The Effects of Social Support on Health-Related Quality of Life of Patients with Metastatic Prostate Cancer

Social support moderates the relationship between emotion regulation and health-related quality of life in cancer patients

The relationship between emotion regulation (cognitive reappraisal and expressive suppression) and HRQoL in cancer patients is currently gaining momentum, yet, no research to date has investigated the nature of this relationship. The purpose of this study was to investigate the moderating role of social support in the relationship between ER and HRQoL in Nigerian cancer patients. Participants included 361 cancer patients (female = 56.79%, mean age = 41.61, SD 15.47) conveniently drawn from the oncology unit of the University Teaching Hospital, Nigeria. They completed the measures of Functional Assessment of Cancer Therapy-General (FACT-G), emotion regulation and Perceived Social Support. The moderated regression analysis via PROCESS procedures for SPSS Version 3 was used for data analysis. The results showed that cognitive reappraisal significantly predicted HRQoL (β = 2.12, t = 4.39, p = .000). Social support also significantly predicted HRQoL (β = .73, t = 4.57, p = .000). Most importantly, social support moderated the relationship between cognitive reappraisal and HRQoL (β = -.034, t= -4.23, p = .000), but not between expressive suppression and HRQoL (β = -.015, t= -1.61, p = .10). The moderation slope revealed that cognitive reappraisal significantly predicted HRQoL particularly at lower and moderate levels of social support. These findings reveal that the effect of emotion regulation on HRQoL depends much on an individual's level of perceived social support. It also means that social support boosted the positive impact of emotion regulation on HRQoL. The findings highlighted the importance of social-support and emotion regulation particularly, cognitive-reappraisal in improving health-related quality of life in cancer patients.

Health-related quality of life in ethnically diverse Black prostate cancer survivors: a convergent parallel mixed-methods approach

PURPOSE

This study examined the health-related quality of life (HRQoL) among ethnically diverse Black men (BM) with prostate cancer (CaP) in the United States.

METHODS

A convergent parallel mixed-methods design, employing both qualitative and quantitative research, involved recruiting Black CaP survivors through multiple channels. The target population was native-born BM (NBBM), African-born BM (ABBM), and Caribbean-born BM (CBBM). QoL for all men was assessed using The Functional Assessment Cancer Therapy-Prostate (FACT-P) measure, which includes five domains: physical- (PWB), emotional- (EWB), social-(SWB), and functional-wellbeing (FWB), and a CaP subscale (PCS). A subset of men completed qualitative interviews. Demographic and clinical characteristics were also collected.

RESULTS

Black CaP survivors aged 49-85 participated in the study (n = 108), with a subset (n = 31) completing a qualitative interview. Participants were mainly NBBM (72.2%) and treated with radiotherapy (51.9%). The FACT-P scale total mean score (± SD) was 114 ± 24.1 (theoretical range 0-156), with lower scores reported on the SWB, FWB, and EWB domains. The mixed-methods findings approach included meta-inferences derived from integrating the corresponding quantitative and qualitative data, covering all the domains within the FACT-P.

CONCLUSION

Black CaP survivors experienced significant burdens that impacted their overall HRQoL. The analysis revealed impacts on physical, social, and emotional well-being, with variations among ethnic groups suggesting the need for culturally tailored interventions. EWB was also profoundly impacted by CaP treatment, with universal emotional burdens emphasized across all groups. Healthcare providers must recognize and address these multifaceted needs to promote better outcomes and HRQoL for Black CaP survivors.

Case studies on psychosocial factors that help make exercise programmes for prostate cancer patients self-sustaining

OBJECTIVES

Patients with prostate cancer (PCa) benefit from regular exercise, but it is difficult for patients to maintain an exercise regime. We examined two exercise programmes that have proven to be self-sustaining with the goal of identifying features they share that may contribute to their success.

METHODS

We compared the FC Prostata football (soccer) league in Denmark and the 'Butts in a Boat' (BIAB) dragon-boating team in Canada. The FC Prostata Project Coordinator and the BIAB team leaders provided information on their programmes' history and structure.

RESULTS

Both programmes are team-based with regularly scheduled intense exercise at their core. In both cases, social activities evolved spontaneously, starting with the men going out for food and/or drinks after practices. The sustainability of these programmes may be driven by the regular socialisation linked to the fitness activities.

