Top

Published in:

01-06-2019 | Original Article

Social correlates of mental health in gastrointestinal cancer patients and their family caregivers: Exploring the role of loneliness

Authors: Ekin Secinti, Kevin L. Rand, Shelley A. Johns, Bert H. O’Neil, Paul R. Helft, Safi Shahda, Shadia I. Jalal, Catherine E. Mosher

Published in: Supportive Care in Cancer | Issue 6/2019

Abstract

Purpose

The present study examined the degree to which loneliness mediated the influence of negative (social constraints) and positive (emotional support) relationship qualities on the global mental health of advanced gastrointestinal (GI) cancer patients and their family caregivers.

Methods

Fifty patient-caregiver dyads completed measures assessing social constraints (e.g., avoidance, criticism) from the other dyad members, emotional support from others, loneliness, and global mental health. Structural equation modeling was used to examine individual models, and Actor-Partner Interdependence Mediation Modeling was used to examine dyadic associations.

Results

Individual path analyses for patients and caregivers demonstrated that emotional support had a significant indirect effect on mental health through loneliness (Bs = 0.32 and 0.30, respectively), but no associations were found between social constraints and mental health. In dyadic analyses, participants’ loneliness and mental health were not significantly related to their partner’s emotional support, loneliness, or mental health (Bs = − 0.18 to 0.18).

Conclusions

Findings suggest that for advanced GI cancer patients and caregivers, emotional support from others alleviates feelings of loneliness, which may lead to better mental health. However, the benefits of emotional support appear to be primarily intrapersonal rather than interpersonal in nature. Additionally, participants endorsed low levels of social constraints, which might explain their lack of relation to loneliness and mental health. Continued examination of interdependence in social processes between cancer patients and caregivers will inform intervention development.

American Cancer Society (2018) Cancer facts and figures 2018. American Cancer Society, Atlanta

Krouse RS (2010) Gastrointestinal cancer. In: Holland J, Breitbart WS, Jacobsen PB, Lederberg M, Loscalzo M, McCorkle R (eds) Psycho-oncology, 2nd edn. Oxford University Press, New York, pp 140–145CrossRef

Zaboraa J, Brintzenhofe-Szoc K, Curbow B, Hooker C, Piantadosi S (2001) The prevalence of psychological distress by cancer site. Psychooncology 10:19–28. https://doi.org/10.1002/1099-1611(200101/02)10:1<19::AID-PON501>3.0.CO;2-6 CrossRef

Haun MW, Sklenarova H, Brechtel A, Herzog W, Hartmann M (2014) Distress in cancer patients and their caregivers and association with the caregivers’ perception of dyadic communication. Oncol Res Treat 37:384–388. https://doi.org/10.1159/000364885 CrossRefPubMed

Shaw J, Harrison J, Young J, Butow P, Sandroussi C, Martin D, Solomon M (2013) Coping with newly diagnosed upper gastrointestinal cancer: A longitudinal qualitative study of family caregivers' role perception and supportive care needs. Support Care Cancer 21:749–756. https://doi.org/10.1007/s00520-012-1575-8 CrossRefPubMed

National Alliance for Caregiving (2016) Cancer caregiving in the U.S. - An intense, episodic, and challenging care experience. National alliance for caregiving. http://www.caregiving.org/wp-content/uploads/2016/06/CancerCaregivingReport_FINAL_June-17-2016.pdf. Accessed 8 April 2018

Kim Y, Carver CS, Rocha-Lima C, Shaffer KM (2013) Depressive symptoms among caregivers of colorectal cancer patients during the first year since diagnosis: A longitudinal investigation. Psychooncology 22:362–367. https://doi.org/10.1002/pon.2100 CrossRefPubMed

Chambers S, Meng X, Youl P, Aitken J, Dunn J, Baade P (2012) A five-year prospective study of quality of life after colorectal cancer. Qual Life Res 21:1551–1564. https://doi.org/10.1007/s11136-011-0067-5 CrossRefPubMed

House JS, Kahn RL (1985) Measures and concepts of social support. In: Cohen S, Syme L (eds) Social support and health. Academic Press, Orlando, pp 83–108

10.

Kayser K, Acquati C, Reese JB, Mark K, Wittmann D, Karam E (2018) A systematic review of dyadic studies examining relationship quality in couples facing colorectal cancer together. Psychooncology 27:13–21. https://doi.org/10.1002/pon.4339 CrossRefPubMed

11.

Revenson TA, DeLongis A (2011) Couples coping with chronic illness. In: Folkman S (ed) The Oxford handbook of stress, health, and coping. Oxford library of psychology. Oxford University Press, New York, pp 101–123

12.

Revenson TA, Kayser K, Bodenmann G (2005) Couples coping with stress: Emerging perspectives on dyadic coping. American Psychological Association, WashingtonCrossRef

13.

Lepore SJ, Revenson TA (2007) Social constraints on disclosure and adjustment to cancer. Soc Personal Psychol Compass 1:313–333. https://doi.org/10.1111/j.1751-9004.2007.00013.x CrossRef

14.

