Social support, fear of cancer recurrence and sleep quality in breast cancer: A moderated network analysis

Abstract

Purpose

Fear of cancer recurrence (FCR) contributes to sleep problems and social support is a buffering factor in the literature. However, the moderating effect of social support between FCR and sleep quality is unclear.

Methods

The moderating role of social support was examined in a cohort of 460 breast cancer patients from the 2024 Be Resilient to Breast Cancer (BRBC) program from a microscopic perspective using moderated network analysis, and then assessed macroscopically by Johnson-Neyman and response surface analysis. The Fear of Progression Questionnaire-Short Form, Perceived Social Support Scale and Pittsburgh Sleep Quality Index scale were employed in this study.

Results

Social support significantly moderated the relationship between general anxiety and sleep efficiency. General anxiety was positively correlated with sleep efficiency at high levels of social support (t = 3.774, P < 0.001). Patients with high social support and low FCR experienced better sleep (F = 6.166, P < 0.01).

Conclusion

Our study deepens the understanding of the association between FCR, social support, and sleep quality, and emphasizes social support as a positive strategy for cancer patients to improve their physical and mental health.