CONCLUSIONS

Our case studies suggest that exercise programmes for PCa patients may have a good chance of being self-sustaining, if they are: (1) centred around intense exercise, (2) of a team nature, (3) structured to promote egalitarianism and avoid one-on-one competition within teams, yet (4) have some competitions between teams. The data suggest that informal social activities organised by patients after team practices may be important for building fellowship and strengthening patients' commitment to exercise both for themselves and for their team members.

The role of social support and the built environment on diabetes management among structurally exposed populations in three regions in Ghana

Sub-Saharan Africa is undergoing an epidemiological transition driven by rapid, unprecedented demographic, socio-cultural, and economic transitions. These transitions are driving increases in the risk and prevalence of diabetes and other non-communicable diseases (NCDs). As NCDs rise, several attempts have been made to understand the individual level factors that increase NCDs risks, knowledge, and attitudes around specific NCDs as well as how people live and manage NCDs. While these studies are important, and enhance knowledge on chronic diseases, little attention has been given to the role of social and cultural environment in managing chronic NCDs in underserved settings. Using purposive sampling among persons living with Diabetes Mellitus (PLWD) and participating in diabetes programs from regional and municipal hospitals in the three underserved regions in Ghana (n = 522), we assessed diabetes management and supportive care needs of PLWDs using linear latent and mixed models (gllamm) with binomial and a logit(log) link function. The result indicates that PLWDs with strong perceived social support (OR = 2.27, p ≤ 0.05) were more likely to report good diabetes management compared to PLWDs with weak perceived social support. The built environment, living with other health conditions, household wealth, ethnicity and age were associated with diabetes management. Overall, the study contributes to wider discussions on the role changing built and socio-cultural environments in the rise of diet-related diseases and their management as many Low- and Middle-Income Countries (LMICs) experience rapid epidemiological and nutrition transitions.

Assessing the Efficacy of a 28-Day Comprehensive Online Prostate Cancer Patient Empowerment Program (PC-PEP) in Facilitating Engagement of Prostate Cancer Patients in Their Survivorship Care: A Qualitative Study

A 28-day Prostate Cancer-Patient Empowerment Program (PC-PEP) developed through patient engagement was successful at promoting mental and physical health. Thirty prostate cancer patients from Halifax, Canada participated in the 28-day PC-PEP intervention in early 2019. PC-PEP encompassed daily patient education and empowerment videos, prescribed physical activities (including pelvic floor exercises), a mostly plant-based diet, stress reduction techniques, intimacy education, social connection, and support. Quantitative exit surveys and semi-structured interviews (conducted in focus groups of ten) were used to assess perceived factors that facilitated or impeded adherence to the program. The program received high praise from the patients and was deemed extremely useful by the participating men, who rated it 9 out of 10. Patients expressed that the multifaceted, online, home-based nature of the program helped them adhere to it better than they would have had to a single or less comprehensive intervention. Feedback from the participants indicated that the program, when viewed as a whole, was perceived as greater than the sum of its individual parts. Furthermore, the program addressed various issues, including emotional vulnerability and distress, physical fitness, urinary incontinence, challenges in expressing emotions, perceived lack of control over healthcare decisions, emotional fragility, and hesitancy to discuss prostate cancer-related matters in social settings. Patients highly (9.6/10) endorsed integrating the program into the standard care regimen from the very beginning of diagnosis. However, challenges such as work commitments were noted. Patients' high endorsement of PC-PEP suggests that its implementation into the standard of care from day one of diagnosis may be warranted.

Comparison of two validated instruments to measure financial hardship in cancer survivors: comprehensive score for financial toxicity (COST) versus personal financial wellness (PFW) scale

PURPOSE

Financial distress and financial toxicity are recognized challenges in cancer survivorship. Financial toxicity includes both objective measures of hardship and subjective distress. We hypothesized that subjective financial distress is correlated to overall holistic financial toxicity. We compared two widely accepted instruments to measure financial distress and financial toxicity.