Mosher CE, Lepore SJ, Wu L, Austin J, Valdimarsdottir H, Rowley S, Isola L, Redd WH, Rini C (2012) Social correlates of distress following hematopoietic stem cell transplantation: Exploring the role of loneliness and cognitive processing. J Health Psychol 17:1022–1032. https://doi.org/10.1177/1359105311432490 CrossRefPubMedPubMedCentral

15.

Lepore SJ (2001) A social-cognitive processing model of emotional adjustment to cancer. In: Baum A, Andersen BL (eds) Psychosocial interventions for cancer. American Psychological Association, Washington, pp 99–118CrossRef

16.

Cohee AA, Adams RN, Fife BL, Von Ah DM, Monahan PO, Zoppi KA, Cella D, Champion VL (2017) The relationship between depressive symptoms and social cognitive processing in partners of long-term breast cancer survivors. Oncol Nurs Forum 44:44–51. https://doi.org/10.1188/17.ONF.44-51 CrossRefPubMedPubMedCentral

17.

Manne SL (1999) Intrusive thoughts and psychological distress among cancer patients: The role of spouse avoidance and criticism. J Consult Clin Psychol 67:539–546. https://doi.org/10.1037/0022-006X.67.4.539 CrossRefPubMed

18.

Soylu C, Ozaslan E, Karaca H, Ozkan M (2016) Psychological distress and loneliness in caregiver of advanced oncological inpatients. J Health Psychol 21:1896–1906. https://doi.org/10.1177/1359105314567770 CrossRefPubMed

19.

Deckx L, van den Akker M, Buntinx F (2014) Risk factors for loneliness in patients with cancer: A systematic literature review and meta-analysis. Eur J Oncol Nurs 18:466–477. https://doi.org/10.1016/j.ejon.2014.05.002 CrossRefPubMed

20.

Hawkley LC, Cacioppo JT (2010) Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Ann Behav Med 40:218–227. https://doi.org/10.1007/s12160-010-9210-8 CrossRefPubMed

21.

Sahin ZA, Tan M (2012) Loneliness, depression, and social support of patients with cancer and their caregivers. Clin J Oncol Nurs 16:145–149. https://doi.org/10.1188/12.CJON.145-149 CrossRefPubMed

22.

Kelley HH, Thibaut JW (1978) Interpersonal relations: A theory of interdependence. Wiley Interscience, New York

23.

Lewis MA, McBride CM, Pollak KI, Puleo E, Butterfield RM, Emmons KM (2006) Understanding health behavior change among couples: An interdependence and communal coping approach. Soc Sci Med 62:1369–1380. https://doi.org/10.1016/j.socscimed.2005.08.006 CrossRefPubMed

24.

Hodges LJ, Humphris GM, Macfarlane G (2005) A meta-analytic investigation of the relationship between the psychological distress of cancer patients and their carers. Soc Sci Med 60:1–12. https://doi.org/10.1016/j.socscimed.2004.04.018 CrossRefPubMed

25.

Li Q, Loke AY (2014) A literature review on the mutual impact of the spousal caregiver–cancer patients dyads: ‘Communication’, ‘reciprocal influence’, and ‘caregiver–patient congruence’. Eur J Oncol Nurs 18:58–65. https://doi.org/10.1016/j.ejon.2013.09.003 CrossRefPubMed

26.

Jacobs JM, Shaffer KM, Nipp RD, Fishbein JN, MacDonald J, El-Jawahri A, Pirl WF, Jackson VA, Park ER, Temel JS, Greer JA (2017) Distress is interdependent in patients and caregivers with newly diagnosed incurable cancers. Ann Behav Med 51:519–531. https://doi.org/10.1007/s12160-017-9875-3 CrossRefPubMedPubMedCentral

27.

Manne S, Badr H (2010) Intimacy processes and psychological distress among couples coping with head and neck or lung cancers. Psychooncology 19:941–954. https://doi.org/10.1002/pon.1645 CrossRefPubMedPubMedCentral

28.

Callahan CM, Unverzagt FW, Hui SL, Perkins AJ, Hendrie HC (2002) Six-item screener to identify cognitive impairment among potential subjects for clinical research. Med Care 40:771–781. https://doi.org/10.1097/01.mlr.0000024610.33213.c8 CrossRefPubMed

29.

Dajczman E, Kasymjanova G, Kreisman H, Swinton N, Pepe C, Small D (2008) Should patient-rated performance status affect treatment decisions in advanced lung cancer? J Thorac Oncol 3:1133–1136. https://doi.org/10.1097/JTO.0b013e318186a272 CrossRefPubMed

30.

Mosher CE, Secinti E, Johns SA, O’Neil BH, Helft PR, Shahda S, Jalal SI, Champion VL (2018) Examining the effect of peer helping in a coping skills intervention: A randomized controlled trial for advanced gastrointestinal cancer patients and their family caregivers. Qual Life Res 27:515–528. https://doi.org/10.1007/s11136-017-1620-7 CrossRefPubMed

31.

