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Staying Healthy After Cancer: The Hidden Influence of Social Networks

机译：癌症后保持健康：社交网络的隐藏影响

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Background: Few rigorous empirical studies have used social network models to investigate changes to the relationships most important to cancer survivors and their effects on health. The objective of this dissertation was to longitudinally examine the associations between egocentric social network change over time and physical, physiological, and mental health among cancer survivors and older adults without a history of cancer.;Method: The National Social Life Health and Aging Project (NSHAP) (2004-2011) is a nationally representative cohort of older adults aged 57 and older. Physical functioning was measured with the Activities of Daily Living Scale and inflammation was measured by C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha), and vascular endothelial growth factor (VEGF). Depressive symptoms were measured with the 11-item version of the Centers for Epidemiologic Studies Depression (CES-D) Scale. Multiple logistic and linear regression and structural equation modeling were used to assess the relationships of interest.;Results: Older cancer survivors and older adults without cancer experienced similar social network changes over time. In the overall NSHAP sample, adding new network members was protective of functional decline [odds ratio (OR): 0.64, 95% confidence interval (CI): 0.41-0.99] and experiencing a change in the frequency of contact was positively associated with functional decline (OR: 1.92, 95% CI: 1.15- 3.20). CRP levels were significantly 26% lower among cancer survivors who added two network members compared to those who added no network members. Experiencing a change in the frequency of contact was associated with a 19% higher level of TNF-alpha. Social support was directly associated with depressive symptoms and did not vary by cancer status. No mediation effects between social support, inflammation, and depressive symptoms were observed in path models and latent variable models.;Conclusion: Together these results suggest that when new relationships form or when stable relationships remain strong over time, their effects on health are positive. Alternatively, negative health effects may emerge when relationships become weaker over time. This study provides significant and timely information to develop effective interventions to improve quality of life for cancer survivors and older adults.
机译：背景：很少有严格的经验研究使用社交网络模型来调查对癌症幸存者及其健康影响最重要的关系的变化。本论文的目的是纵向研究以自我为中心的社交网络随时间的变化与癌症幸存者和没有癌症病史的老年人之间的身体，生理和心理健康之间的关联。方法：国家社会生活健康与衰老项目（ NSHAP）（2004-2011年）是年龄在57岁以上的老年人的全国代表队列。用日常生活活动量表测量身体机能，用C反应蛋白（CRP），肿瘤坏死因子-α（TNF-α）和血管内皮生长因子（VEGF）测量炎症。抑郁症状是使用《流行病学研究中心抑郁症（CES-D）量表》的11个项目进行测量的。结果：随着年龄的增长，癌症幸存者和没有癌症的成年人经历了相似的社交网络变化。在整个NSHAP样本中，添加新的网络成员可以防止功能下降[优势比（OR）：0.64，95％置信区间（CI）：0.41-0.99]，并且接触频率的变化与功能正相关下降（或：1.92，95％CI：1.15- 3.20）。与未添加网络成员的癌症幸存者相比，添加两个网络成员的癌症幸存者的CRP水平显着降低了26％。接触频率的变化与TNF-α水平升高19％有关。社会支持与抑郁症状直接相关，并且不会因癌症状态而异。在路径模型和潜在变量模型中未观察到社会支持，炎症和抑郁症状之间的中介作用。结论：这些结果共同表明，当新的关系形成或稳定的关系随着时间的推移保持牢固时，它们对健康的影响是积极的。或者，当关系随着时间而变弱时，可能对健康产生负面影响。这项研究为开发有效的干预措施以改善癌症幸存者和老年人的生活质量提供了重要而及时的信息。

著录项

  • 作者

    Guida, Jennifer Lyn.;

  • 作者单位

    University of Maryland, College Park.;

  • 授予单位 University of Maryland, College Park.;
  • 学科 Epidemiology.;Public health.;Oncology.;Aging.
  • 学位 Ph.D.
  • 年度 2017
  • 页码 203 p.
  • 总页数 203
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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