METHODS

Patients in the follow-up phase of care at a single institution were surveyed regarding demographic and economic status. Financial toxicity was measured using the comprehensive score for financial toxicity-functional assessment of chronic illness (COST-FACIT) and financial distress using the personal financial wellness (PFW) scale. Surveys were analyzed for correlation and internal consistency. Patient score distributions were compared. Associations between survey scores and patient factors were assessed using multivariable linear regression models.

RESULTS

A total of 116 patients were included. Scores from the COST-FACIT showed a strong correlation with PFW scores (r = 0.90, p < 0.0001). Scale reliability was high for both the COST-FACIT (α = 0.92) and PFW (α = 0.97) surveys. Score distributions exhibited left skew for both surveys, with 9.5% of patient scores falling in the worst quartile of possible scores on each respective survey. The strongest predictors of financial distress and financial toxicity included young age, lower monetary savings, lower household income, and less perceived social support during cancer treatment.

CONCLUSIONS

The COST-FACIT measure of financial toxicity correlated strongly with PFW measure of financial distress. Although these instruments were designed to assess different concepts (financial distress vs financial toxicity), they gave strikingly similar results. Either instrument may be used as a meaningful patient-reported outcome for study of financial distress in cancer survivors. However, the COST-FACIT construct of financial toxicity does not appear to add additional information beyond financial distress.

Impact of treatment on elder-relevant physical function and quality of life outcomes in older adults with metastatic castration-resistant prostate cancer

INTRODUCTION

Understanding physical function (PF) and quality of life (QoL) treatment effects are important in treatment decision-making for older adults with cancer. However, data are limited for older men with metastatic castration-resistant prostate cancer (mCRPC). We evaluated the effects of treatment on PF and QoL in older men with mCRPC.

MATERIALS AND METHODS

Men aged 65+ with mCRPC were enrolled in this multicenter prospective observational study. PF measures included instrumental activities of daily living, grip strength, chair stands, and gait speed. QoL measures included fatigue, pain, mood, and Functional Assessment of Cancer Therapy (FACT)-General total and sub-scale scores. Outcomes were collected at baseline, three, and six months. Linear mixed effects regression models were used to examine PF and QoL differences over time across various treatment cohorts.

RESULTS

We enrolled 198 men starting chemotherapy (n = 71), abiraterone (n = 37), enzalutamide (n = 67), or radium-223 (n = 23). At baseline, men starting chemotherapy had worse measures of PF, QoL, pain, and mood than the other groups. Over time, all PF measures remained stable, pain improved, but functional wellbeing (FWB) and mood worsened significantly for all cohorts. However, change over time in all outcomes was not appreciably different between treatment cohorts. Worst-case sensitivity analyses identified attrition (ranging from 22 to 42% by six months) as a major limitation of our study, particularly for the radium-223 cohort.

DISCUSSION

FWB and mood were most prone to deterioration over time, whereas pain improved with treatment. Although patients initiating chemotherapy had worse baseline PF and QoL, chemotherapy was not associated with significantly greater worsening over time compared to other common therapies for mCRPC. These findings may assist in treatment discussions with patients. However, given the modest sample size, attrition, and timeframe of follow-up, the impact of treatment on PF and QoL outcomes in this setting requires further study, particularly for radium-223.

Does social support at home moderate the association between social support at work and work functioning among cancer patients?

PURPOSE

The aims of this study were to examine (1) the longitudinal associations of supervisor and colleague social support with work functioning in cancer patients who have returned to work and (2) the moderating role of social support at home.

METHODS

Data from the longitudinal Work Life after Cancer study were used (n = 384). Work functioning (low versus moderate to high work functioning) was measured with the validated Work Role Functioning Questionnaire 2.0. Social support at work was measured from both supervisor and colleagues with the Copenhagen Psychosocial Questionnaire. Social support at home was measured with the Social Support List-Discrepancies. Logistic generalized estimating equations were used to analyse associations between supervisor and colleague social support and work functioning, and to examine the possible moderating effect of social support at home.

RESULTS

More supervisor (OR: 1.21; 95% CI: 1.10, 1.32) and colleague (1.13; 1.03, 1.24) social support were significantly associated with moderate to high work functioning. The association between colleague social support and work functioning was attenuated for those who did not experience enough social support at home but remained almost significant for supervisor social support (1.17; 1.00, 1.37).