Roth AJ, Kornblith AB, Batel-Copel L, Peabody E, Scher HI, Holland JC (1998) Rapid screening for psychologic distress in men with prostate carcinoma. Cancer 82:1904–1908. https://doi.org/10.1002/(SICI)1097-0142(19980515)82:10<1904::AID-CNCR13>3.0.CO;2-X CrossRefPubMed

32.

Hays RD, Bjorner JB, Revicki DA, Spritzer KL, Cella D (2009) Development of physical and mental health summary scores from the patient-reported outcomes measurement information system (PROMIS) global items. Qual Life Res 18:873–880. https://doi.org/10.1007/s11136-009-9496-9 CrossRefPubMedPubMedCentral

33.

Jensen RE, Potosky AL, Moinpour CM, Lobo T, Cella D, Hahn EA, Thissen D, Smith AW, Ahn J, Luta G, Reeve BB (2017) United States population-based estimates of patient-reported outcomes measurement information system symptom and functional status reference values for individuals with cancer. J Clin Oncol 35:1913–1920. https://doi.org/10.1200/jco.2016.71.4410 CrossRefPubMedPubMedCentral

34.

Hahn EA, DeWalt DA, Bode RK, Garcia SF, DeVellis RF, Correia H, Cella D (2014) New English and Spanish social health measures will facilitate evaluating health determinants. Health Psychol 33:490–499. https://doi.org/10.1037/hea0000055 CrossRefPubMedPubMedCentral

35.

Lepore SJ, Silver RC, Wortman CB, Wayment HA (1996) Social constraints, intrusive thoughts, and depressive symptoms among bereaved mothers. J Pers Soc Psychol 70:271–282. https://doi.org/10.1037/0022-3514.70.2.271 CrossRefPubMed

36.

Kline RB (2015) Principles and practice of structural equation modeling 4th edn. Guilford Press, New York

37.

Thoemmes F, MacKinnon DP, Reiser MR (2010) Power analysis for complex mediational designs using Monte-Carlo methods. Struct Equ Model 17:510–534. https://doi.org/10.1080/10705511.2010.489379 CrossRef

38.

Ledermann T, Macho S, Kenny DA (2011) Assessing mediation in dyadic data using the actor-partner interdependence model. Struct Equ Model 18:595–612. https://doi.org/10.1080/10705511.2011.607099 CrossRef

39.

Götze H, Friedrich M, Brähler E, Romer G, Mehnert A, Ernst J (2017) Psychological distress of cancer patients with children under 18 years and their partners-a longitudinal study of family relationships using dyadic data analysis. Support Care Cancer 25:255–264. https://doi.org/10.1007/s00520-016-3411-z CrossRefPubMed

40.

Harrison J, Maguire P, Pitceathly C (1995) Confiding in crisis: Gender differences in pattern of confiding among cancer patients. Soc Sci Med 41:1255–1260. https://doi.org/10.1016/0277-9536(94)00411-L CrossRefPubMed

41.

Bodenmann G, Meuwly N, Kayser K (2011) Two conceptualizations of dyadic coping and their potential for predicting relationship quality and individual well-being: A comparison. Eur Psychol 16:255–266. https://doi.org/10.1027/1016-9040/a000068 CrossRef

42.

Rook KS (1987) Social support versus companionship: Effects on life stress, loneliness, and evaluations by others. J Pers Soc Psychol 52:1132–1147. https://doi.org/10.1037/0022-3514.52.6.1132 CrossRefPubMed

43.

Määttä K, Uusiautti S (2013) Silence is not golden: Review of studies of couple interaction. Commun Stud 64:33–48. https://doi.org/10.1080/10510974.2012.731467 CrossRef

44.

Badr H, Krebs P (2013) A systematic review and meta-analysis of psychosocial interventions for couples coping with cancer. Psychooncology 22:1688–1704. https://doi.org/10.1002/pon.3200 CrossRefPubMed

45.

Masi CM, Chen H-Y, Hawkley LC, Cacioppo JT (2010) A meta-analysis of interventions to reduce loneliness. Personal Soc Psychol Rev 15:219–266. https://doi.org/10.1177/1088868310377394 CrossRef

Title: Social correlates of mental health in gastrointestinal cancer patients and their family caregivers: Exploring the role of loneliness
Authors: Ekin Secinti
Kevin L. Rand
Shelley A. Johns
Bert H. O’Neil
Paul R. Helft
Safi Shahda
Shadia I. Jalal
Catherine E. Mosher
Publication date: 01-06-2019
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 6/2019
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-018-4467-8

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 6/2019

Patients and caregivers’ unmet information needs in the field of patient education: results from an Italian multicenter exploratory survey

Design, implementation, and evaluation of an intervention to improve referral to smoking cessation services in breast cancer patients

Establishing an integrative oncology service in the Australian healthcare setting—the Chris O’Brien Lifehouse Hospital experience

Family caregivers for adult cancer patients: knowledge and self-efficacy for pain management in a resource-limited setting

A systematic review of psychological interventions for patients with head and neck cancer

A phase II open-label study of aprepitant as anti-emetic prophylaxis in patients with acute myeloid leukemia (AML) undergoing induction chemotherapy

Keynote webinar | Spotlight on antibody–drug conjugates in cancer