Internet use and social support in women with breast cancer.

Many Web sites offer information to breast cancer patients, who are increasingly using these sites. The authors investigated the potential psychological benefits of Internet use for medical information by breast cancer patients. Of the 251 women approached, 188 were successfully interviewed (74.9%). Forty-two percent used the Internet for medical information related to breast health issues and did so for an average of 0.80 hr per week. The Interpersonal Support Evaluation List and the UCLA Loneliness Scale, with results controlled for covariates, showed that Internet use for breast health issues was associated with greater social support and less loneliness than Internet use for other purposes or nonuse. Breast cancer patients may obtain these psychological benefits with only a minimal weekly time commitment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interactions between job stressors and social support: Some counterintuitive results.

Job stressors (underutilization of skills, quantitative workload, and job future ambiguity) and social support (tangible and emotional support from supervisor, coworkers, and nonjob sources) were used to predict psychological and physiological strains (job dissatisfaction, boredom, workload dissatisfaction, depression, heart rate, and blood pressure) and organizational consequences (absenteeism and job performance) among 102 hospital nurses (mean age 37.4 yrs). Based on previous theory and research, social support was expected to moderate the relationship between stressors and strains so that stressors would be less strongly related to strains in the presence of strong social support than under conditions of less social support. Several interactions were found, but all were in the direction opposite from predictions (i.e., social support strengthened the positive relationship between stressors and strains). This result contradicts most theories and models of job stress and social support. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender differences in perceptions of stressors and utilization of social support among university students.

Although researchers have found that social support is an effective coping mechanism to deal with stress, there has been little research on gender differences in perceived stress and use of social support. In the present study, 186 undergraduate students from a Maritime university rated the perceived stressfulness of five scenarios, and identified the type and source of social support they would use to cope with each of the situations. Women perceived three of the five scenarios as significantly more stressful than did men. Women indicated that they would turn to their partner and friends to a greater extent than men would. Women also reported that they would seek emotional support to a greater degree than did men. However, when the perceived stressfulness of the scenarios was controlled, some of the gender differences in the sources and types of support disappeared. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress buffering effects of daily spousal support on women's daily emotional and physical experiences in the context of breast cancer concerns.

Objective: This study examined whether the relationship between daily spousal support and daily psychological and physical outcomes varied as a function of level of breast cancer related concern (stress buffering model). Design: Ninety-five women with early stage breast cancer completed daily reports of emotional and physical experiences and satisfaction with spousal support for 30 days. Women also rated problems dealing with three types of cancer specific concerns: emotional, physical, and social. Main outcome measures: Women's positive and negative affect and cancer related pain and fatigue. Results: Multilevel analyses supported a stress buffering effect for social concerns and a reverse stress buffering effect for emotional and physical concerns. Conclusion: Daily spousal support appears to be an important contributor to the daily emotional and physical wellbeing of women with breast cancer. Contrary to the tenets of the stress buffering model, these data suggest that the buffering effect of spousal support is attenuated when breast cancer related emotional and physical concerns reach high levels. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence of stressors on breast cancer incidence in the Women's Health Initiative.

Objective: To examine associations among life events stress, social support, and breast cancer incidence in a cohort of postmenopausal women. Design and main outcome measure: Women's Health Initiative observational study participants, breast cancer free at entry, who provided assessment of stressful life events, social support, and breast cancer risk factors, were prospectively followed for breast cancer incidence (n = 84,334). Results: During an average of 7.6 years of follow-up, 2,481 invasive breast cancers were diagnosed. In age-adjusted proportional hazards models, 1 stressful life event was associated with increased risk, but risk decreased with each additional stressful life event. After adjustment for confounders the decreasing risk was not significant. Stressful life events and social support appeared to interact in relation to breast cancer risk such that women who had greater number of stressful life events and low social support had a decreased risk of breast cancer. Conclusions: This study found no independent association between stressful life events and breast cancer risk. The results are compatible with a more complex model of psychosocial factors interacting in relation to breast cancer risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Communicating breast cancer on-line: support and empowerment on the Internet

Using participant-observation and discourse analysis, this study explores the communication occurring on the Breast Cancer List, an on-line discussion group which continues to grow in membership and activity. Issues discussed include the evolution of the List, who participates, what topics are discussed. Three major dimensions are identified: exchange of information, social support, and personal empowerment. Social support via computer is compared with face-to-face groups. Empowerment centers on enhanced decision-making and preparation for new illness-related experiences. The influence of gender is considered in terms of communicative style and limitations of access. It is concluded that the List fulfills the functions of a community, with future concerns about information control and the potential to enhance patient-provider understanding.     