CONCLUSIONS

Supervisor social support is associated with better work functioning regardless of social support at home, while colleague social support is only associated with better work functioning when cancer patients experience enough social support at home.

IMPLICATIONS FOR CANCER SURVIVORS

Occupational physicians may play a key role in creating awareness that social support at work and at home are beneficial for cancer patients' work functioning.

Predictors for the utilization of social service counseling by prostate cancer patients

PURPOSE

Social service counseling (SSC) is an important instrument to support cancer patients, for example, regarding legal support, or rehabilitation. Several countries have established on-site SSC in routine care. Previous analyses have shown that SSC utilization varies across cancer centers. This analysis investigates patient and center-level predictors that explain variations in SSC utilization between centers.

METHODS

Logistic multilevel analysis was performed with data from 19,865 prostate cancer patients from 102 prostate cancer centers in Germany and Switzerland. Data was collected within an observational study between July 2016 and June 2020 using survey (online and paper) and tumor documentation.

RESULTS

The intraclass correlation coefficient for the null model implies that 51% of variance in SSC utilization is attributable to the center a patient is treated in. Patients aged 80 years and older, with higher education, private insurance, without comorbidities, localized intermediate risk, and undergoing androgen deprivation therapy before study inclusion were less likely to utilize SSC. Undergoing primary radiotherapy, active surveillance, or watchful waiting as compared to prostatectomy was associated with a lower likelihood of SSC utilization. Significant negative predictors at the center level were university hospital, center's location in Switzerland, and a short period of certification.

CONCLUSION

The results show that patient and center characteristics contribute to explaining the variance in SSC utilization in prostate cancer centers to a large extent. The findings may indicate different organizational processes in the countries included and barriers in the sectoral structure of the healthcare system. In-depth analyses of processes within cancer centers may provide further insights into the reasons for variance in SSC utilization.

Treatment Regret, Mental and Physical Health Indicators of Psychosocial Well-Being among Prostate Cancer Survivors

Prostate cancer (PCa) patients and survivors are at high risk of mental health illness. Here, we examined the contribution of treatment regret, mental and physical health indicators to the social/family, emotional, functional and spiritual well-being of PCa survivors. The study assessed 367 men with a history of PCa residing in the Maritimes Canada who were surveyed between 2017 and 2021. The outcomes were social/family, emotional, functional and spiritual well-being (FACT-P,FACIT-Sp). Predictor variables included urinary, bowel and sexual function (UCLA-PCI), physical and mental health (SF-12), and treatment regret. Logistic regression analyses were controlled for age, income, and survivorship time. Poor social/family, emotional, functional and spiritual well-being was identified among 54.4%, 26.5%, 49.9% and 63.8% of the men in the sample. Men who reported treatment regret had 3.62, 5.58, or 4.63 higher odds of poor social/family, emotional, and functional well-being, respectively. Men with low household income had 3.77 times higher odds for poor social/well-being. Good mental health was a protective factor for poor social/family, emotional, functional, or spiritual well-being. Better physical and sexual health were protective factors for poor functional well-being. Seeking to promote PCa patients' autonomy in treatment decisions and recognizing this process' vulnerability in health care contexts is warranted.

Factors associated with post-traumatic growth in male patients with rectal cancer: A cross-sectional study

PURPOSE

This study investigated the major functional issues experienced by male patients with rectal cancer, including fecal function, sexual function, and social support and how they relate to post-traumatic growth. Factors that can be associated with post-traumatic growth were also identified.

METHODS

A questionnaire was administered to 143 male patients with rectal cancer receiving either treatment at a national cancer center or post-therapeutic follow-up in outpatient clinics, from February 18 to May 22, 2020. In addition to questions relating to patients' characteristics, the questionnaire included measures of fecal function, sexual function, social support, and post-traumatic growth.

RESULTS

Post-traumatic growth showed a weak to moderate positive correlation with both sexual function and social support. Moreover, an analysis of the factors associated with post-traumatic growth showed that religion, marital status, and social support were statistically significant; these factors explained 22% of the variance in post-traumatic growth.

