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. 2021 Jan;29(1):331-340.
doi: 10.1007/s00520-020-05497-8. Epub 2020 May 2.

Comparing the roles of social context, networks, and perceived social functioning with health-related quality of life among self-reported rural female cancer survivors

Leslie R Carnahan  1   2 , Garth H Rauscher  3 , Karriem S Watson  4   5 , Susan Altfeld  4 , Kristine Zimmermann  4   6 , Carol E Ferrans  7 , Yamilé Molina  4   6
Affiliations

Comparing the roles of social context, networks, and perceived social functioning with health-related quality of life among self-reported rural female cancer survivors

Leslie R Carnahan et al. Support Care Cancer. 2021 Jan.

Abstract

Purpose: Rural women, compared to urban, experience worse survivorship outcomes, including poorer health-related quality of life (QOL). There is a need to characterize the role of multilevel social factors that contribute to QOL, including context, networks, and functioning. Our objectives were to (1) use latent class analysis to identify distinct classes of social context and social networks and (2) examine how multilevel social factors (context, networks, and functioning) are associated with health-related QOL.

Methods: We recruited self-identified rural survivors to the Illinois Rural Cancer Assessment (2017-2018), via community-based sampling methods, and participants completed the survey online, by phone, or on paper. We used latent class analysis to generate multidimensional variables for contextual and network factors. We next modeled each social factor sas a predictor in separate, bivariable linear regressions for the QOL outcomes, followed by multivariable, adjusted regressions.

Results: For our first objective, there were three classes each of county-level contexts (1, highly rural, socioeconomically disadvantaged, and mostly lacking in cancer-related services; 2, mostly rural, moderately disadvantaged, and underserved; 3, mostly metropolitan, less disadvantaged, and most-resourced) and social networks (1, no caregivers; 2, only spousal caregivers with whom they communicated daily; 3, multiple caregivers with varying daily communication). For our second objective, among all social factors, only functioning was associated with better mental health-related QOL. No factors were associated with physical health-related QOL.

Conclusions: Our findings suggest a rich diversity of social context and networks among rural female cancer survivors, and social functioning is particularly important for mental health-related QOL.

Keywords: Cancer survivors; Latent class analyses; Quality of life; Rural health; Sociological factors.

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Conflict of interest statement

CONFLICT OF INTEREST

Ms. Carnahan, Dr. Rauscher, Dr. Watson, Dr. Altfeld, Dr. Zimmermann, Dr. Ferrans, and Dr. Molina have no financial relationships to disclose. Ms. Carnahan reports this manuscript is a component of their working dissertation and will be included in as a chapter in the thesis. The authors have full control of all primary data and will all the journal to review the data if requested.

Figures

Figure 1:
Figure 1:. Multilevel Social Factors and Health-Related Quality of Life
See this image and copyright information in PMC

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