Social Support and Quality-of-Life Outcomes in Patients with Cancer

Abstract Background: Social support is a critical social determinant of health that has a substantive influence on physical and psychological well-being. Social support is associated with improved health behaviors, while social isolation is a predictor of mortality comparable to factors like smoking and hypertension. In patients with cancer, social support has been found to decrease mortality risk and improve quality of life. Social support has been proposed as a prognostic factor in some patients. Despite the importance of social support in patients with cancer, it is not often emphasized as an essential component of treatment when a cancer diagnosis is made. This study aims to explore how social support impacts cancer patients using qualitative and quantitative methods. Methods: For the qualitative aim, patients were recruited from Froedtert Hospital after seeing a surgical oncologist for their cancer. Researchers conducted in-depth ten (n=10) interviews using open-ended October 2020- May 2022. Transcripts were coded, and at least two researchers discussed themes that developed for accuracy. A grounded theory approach was used to analyze the data. For the quantitative aim, a cross-sectional analysis of 1351 cancer patients over the age of 50 was conducted using the 2016 and 2018 waves of the Health and Retirement Study. Tangible support, emotional support, and social network size were studied as they related to quality-of-life outcomes, including health-related quality of life, life satisfaction, and depressive symptoms. Results: The coding of eleven interviews resulted in four primary themes: Sources of Support, Tangible Support, Emotional Support, and Mechanisms of Social Support. The interviews highlighted the importance of social support networks in helping patients feel stable during cancer diagnosis and treatment. The results of the survey-weighted adjusted multivariate ordinal  regression showed a significant association between emotional support and health-related quality of life (p<.001), life satisfaction (p<.001), and depressive symptoms (p<.001). Social network size was also associated with health-related quality of life (p=.029) and life satisfaction (p=.004). Tangible support was not significantly related to dependent variables in the unadjusted or adjusted multivariate regression models. However, when controlling for recent cancer treatment, tangible support became significantly associated with health-related quality of life (p=.009). Conclusions: In conclusion, this study has provided a comprehensive exploration of how patients with cancer experience social determinants of health and the critical role social support plays in shaping their quality-of-life outcomes. Through an approach encompassing qualitative in-depth interviews and quantitative analyses, we have gained a nuanced understanding of the multifaceted dimensions of social support. It is essential to recognize cancer patients' dynamic social needs and tailor interventions accordingly. Our results suggest that interventions focusing on emotional support may yield more substantial benefits in terms of quality-of-life outcomes.