CONCLUSIONS

Post-traumatic growth in male patients with rectal cancer can be associated with psychosocial factors, such as religion and social support, rather than physical functions, such as fecal function and sexual function. Interventions to enhance social support for men who are single or non-religious could promote post-traumatic growth in male patients with rectal cancer.

Integrated analysis of pain, health-related quality of life, and analgesic use in patients with metastatic castration-resistant prostate cancer treated with Radium-223

Background

Radium-223 (Ra-223), an alpha-emitting radiopharmaceutical, established an improved overall survival and health-related quality of life (HRQoL) in symptomatic metastatic castration-resistant prostate cancer (mCRPC) patients. However, effects on pain were not specifically evaluated. Here we assess integrated HRQoL, pain, and opioid use in a contemporary, more extensively pretreated, symptomatic and asymptomatic mCRPC population.

Methods

mCRPC patients scheduled for Ra-223 treatment were included and analyzed for HRQoL, pain, and opioid use, using Functional Assessment of Cancer Therapy-Prostate (FACT-P) and Brief Pain Inventory-Short Form (BPI-SF) questionnaires and recording of opioid use and dosage, respectively. Primary outcome measure was the percentage of patients experiencing a complete pain response (score of 0 on the BPI-SF Worst pain item and no increase in daily use of analgesics). A complete or partial pain response (better BPI-SF score and decrease in opioid use) and a better or no change in HRQoL was evaluated as an integrated overall clinical response (IOCR). Secondary endpoints included the time to pain progression (TPP) and Total FACT-P deterioration (TTFD), defined as time from first Ra-223 treatment to clinical meaningful increase in BPI-SF Worst pain item score and Total FACT-P score, respectively.

Results

This registry included 300 patients, of whom 105 (35%) were evaluable for FACT-P and BPI-SF during Ra-223 treatment. Forty-five (43%) patients had pain at baseline (PAB) (BPI-SF Worst pain score 5–10 points) and 60 (57%) had no pain at baseline (no-PAB) (BPI-SF Worst pain score 0–4 points). Complete pain response was achieved in 31.4% of the patients, while 58% had an IOCR. The median TTP and TTFD were 5.6 and 5.7 months, respectively, while the difference between PAB and no-PAB patients was not significant.

Conclusions

In contemporary, extensively pretreated mCRPC patients, Ra-223 treatment induced complete pain responses while integrated analysis of HRQoL, pain response, and opioid use demonstrated that the majority of patients derive clinical benefit.

Paired exercise has superior effects on psychosocial health compared to individual exercise in female cancer patients

Purpose

Exercise improves the quality of life (QOL) in cancer patients recovering from treatment. Since group exercise fosters cohesion, we sought to determine if paired exercise would have similar, positive effects. An experiential study design was used to compare the effect of exercise (12 weeks) on psychosocial health in paired versus individually trained cancer patients.

Methods

Female cancer patients (n = 28) who completed cancer treatment were placed into either the singly trained or paired group. Groups were matched for cardiorespiratory fitness (peak oxygen consumption, single: 24.1 ± 7.4, pair: 24.8 ± 6.3 ml/kg/min) and age (single: 58 ± 12, pair: 58 ± 9 years). Patients participated in 36, 90-min exercise sessions in accordance with exercise recommendations. QOL (Functional Assessment of Cancer Therapy-General, FACT-G), depressive, fatigue, and insomnia symptoms were measured before, midway, and after the intervention. Fitness was measured pre- and post-intervention. Participants did not meet prior to the intervention. Two-way ANOVAs and multiple comparisons tests were used to detect differences (p < 0.05).

Results

Emotional well-being and total FACT-G scores were significantly improved in the paired but not individually trained patients. Depressive symptoms were significantly improved at mid- and final time points in the paired group. Paired patients reported significant improvements in insomnia symptoms from pre- to mid-intervention. Depressive and insomnia symptoms in the individually trained group were unchanged. A significant main effect of group was detected in fatigue scores in patients who were not chronically tired at baseline (F(1, 12) = 6.318, p = 0.0272). Both groups exhibited similar improvements in fitness.

Conclusion

Paired exercisers had greater benefits in QOL, emotional well-being, and insomnia and depressive symptoms compared to individual exercisers.

