年轻成年癌症幸存者的社会孤立、抑郁和焦虑:社会联系的中介作用。
Social isolation, depression, and anxiety among young adult cancer survivors: The mediating role of social connectedness.
发表日期:2024 Aug 04
作者:
Xiaoyin Li, Cassandra A Hathaway, Brent J Small, Danielle B Tometich, Lisa M Gudenkauf, Aasha I Hoogland, Rina S Fox, David E Victorson, John M Salsman, Brian D Gonzalez, Heather S L Jim, Erin M Siegel, Shelley S Tworoger, Laura B Oswald
来源:
CANCER
摘要:
社会孤立和社会联系是健康的决定因素和社会福祉的方面,与心理困扰密切相关。本研究评估了 18-39 岁年轻成人 (YA) 癌症幸存者一年多的时间里社会孤立、社会联系和心理困扰(即抑郁、焦虑)之间的关系。 参与者是一项大型队列研究中的 YA,该研究每年完成一次调查问卷2个月1年。使用患者报告结果测量信息系统简短测量来评估社会孤立、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。混合效应模型用于评估随时间的变化。使用验证性因素分析和多级结构方程模型将社会关联性定义为潜在结构,并确定社会孤立与心理困扰之间的关系是否由社会关联性介导。参与者 (N = 304) 的平均年龄 (M) = 33.5 岁 ( SD = 4.7) 和 M = 4.5 年 (SD = 3.5) 初始癌症诊断后。大多数参与者是女性(67.4%)和非西班牙裔白人(68.4%)。社会幸福感和心理困扰的平均得分在正常范围内并且没有变化(p 值>.05)。然而,很大一部分参与者在每个时间点都报告至少有轻度的社交孤立(27%-30%)、抑郁症状(36%-37%)和焦虑症状(49%-51%)。在参与者中,更多的社会孤立与更少的社会联系(p值<.001)、更多的抑郁症状(p<.001)和更多的焦虑症状(p<.001)相关。社会联系可以调节社会孤立和抑郁之间的关系 (p = .004),但不能调节焦虑 (p > .05)。社会孤立和联系可以成为减少 YA 癌症幸存者抑郁的干预目标。© 2024 美国癌症协会。
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.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.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).Social isolation and connectedness could be intervention targets for reducing depression among YA cancer survivors.© 2024 American Cancer Society.