Top

19-01-2016 | Neuroendocrine tumors | Article

Association between general self-efficacy, social support, cancer-related stress and physical health-related quality of life: a path model study in patients with neuroendocrine tumors

Journal: Health and Quality of Life Outcomes

Authors: Trude Haugland, Astrid Klopstad Wahl, Dag Hofoss, Holli A. DeVon

Publisher: BioMed Central

Abstract

Background

A diagnosis of neuroendocrine tumors (NET) provides challenges to patients and clinicians due to physical side effects of and mental response to treatment resulting in increased perceived stress. General self-efficacy, social support and cancer-related stress are key factors in coping. Thus, knowledge of these factors may be of value in improving health-related quality of life (HRQoL). The aim of the study was to examine the relationships between general self-efficacy, social support, cancer-related stress and HRQoL in patients with NET using a path model.

Methods

196 Norwegian patients living with NET were enrolled in this cross-sectional study. Inclusion criteria were: patients with tumors restricted to the GI tract; ability to speak and write Norwegian; over 18 years of age; undergoing medical treatment for NET. Measures used in the study were background characteristics, Health-related Quality of Life (SF-36), the Impact of Event Scale (IES), General Self-efficacy and the Interpersonal Support Evaluation List (ISEL). Relationships between sociodemographic variables, general self-efficacy, social support, cancer-related stress and mental and physical components scores were tested by path analysis with AMOS 22 using maximum standard likelihood estimation.

Results

The sample consisted of 50.5 % women and the average age was 65 years and the median disease duration was 4 years. Sociodemographic variables of gender, education and whether the patient lived alone or with someone were unrelated (directly or indirectly) to HRQoL. Age was directly and negatively correlated with physical HRQoL, general self-efficacy and social support in a well-fitting path model. General self-efficacy modified the negative effects of age on physical HRQoL. Physical and mental HRQoL were not associated with cancer-related stress. Higher social support was related to less stress.

Conclusion

Intervening to improve general self-efficacy and social support for patients with NET may improve their HRQoL.

Janson ET, Holmberg L, Stridsberg M, Eriksson B, Theodorsson E, Wilander E, et al. Carcinoid tumors: analysis of prognostic factors and survival in 301 patients from a referral center. Ann Oncol. 1997;8(7):685–90.PubMedCrossRef

Vinik E, Silva MP, Vinik AI. Measuring the relationship of quality of life and health status, including tumor burden, symptoms, and biochemical measures in patients with neuroendocrine tumors. Endocrinol Metab Clin N Am. 2011;40:97–109.CrossRef

Horowitz M, Wilner N, Alvarez W. Impact of event scale: a measure of subjective stress. Psychosom Med. 1979;41(3):209–18.PubMedCrossRef

Rice VH. Handbook of stress, coping and health. Washington: Sage Publications Inc; 2012.

Ferrans CE. Development of a conceptual model of quality of life. Sch Inq Nurs Pract. 1996;10:293–304.PubMed

Cohen S, Hobermann H. Positive events and social supports as buffers of life change stress. J Appl Soc Psychol. 1983;13:99–125.CrossRef

Foster C, Wright D, Hill H, Hopkinson J, Roffe L. Psychosocial implications of living 5 years or more following a cancer diagnosis: a systematic review of the research evidence. Eur J Cancer Care. 2009;18:223–47.CrossRef

Hersch J, Juraskova I, Price M, Mullan B. Psychosocial interventions and quality of life in gynaecological cancer patients: a systematic review. Psychooncology. 2009;18:795–810.PubMedCrossRef

Stanton AL. Psychosocial concerns and interventions for cancer survivors. J Clin Oncol. 2006;24:5132–7.PubMedCrossRef

10.

Mykletun A, Dahl AA, Haaland CF, Bremnes R, Dahl O, Klepp O, et al. Side effects and cancer-related stress determine quality of life in long-term survivors of testicular cancer. J Clin Oncol. 2005;23:3061–8.PubMedCrossRef

11.

van de Wiel H, Geerts E, Hoekstra-Weebers J. Explaining inconsistent results in cancer quality of life studies: the role of the stress–response system. Psychooncology. 2008;17:174–81.PubMedCrossRef

12.

Schwarzer R. Measurement of perceived self-efficacy: psychometric scales for crosscultural research. Berlin: Freie Universität Berlin; 1993.

13.

Robb C, Lee A, Jacobsen P, Dobbin KK, Extermann M. Health and personal resources in older patients with cancer undergoing chemotherapy. J Geriatr Oncol. 2013;4:166–73.PubMedPubMedCentralCrossRef

14.

Carlsson AH, Bjorvatn C, Engebretsen LF, Berglund G, Natvig GK. Psychosocial factors associated with quality of life among individuals attending genetic counseling for hereditary cancer. J Genet Couns. 2004;13:425–45.PubMedCrossRef

15.

Luszczynska A, Sarkar Y, Knoll N. Received social support, self-efficacy, and finding benefits in disease as predictors of physical functioning and adherence to antiretroviral therapy. Patient Educ Couns. 2006;66:37–42.PubMedCrossRef

16.

Boehmer S, Luszczynska A, Schwarzer R. Coping and quality of life after tumor surgery: personal and social resources promote different domains of quality of life. Anxiety Stress Coping. 2007;20:61–75.PubMedCrossRef

17.

Haugland T. Stress, social support, general self-efficacy and health related quality of life in patients with neuroendocrine tumors. A cross-sectional and pilot study. PHD thesis. Department of Public Health and Primary Health Care, Faculty of Medicine and dentistry, University of Bergen; 2013.

18.

Schwarzer R, Knoll N. Functional roles of social support within the stress and coping process: A theoretical and empirical overview. Int J Psychol. 2007;42:243–52.CrossRef

19.

Schwarzer R, Leppin A. Social support and health: a theoretical and empirical overview. J Soc Pers Relat. 1991;8:99–127.CrossRef

20.

Devine D, Parker PA, Fouladi RT, Cohen L. The association between social support, intrusive thoughts, avoidance, and adjustment following an experimental cancer treatment. Psychooncology. 2003;12:453–62.PubMedCrossRef

21.

Cohen S. Social relationships and health. Am Psychol. 2004;59(8):676–84.PubMedCrossRef

22.

Haley WE, Roth DL, Coleton MI, Ford GR, West CA, Collins RP, et al. Appraisal, coping, and social support as mediators of well-being in black and white family caregivers of patients with Alzheimer’s disease. J Consult Clin Psychol. 1996;64:121–9.PubMedCrossRef

23.

Lewis JA, Manne SL, DuHamel KN, Vickburg SM, Bovbjerg DH, Currie V, et al. Social support, intrusive thoughts, and quality of life in breast cancer survivors. J Behav Med. 2001;24:231–45.PubMedCrossRef

24.

Kershaw TS, Mood DW, Newth G, Ronis DL, Sanda MG, Vaishampayan U, et al. Longitudinal analysis of a model to predict quality of life in prostate cancer patients and their spouses. Ann Behav Med. 2008;36(2):117–28.PubMedPubMedCentralCrossRef

25.

Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–83.PubMedCrossRef

26.

McHorney CA, Ware JE, Lu JF, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care. 1994;32:40–66.PubMedCrossRef

27.

Ware JE, Kosinski M, Gandek B. SF-36 health survey : manual & interpretation guide. Lincoln: Quality Metric Inc.; 2000.

28.

Bollen KA. Structural equations with latent variables. New York: Wiley; 2010.