Influence of Psychosocial Variables on the Health of People Living in Housing Exclusion

The aim of this study was to analyze the influence of some personal characteristics, health variables, and social support on the self-rated health of people in housing exclusion in Spain. For that purpose, we used the FOESSA Survey of Social Integration and Needs database, with a final sample of 1574 households. Being more educated and reporting a good life satisfaction stood out as the main factors preventing worse health status. Furthermore, results showed that being female, experiencing poverty-related food insecurity, not having health insurance, experiencing widowhood or partner bereavement, and having caring responsibilities for others or having a disabled person in the household are associated with increased reporting of regular or poor health. On the other hand, being young, having a diagnosed/long-term illness, and a big household size are preventive factors for good health. These results allowed identifying risk and prevention factors to inform interventions to improve the health of those living in housing exclusion. Promoting better education levels, social support, and overall life satisfaction could be important to improve health in this population. Developing social support policies for caring responsibilities and food insecurity must be a priority to improve the health of people living in housing exclusion.

Social consequences of advanced cancer in patients and their informal caregivers: a qualitative study

PURPOSE

Cancer threatens the social well-being of patients and their informal caregivers. Social life is even more profoundly affected in advanced diseases, but research on social consequences of advanced cancer is scarce. This study aims to explore social consequences of advanced cancer as experienced by patients and their informal caregivers.

METHODS

Seven focus groups and seven in-depth semi-structured interviews with patients (n = 18) suffering from advanced cancer and their informal caregivers (n = 15) were conducted. Audiotapes were transcribed verbatim and open coded using a thematic analysis approach.

RESULTS

Social consequences were categorized in three themes: "social engagement," "social identity," and "social network." Regarding social engagement, patients and informal caregivers said that they strive for normality by continuing their life as prior to the diagnosis, but experienced barriers in doing so. Regarding social identity, patients and informal caregivers reported feelings of social isolation. The social network became more transparent, and the value of social relations had increased since the diagnosis. Many experienced positive and negative shifts in the quantity and quality of their social relations.

CONCLUSIONS

Social consequences of advanced cancer are substantial. There appears to be a great risk of social isolation in which responses from social relations play an important role. Empowering patients and informal caregivers to discuss their experienced social consequences is beneficial. Creating awareness among healthcare professionals is essential as they provide social support and anticipate on social problems. Finally, educating social relations regarding the impact of advanced cancer and effective support methods may empower social support systems and reduce feelings of isolation.

Social Support and Health-Related Quality of Life Among Gay and Bisexual Men With Prostate Cancer

OBJECTIVES

To describe social support patterns of gay and bisexual men with prostate cancer (GBMPCa) and how social support is associated with prostate cancer outcomes.

SAMPLE & SETTING

A cross-sectional online survey with 186 GBMPCa recruited from a national cancer support group network.

METHODS & VARIABLES

Descriptive statistics of social support and linear regression of social support on general and prostate cancer-specific quality of life (QOL). Social support and health-related QOL were assessed generally and specific to prostate cancer.

RESULTS

Participants primarily relied on partners or husbands, gay and bisexual friends, chosen family, and men from support groups for support. The most common types of support received were informational and emotional social support. Low general social support was significantly associated with worse prostate cancer symptom bother and general mental QOL. Wanting more social support was significantly associated with worse prostate cancer-specific and general QOL.

IMPLICATIONS FOR NURSING

Clinicians should be aware of the different social support networks and needs of GBMPCa and refer them to relevant support groups to improve QOL.

Perceived social support and health-related quality of life (HRQoL) in Tehranian adults: Tehran lipid and glucose study

BACKGROUND

Several studies have demonstrated the positive association between perceived social support and health-related quality of life (HRQoL) in certain groups; however, few studies have assessed this relationship in general population and between genders. This study aimed to investigate associations between socio-demographic factors, perceived social support and HRQoL among an urban Iranian population.

METHODS

The study population were 1036 adults who had participated in Tehran Lipid and Glucose Study (TLGS). Data on socio-demographic information, perceived social support and HRQoL were collected using standard questionnaires by trained interviewers. Perceived social support and HRQoL were assessed using Iranian versions of the Multidimensional Scale of Perceived Social Support (MSPSS) and Short-Form 12-Item Health Survey version 2 (SF-12v2) respectively. Data on sets of associations among socio-demographic factors, perceived social support and quality of life were analyzed using Structural Equation Modeling (SEM) with IBM SPSS AMOS software.

