Basics of qualitative research: Grounded theory procedures and techniques

The MOS social support survey.

Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines.

Research in aging has emphasized average age-related losses and neglected the substantial heterogeneity of older persons. The effects of the aging process itself have been exaggerated, and the modifying effects of diet, exercise, personal habits, and psychosocial factors underestimated. Within the category of normal aging, a distinction can be made between usual aging, in which extrinsic factors heighten the effects of aging alone, and successful aging, in which extrinsic factors play a neutral or positive role. Research on the risks associated with usual aging and strategies to modify them should help elucidate how a transition from usual to successful aging can be facilitated.

https://science.sciencemag.org/content/sci/237/4811/143.full.pdf

Human aging: usual and successful

Effect of psychosocial treatment on survival of patients with metastatic breast cancer

Our objective was to test a theoretical model that explains quality of life as a function of the intrusiveness of illness encroaching on the different domains of one's life. The intrusiveness of illness is explained not only by disease and treatment related factors, but also by one's psychological and social resources (Devins, 1994). To investigate this issue, a sample of 336 women aged 50 and under, recently diagnosed with breast cancer were interviewed in their homes. Consistent with Devins' model, intrusiveness of illness mediated the effect of disease and treatment factors on quality of life. Contrary to his model, some treatment factors also had direct effects while social and psychological factors had only direct effects on quality of life. Neither time post-diagnosis nor type of treatment affected the psychological component of quality of life. © 1998 John Wiley & Sons, Ltd.

Intrusiveness of illness and quality of life in young women with breast cancer

The study reported here examines the extent to which variations in the perceptions of job characteristics may be associated, not with objective task characteristics, but with perceptual biases refl...

Perceptual Measures of Task Characteristics: The Biasing Effects of Differing Frames of Reference and Job Attitudes

Reports of changes in emotional support following surgery for breast cancer can be attributed to one of two factors: (1) the stigma associated with cancer, or (2) illness-imposed restrictions in one's activities. These explanations were assessed using data from a longitudinal study of women, following their surgical treatment for early breast cancer (N = 145), gallbladder disease (N = 90), benign breast disease (N = 87), or no surgery (N = 90). Multiple regression analysis was used to test the two models. Contrary to the cancer stigma hypothesis, women with breast cancer initially perceived themselves to have more emotional support, rather than less. Type of surgery did not explain the level of emotional support as post-surgery time increased. Instead, support for the social activity hypothesis was found. The results are interpreted as indicating that breast cancer no longer carries with it a stigma, at least not to the extent of reducing the level of women's emotional support.

Emotional support following cancer: a test of the stigma and social activity hypotheses.

Background Age-adjusted cancer mortality is 27% higher for Black Americans than for the general U.S. population, which may result from inappropriate use of cancer detection tests. Social support has been shown to affect adjustment to breast cancer and survival, but it has not been studied as a predictor of use of preventive health care services in the older population. Our hypothesis is that larger social networks are associated with greater utilization of cancer-screening tests in the older population. Purpose The objective of this study was to examine the relationship between social support and use of cancer-screening tests among older Black Americans. Methods Data for this study were obtained from a 1986 baseline survey evaluation of a community intervention program to increase cancer awareness and a 1991 end-point survey of use of cancer detection tests. Our study sample consisted of 617 Black Americans aged 55 years or older who lived in San Francisco (Calif.), the control community, and in Oakland (Calif.), the target community for intervention. The survey included measures of 1) social network characteristics, as determined by a modified version of Berkman and Syme's Social Network Index; 2) demographic characteristics; and 3) use of six cancer-screening tests--mammography, occult blood stool examination, cervical smear, clinical breast examination, digital rectal examination, and sigmoidoscopy. Results Multiple logistic regression analysis of the Social Network Index results indicated statistically significant positive associations of social support with the use of mammography and occult blood stool examination but not with the other cancer-screening tests. There were statistically significant associations between having HMO (Health Maintenance Organization) insurance and increased use of mammography and occult blood stool examination, compared with having Medi-Cal or other insurance. The interval between the surveys had a statistically significant positive association with use of mammography. These significant associations were not explained by differences in the other variables, which included health status, age, gender, education, type of health insurance, interval between the surveys, and a regular source of care. Conclusions Social support seems to be associated with increased use of mammography and occult blood stool examinations among older Black Americans. Implications Interventions designed to increase utilization of social networks may be an effective way to increase use of cancer screening, which may ultimately lead to reduced mortality from cancer.

Social Support and Cancer Screening Among Older Black Americans

Purpose—While previous evidence has shown increased likelihood for survival in cancer patients who have social support, little is known about changes in social support during illness and their impact on survival. This study examines the relationship between social support and survival among women diagnosed with breast carcinoma, specifically assessing the effect of network size and changes in social contact post-diagnosis. Methods—A population-based sample of 584 women was followed for up to 12.5 years (median follow-up =10.3 years). The mean age at diagnosis was 44 years, 81% were married, and 29% were racial/ethnic minorities. Cox regression analysis was used to estimate survival as a function of social support (changes in social contact and the size of social support), disease severity, treatment, health status, and socio-demographic factors. Results—Fifty-four-percent of the women had local and 44% had regional stage disease. About 53% underwent mastectomy, 68% received chemotherapy, and 55% had radiation. Regression results showed that disease stage, estrogen receptor status, and mastectomy were associated with greater risk of dying. Although network size was not related to survival, increased contact with friends/family post-diagnosis was associated with lower risk of death, with a hazard ratio of 0.31 (95% CI, 0.17-0.57). Conclusion—Findings from this study have identified an important aspect of a woman’s social network that impacts survival. An increase in the amount of social contact, representing greater social support, may increase the likelihood of the women’s survival by enhancing their coping skills, providing emotional support, and expanding opportunities for information-sharing.

/pdf/social-support-and-survival-in-young-women-with-breast-taw38nykur.pdf

Joan R. Bloom

Papers

Intrusiveness of illness and quality of life in young women with breast cancer

Perceptual Measures of Task Characteristics: The Biasing Effects of Differing Frames of Reference and Job Attitudes

Emotional support following cancer: a test of the stigma and social activity hypotheses.

Social Support and Cancer Screening Among Older Black Americans

Social Support and Survival in Young Women with Breast Carcinoma