in Patients with Sarcoma: The Moderator Effect of the Disease Phase

Abstract

This study examined the association between different types of perceived social support and adjustment of patients with sarcoma, and if these relationships would differ depending on the outcome measure and phase of disease. Forty-nine patients in the diagnostic phase, 43 in the treatment phase, and 59 in the follow-up phase were recruited. Participants completed the Medical Outcomes Study Social Support Survey Questionnaire, the Hospital Anxiety and Depression Scale, and World Health Organization Quality of Life Assessment. Positive social interaction, emotional/informational, affectionate, and tangible supports were significantly associated with depression scores, but not with anxiety. Except for affectionate support, all the associations with overall quality of life were significant. A moderating effect of the phase of the disease was also found in the association between tangible support and anxiety, and between affectionate support, depression, and overall quality of life. In clinical practice it is important to implement phase-specific psychosocial interventions and to take into consideration other factors beyond perceived social support while handling patients with sarcoma.

Health‐related quality of life, psychosocial functioning, and unmet health needs in patients with sarcoma: A systematic review

“…Clinical levels of depression were most prevalent during the treatment phase, followed by the diagnostic, and follow‐up phases . Risk factors for higher depression scores included being female, older, and married, while availability to affectionate, emotional/informational, and tangible support, as well as positive social interaction were associated with lower levels of depression …”

“…A number of factors were associated with an increased risk of poor HRQoL outcomes. Females were reported to have lower global HRQoL scores, as well as lower physical and mental functioning across different sarcoma subtypes and tumour locations . Additionally, lower physical functioning was reported to be associated with receiving amputation, being older, and having a higher body mass index .…”

“…Females were reported to have lower global HRQoL scores, as well as lower physical and mental functioning across different sarcoma subtypes and tumour locations. 34,36,37,48,51 Additionally, lower physical functioning was reported to be associated with receiving amputation, being older, and having a higher body mass index. 34 It is possible that these issues are being undertreated in patients with sarcoma following their treatment.…”

“…Nine of the included studies focused on psychosocial issues in patients with sarcoma. 38,[49][50][51]53,[55][56][57][58] Common psychological concerns reported by patients with sarcoma included anxiety, depression, and changes to identity or role.…”

Sarcoma survivors’ perspectives on their body image and functional quality of life post-resection/limb salvage surgery

“…Schreiber et al (2006) noted that it is these everyday role limitations that impact on survivors' longer term mental health and functional quality of life, andParedes et al (2012) reported that sarcoma survivors are vulnerable to social isolation. Although limb-loathing is somewhat specific to sarcoma patients, within the broader body of cancer literature it has been reported that the negative effects on patients of a cancer diagnosis include a loss of vitality, self-absorption, social withdrawal, psychological maladjustment, poor cognitive adaptation, and elevated levels of depression(Buchanan, Milroy, Baker, Thompson, & Levack, 2010;Cicero, Coco, Gullo, & Lo Verso, 2009;Götte, Kesting, Winter, Rosenbaum, & Boos, 2014;Paredes et al, 2012). For instance, they wrote of their feelings of revulsion upon viewing their disfigured and scarred limb; frustration at their dependency on others; distrust of their limb's ability to support their weight; embarrassment when strangers stared at their wound; and sadness over their progressive loss of contact with friends and work/ school mates.…”