Social isolation, depression, and anxiety among young adult cancer survivors: The mediating role of social connectedness

IF 5.1 2区医学 Q1 ONCOLOGY Cancer Pub Date : 2024-08-04 DOI:10.1002/cncr.35508

Xiaoyin Li PhD, Cassandra A. Hathaway PhD, MPH, Brent J. Small PhD, Danielle B. Tometich PhD, Lisa M. Gudenkauf PhD, MPH, Aasha I. Hoogland PhD, Rina S. Fox PhD, MPH, David E. Victorson PhD, John M. Salsman PhD, Brian D. Gonzalez PhD, Heather S. L. Jim PhD, Erin M. Siegel PhD, MPH, Shelley S. Tworoger PhD, Laura B. Oswald PhD

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Abstract

Background

Social isolation and social connectedness are health determinants and aspects of social well-being with strong associations with psychological distress. This study evaluated relationships among social isolation, social connectedness, and psychological distress (i.e., depression, anxiety) over 1 year in young adult (YA) cancer survivors 18–39 years old.

Methods

Participants were YAs in a large cohort study that completed questionnaires every 2 months for 1 year. Social isolation, aspects of social connectedness (i.e., companionship, emotional support, instrumental support, and informational support), depression, and anxiety were assessed with Patient-Reported Outcomes Measurement Information System short form measures. Mixed-effect models were used to evaluate changes over time. Confirmatory factor analysis and multilevel structural equation modeling were used to define social connectedness as a latent construct and determine whether relationships between social isolation and psychological distress were mediated by social connectedness.

Results

Participants (N = 304) were mean (M) = 33.5 years old (SD = 4.7) and M = 4.5 years (SD = 3.5) post-initial cancer diagnosis. Most participants were female (67.4%) and non-Hispanic White (68.4%). Average scores for social well-being and psychological distress were within normative ranges and did not change (p values >.05). However, large proportions of participants reported at least mild social isolation (27%–30%), depressive symptoms (36%–37%), and symptoms of anxiety (49%–51%) at each time point. Across participants, more social isolation was related to less social connectedness (p values <.001), more depressive symptoms (p < .001), and more symptoms of anxiety (p < .001). Social connectedness mediated the relationship between social isolation and depression (p = .004), but not anxiety (p > .05).

Conclusions

Social isolation and connectedness could be intervention targets for reducing depression among YA cancer survivors.

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年轻的成年癌症幸存者的社会隔离、抑郁和焦虑：社会联系的中介作用

背景：社会隔离和社会连通性是健康的决定因素，也是与心理困扰密切相关的社会福祉的两个方面。本研究评估了 18-39 岁青年癌症幸存者一年内的社会隔离、社会联系和心理困扰（即抑郁、焦虑）之间的关系：方法：参与者是一项大型队列研究中的青年癌症幸存者，他们每两个月填写一次问卷，为期一年。社会隔离、社会联系的各个方面（即陪伴、情感支持、工具支持和信息支持）、抑郁和焦虑通过患者报告结果测量信息系统简表进行评估。采用混合效应模型评估随时间的变化。确认性因素分析和多层次结构方程模型用于将社会联系定义为一种潜在的结构，并确定社会隔离和心理困扰之间的关系是否由社会联系中介：参与者（N = 304）的平均年龄（M）= 33.5 岁（SD = 4.7），首次癌症诊断后的平均年龄（M）= 4.5 年（SD = 3.5）。大多数参与者为女性（67.4%）和非西班牙裔白人（68.4%）。社会幸福感和心理压力的平均得分在正常范围内，没有变化（P 值大于 0.05）。然而，大部分参与者在每个时间点都报告了至少轻微的社会隔离（27%-30%）、抑郁症状（36%-37%）和焦虑症状（49%-51%）。在所有参与者中，社会隔离度越高，社会联系越少（P 值为 0.05）：结论：社会隔离和社会联系可能是减少亚裔癌症幸存者抑郁症的干预目标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer 医学-肿瘤学

CiteScore

13.10

自引率

3.20%

发文量

480

审稿时长

2-3 weeks

期刊介绍： The CANCER site is a full-text, electronic implementation of CANCER, an Interdisciplinary International Journal of the American Cancer Society, and CANCER CYTOPATHOLOGY, a Journal of the American Cancer Society. CANCER publishes interdisciplinary oncologic information according to, but not limited to, the following disease sites and disciplines: blood/bone marrow; breast disease; endocrine disorders; epidemiology; gastrointestinal tract; genitourinary disease; gynecologic oncology; head and neck disease; hepatobiliary tract; integrated medicine; lung disease; medical oncology; neuro-oncology; pathology radiation oncology; translational research