Introduction
Recent meta-analyses confirmed the significance of social relationships and mortality risk1 and sought to examine the association of social networks with length of life for patients with advanced cancer 2. The impact of perceived social support in studies of patients diagnosed with cancer confirms its importance in coping with treatment. However, little is known about the prevalence of social support for patients and their family caregivers nor the interrelationship of social support and its impact on patients with advanced cancer.
Methods
Patients (n=142) with advanced cancer were identified consecutively as they presented to Radiation Oncology at Princess Alexandra, Brisbane, Australia over a seven-week period in late 2008. Caregivers (n=110) identified by patients were also included in the study. Socio-demographic and clinical data was collected together with measures of social support using the RAND MOS instrument. Patients observed over time, censored in late 2011 using the National Death Index, confirmed half remained alive.
Findings
Patients were well supported across all five scales, particularly for emotional support, 82.2 (78.5-86.9) and social relations 81.6 (77.4-85.8). By contrast, family caregivers reported significantly lower scores, in particular for affection where the median score was 60.2 in contrast to patient scores of 79.4 and social relations 66.2 (60.3-72.0). Analysis by gender found surprisingly no significant differences between cohorts. Age stratification identified a complex picture: those under 44 years generally reported lower scores and they were significant for family caregivers. By contrast, patients over 75 years were very well supported reporting scores of 91.7 for affection, and 91.4 for emotional support. These reports were in stark contrast to older family caregivers who reported a score of 63.3 for affection and 71.3 for tangible assistance. Caregivers aged 55 to 64 also reported very low scores (55.6) for affection. Implications of these findings for clinical practice will be discussed.