RESULTS

Mean ages were 50.3 ± 16.3 and 49.6 ± 14.0 years in men and women respectively and 40.9% of participants were male. In terms of perceived social support scores, except for family subscale scores (p = 0.003), there were no significant differences between men and women. However, men had significantly higher HRQoL scores, compared to women in all subscales. The findings of SEM analysis demonstrated that being married in both genders (p < 0.001) and lower age in men (p < 0.05) were significantly associated with higher level of perceived social support. In terms of physical HRQoL, being single and higher perceived social support in both genders and lower age and not having any chronic diseases, only in women were associated with higher physical HRQoL. However, for mental HRQoL, age and perceived social support had significant direct associations with mental HRQoL in both genders (p < 0.001); in women, being single (p < 0.05) and not having chronic diseases (p < 0.001) were also significantly associated with better mental HRQoL.

CONCLUSION

Perceived social support was found to be both directly and indirectly associated with physical and mental aspects of HRQoL in both genders. Current structural models provide beneficial information for planning health promotion programs aimed at improving HRQoL among Tehranian adults.

A PERCEPÇÃO DE HOMENS E COMPANHEIRAS ACERCA DA DISFUNÇÃO ERÉTIL PÓS-PROSTATECTOMIA RADICAL

RESUMO Objetivo: analisar a percepção de pacientes prostatectomizados e de suas companheiras acerca dos desafios vivenciados após a cirurgia, relacionados à sexualidade do casal e aos efeitos da disfunção erétil. Método: estudo descritivo-exploratório, de abordagem qualitativa com coleta de dados a partir de um roteiro semiestruturado aplicado com nove casais. A análise dos dados ocorreu por meio do levantamento de unidades de sentidos e formação de categorias empíricas a partir do referencial da Teoria Social Cognitiva. Resultados: o tempo de realização da prostatectomia variou entre um ano e oito meses a três anos e dois meses. Dentre os homens, a média de idade foi de 65 anos e das mulheres 59 anos. O processo de análise dos dados permitiu a identificação de duas categorias empíricas e os resultados apontam que os desafios enfrentados pelos pacientes se referem à dificuldade de diálogo e ao distanciamento entre o casal e a consequente introspecção dos homens, a preocupação com o fator idade, o medo de abandono e a insegurança dos homens quanto ao uso de medidas terapêuticas para recuperação da capacidade de ereção. Entretanto, outros casais vivenciaram aspectos positivos baseados na compreensão e apoio psicológico, e até mesmo em mudanças na forma de pensarem e viverem após a cirurgia. Conclusão: a cirurgia de prostatectomia gera repercussões no cotidiano dos pacientes e de suas companheiras, sendo que a percepção do casal em relação às implicações da cirurgia é fator determinante no processo de recuperação e enfrentamento dos desafios advindos do tratamento.

Association between social capital and quality of life among urban residents in less developed cities of western China: A cross-sectional study

China has experienced rapid urbanization over the past several decades. Social capital is considered a vital human resource, and quality of life (QoL) is an important measure of human health embedded in a physical, mental, and social context. No studies have reported on the association between social capital and QoL in Chinese urban residents. We performed a cross-sectional study to investigate social capital in urban community residents of West China, and its relationship with QoL.Our study was carried out between June and July of 2015. A total of 1136 households were surveyed. The Chinese-translated version of the Short-Form Health Survey (SF-12) and social capital questionnaire were used to evaluate people's QoL and social capital. Associations between QoL and social capital were evaluated by 3 logistic regression analyses.A total of 1136 adult participants aged 18 years and older completed the questionnaire. Young residents were more likely to have lower second (SC2), third (SC3), and fourth (SC4) dimensions of social capital. Migrants and residents with higher education levels and high incomes showed lower SC1 and SC2 relative to other participants, and employed residents had relatively low SC1. Unmarried residents had lower SC2 and SC3. Without adjustment for potential confounding factors, participants with higher SC2 had higher average scores for mental components (MCS) of QoL [odds ratio (OR) = 1.48, 95% confidence interval (95% CI): 1.09-2.02], and the same was seen for SC3 (OR = 1.70, 95% CI: 1.24-2.34). After adjusting for socioeconomic status (SES) and risk factors, SC2 and SC3 were still significantly associated with MCS. Social capital was not significantly associated with physical components of QoL in any of the 3 logistic regression models.In conclusion, social capital is related to MCS of QoL, and increasing it may be an effective way to promote health.