Social support and survival among women with breast cancer

BACKGROUND: Two recently reported randomized trials, one among patients with advanced breast cancer and the other among patients with early stage melanoma, suggested that social support may affect survival favorably. This study assesses relationships of social support indicators with 7-year survival among women diagnosed with localized or regional stage breast cancer. METHODS: All newly diagnosed patients with surgically treated localized or regional disease in seven Quebec City hospitals in 1984 were considered for this analysis. Among 235 eligible patients, 224 (95%) participated in a home interview 3 months after surgery. This interview provided information on the use of confidants in the 3 months after surgery. Data on disease and treatment characteristics were abstracted from patients' medical records. RESULTS: Compared with women who used no confidant in the 3 months after surgery, the hazard ratio for the 7-year period was 0.61 (95% confidence interval [CI], 0.33-1.12) among those who had used at least one confidant, 0.54 (95% CI, 0.28-1.06) in women who used two or more types of confidant, and 0.51 (95% CI, 0.22-1.18) among those whose confidants included either physician or nurse. These results were adjusted for age, presence of invaded axillary lymph nodes, adjuvant radiotherapy, and adjuvant systemic therapy (hormone or chemotherapy). CONCLUSION: These results support the view that social support may be associated with longer survival among women with localized or regional stage breast cancer.     

Mental health and support of women treated for breast cancer

This article presents the results of a pilot-study conducted on a small sample of women with breast cancer and the members of their social support system. The purpose was to determine the potential link between the mental health of the breast cancer patient and their support system. Mental health was assessed with the SCL-90-R (Derogatis, 1977), a self-report scale composed of 90 items divided into nine categories, offering three global indicators of distress: the Global Severity Index (GSI); the Positive Symptom Distress Index (PSDI), and the Positive Symptom Total (PST). The SCL-90-R was distributed to a sample of 14 subjects: seven women treated for breast cancer and seven significant others (social support). The results led to the definition of symptoms such as hostility, phobic anxiety and psychosis specific to either the woman or the support system.     

Life after breast cancer: understanding women's health-related quality of life and sexual functioning

PURPOSE: To describe the health-related quality of life (HRQL), partner relationships, sexual functioning, and body image concerns of breast cancer survivors (BCS) in relation to age, menopausal status, and type of cancer treatment. PATIENTS AND METHODS: A cross-sectional sample of BCS in two large metropolitan areas was invited to participate in a survey study that included the following standardized measures: the RAND 36-Item Health Survey; the Centers for Epidemiologic Studies-Depression Scale (CES-D); the Dyadic Adjustment Scale (DAS); the Breast Cancer Prevention Trial (BCPT) Symptom Checklist; the Watts Sexual Functioning Questionnaire (WSFQ); and subscales from the Cancer Rehabilitation Evaluation System (CARES). RESULTS: Eight hundred sixty-four BCS completed the survey. RAND Health Survey scores were as good or better than those of healthy, age-matched women, and the frequency of depression was similar to general population samples. Marital/partner adjustment was similar to normal healthy samples, and sexual functioning mirrored that of healthy, age-matched postmenopausal women. However, these BCS reported higher rates of physical symptoms (eg, joint pains, headaches, and hot flashes) than healthy women. Sexual dysfunction occurred more frequently in women who had received chemotherapy (all ages), and in younger women who were no longer menstruating. In women > or = 50 years, tamoxifen therapy was unrelated to sexual functioning. CONCLUSION: BCS report more frequent physical and menopausal symptoms than healthy women, yet report HRQL and sexual functioning comparable to that of healthy, age-matched women. Nevertheless, some survivors still experience poorer functioning, and clinicians should inquire about common symptoms to provide symptomatic management or counseling for these women.     

Cardiovascular reactivity during social and nonsocial stressors: Do children's personal goals and expressive skills matter?

The relationships between social competence and cardiovascular reactivity were evaluated in 180 children (ages 8-17; 52% female; 53% Caucasian). Participants performed a social task (Social Competence Interview [SCI]) and 2 nonsocial tasks while reactivity measures were obtained. Social competence was coded from SCI audiotapes. Among adolescents, higher scores on the Acceptance-Affiliation subscale were associated with increased heart rate (HR) and blood pressures and with decreased HR variability during the SCI. Among boys, greater Acceptance-Affiliation scores were associated with increased vascular reactivity during the SCI. During the nonsocial tasks, higher Self-Defensiveness and Expressiveness scores were associated with increased cardiac output and stroke volume among African American children. Personal strivings and expressive skills do matter for understanding cardiovascular responses in children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of breast cancer during pregnancy

Breast cancer occurring during pregnancy is a rare clinical situation. A multidisciplinary approach is needed involving an obstetrician a medical oncologist and a surgeon. It should be treated according to the same principles applied in non pregnant patients. Abortion or termination of pregnancy don't improve survival. Decisions regarding abortion should be based on the desires of the patient and on therapeutic necessities. Surgery if necessary is always possible, radiation therapy should be avoided by reason of fetal toxicity, chemotherapy if absolutely necessary is possible after the first trimester.     

Traumatic stress, life events, and emotional support in women with metastatic breast cancer: Cancer-related traumatic stress symptoms associated with past and current stressors.