FORECAST - A cloud-based personalized intelligent virtual coaching platform for the well-being of cancer patients

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The challenges of cancer patients and the benefits of coaching are presented.

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Evidence of impact of coaching on the well being of cancer patients is presented.

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A cloud-based personalized intelligent virtual coaching platform for the well-being of cancer patients is proposed.

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Technology acceptance of the platform is presented, based on validation trials.

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Future work is discussed.

Well-being of cancer patients and survivors is a challenge worldwide, considering the often chronic nature of the disease. Today, a large number of initiatives, products and services are available that aim to provide strategies to face the challenge of well-being in cancer patients; nevertheless the proposed solutions are often non-sustainable, costly, unavailable to those in need, and less well-received by patients. These challenges were considered in designing FORECAST, a cloud-based personalized intelligent virtual coaching platform for improving the well-being of cancer patients. Personalized coaching for cancer patients focuses on physical, mental, and emotional concerns, which FORECAST is able to identify. Cancer patients can benefit from coaching that addresses their emotional problems, helps them focus on their goals, and supports them in coping with their disease-related stressors. Personalized coaching in FORECAST offers support, encouragement, motivation, confidence, and hope and is a valuable tool for the wellbeing of a patient.

African American prostate cancer survivorship: Exploring the role of social support in quality of life after radical prostatectomy

Purpose: The aim of this study was to explore the African American prostate cancer survivorship experience following radical prostatectomy and factors contributing to quality of life during survival. Design: African American men who were part of a larger prostate cancer cohort were invited to participate in a focus group. Eighteen open-ended questions were designed by the study team and an experienced moderator to elicit participants' survivorship experiences. Results: Twelve men consented to participate in the study. Emergent themes included views of prostate cancer in the African American community, perceptions of normalcy, emotional side effects following radical prostatectomy, and social support involvement and impact during recovery. Conclusions: Previous findings suggest that African American men may experience more distress than Caucasian men when facing typical prostate cancer side effects. Traditional masculine role norms and negative perceptions of “disease disclosure” in the African American community could be contributing to the distress reported by some in this study. Strengthening social support systems by promoting more prosocial coping and help-seeking behaviors early in the survivorship journey may help bypass the detrimental health effects associated with masculine role identification, resulting in improved quality of life throughout the lengthy survival period anticipated for these men.

Caregiving and social support for gay and bisexual men with prostate cancer

OBJECTIVE

Prostate cancer, the second most common cancer among men, typically onsets in middle or older age. Gay/bisexual men have different social networks and unique social support needs, particularly as it pertains to health care access and prostate side effects. Few studies have investigated the availability and provision of social support for gay and bisexual men with prostate cancer (GBMPCa).

METHODS

This study used qualitative data from in-depth, semistructured, one-on-one telephone interviews with 30 GBMPCa recruited from a national cancer support group network, Malecare. Inductive and deductive codes were used to identify themes about social support provided to GBMPCa during diagnosis and treatment.

RESULTS

GBMPCa reported help from friends, family (parents and siblings), ex-partners, and paid caregivers. Men in relationships reported varying levels of reliance on their partners for support, in part due to relationship dynamics and living arrangements. Single men showed a theme of independence ("I turned down all help," "My friends don't want to be bothered"). After diagnosis, many men reported seeking informational and emotional support from prostate cancer support groups; most expressed wanting more support groups specifically for GBMPCa. During or after treatment, men reported receiving a range of instrumental support, largely a function of relationship status and treatment type.

CONCLUSIONS

GBMPCa received variable, but generally low, social support during diagnosis and treatment and from a diverse social network, including a prominence of friends and family. Clinicians should be aware of GBMPCa's distinct patterns of social support needs and providers.