This study examined levels of intrusion and avoidance symptoms and their relationships to past life stress, current emotional support, disease-related variables, and age in 125 women with metastatic breast cancer. The results indicate that a sizable proportion of these women experienced clinically significant levels of intrusion and avoidance symptoms related to their cancer, particularly those with both more stressful past life events and higher current levels of aversive emotional support. Additionally, both types of symptoms were associated with shorter time since recurrence, and avoidance symptoms were associated with smaller emotional support networks. These results indicate that metastatic breast cancer is an emotionally traumatic event for a significant proportion of women, particularly those with past life stressors and unsupportive social environments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Staff nurse perceptions of stressors and support needs in their workplace

The purpose of this study was to test a causal model developed from a theoretical formulation of the health consequences of loneliness in adolescents. The sample consisted of 325 adolescents, ages 12 to 21. Data were obtained in classroom settings on the variables of age, gender, and loneliness on one testing date; and on the variables of introspectiveness, symptom patterns, and perceived health status on another testing date 1 week later. The causal model was tested via the LISREL 7 program. By all indicators used in this study, there was a very good fit of the overidentified model with the data, the causal relationships predicted in the model were correctly specified, and modification of the model was not indicated. The results indicated that loneliness contributed to introspectiveness, that both loneliness and introspectiveness contributed to the reporting of symptom patterns, and that all of the aforementioned variables contributed directly and/or indirectly to a less positive perception of health status among adolescents. A vast majority of the direct and indirect effects of age and gender predicted on other variables in the model were supported.     

Autologous bone marrow support and bone disease in metastatic breast cancer

Production of IgM, IgG and IgA was induced from human blood B lymphocytes by culturing with a CD40 MoAb and IL-2 for 9 days. Replacement of IL-2 by IL-10 markedly enhanced production of all three isotypes. High levels of immunoglobulin production also occurred when activated irradiated autologous T cells replaced the CD40 MoAb, and when IL-10 replaced IL-2 in these cultures a spectacular increase in IgG production occurred. The effectiveness of the T cell stimulus depended on the mode of purification of the T cells and the nature of the stimulant used to activate them. Differences in the kinetics and level of expression of CD40L on the various T cell preparations were observed, but did not account for variations in immunoglobulin-inducing efficiency. Immunoglobulin production from sIgD+ and sIgD- B cells was investigated. IgG and IgA were found in sIgD+ cultures, indicating that some isotype switching had occurred, but the major part of the IgG and IgA secreted was from cells already committed to these isotypes. Anti-IgD or anti-IgM MoAbs enhanced the proliferation of B cells induced by anti-CD40 antibody, but immunoglobulin production was not enhanced. Factors affecting the balance of proliferation and differentiation are discussed.     

Work stressors, role-based performance, and the moderating influence of organizational support.

As a test of the 2-dimensional model of work stressors, the present study proposed differential relationships between challenge stressors and hindrance stressors and role-based performance, which were expected to be moderated by organizational support. In a sample of 215 employees across 61 offices of a state agency, the authors obtained a positive relationship between challenge stressors and role-based performance and a negative relationship between hindrance stressors and role-based performance. In addition, organizational support moderated the relationship between challenge stressors and role-based performance but did not moderate the relationship between hindrance stressors and role-based performance. This suggests that organizations would benefit from increasing challenges in the workplace as long as they are supportive of employees and removing hindrances. Further implications for organizational theory and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of social support and battle intensity on loneliness and breakdown during combat.

A sample of 382 Israeli soldiers who developed combat stress reactions (CSR) during the 1982 Israel-Lebanon War were compared with groups of carefully matched controls who did not develop CSR. Lack of social support from officers was found to be related to greater feelings of loneliness and greater likelihood of CSR in soldiers. Lack of social support from buddies was found to be related to greater loneliness. Intensity of battle was also found to be related to greater feelings of loneliness and increased likelihood of CSR. A path model was tested and supported. The model suggests that battle intensity and officer support lead to CSR directly and indirectly by causing increased feelings of loneliness. Possible cognitive and psychodynamic explanations for the findings are offered. The limitations of making causal statements from retrospective perceptions are discussed. (33 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The timing of breast cancer surgery during the menstrual cycle

A number of recent studies have suggested that survival among premenopausal women after primary treatment of breast cancer may be affected by the estimated hormonal milieu at the time of surgery, especially in those with axillary lymph node metastases. The concept has created considerable controversy and has resulted in the publication of many negative reports. However, several biological mechanisms have been suggested for the observed survival advantage. These include cyclical patterns of immune function, as well as cell division and cell death, that correlate with hormonal fluctuations of the menstrual cycle. Comparisons among studies of timing have been complicated by differences in menstrual cycle divisions, variability in the sources of study populations, limited availability of menstrual history data, and changes over the past 2 decades in primary and adjuvant breast cancer therapy. Several recent publications have been enhanced by the availability of serum collected at the time of surgery that enables accurate measurement of the hormonal milieu. In these studies, the likelihood of misclassification by menstrual cycle phase is reduced, and dependence on recalled menstrual history is eliminated. High progesterone levels have been associated with improved survival. These findings have encouraged some to suggest that perioperative administration of progesterone or tamoxifen (Nolvadex) may provide a preventive avenue comparable to scheduling surgery during the luteal phase. Further multidisciplinary studies are needed, however, to clarify the influence of the naturally occurring or medically induced hormonal milieu at the time of breast cancer surgery on survival in premenopausal women.