Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2021 Sep;29(9):5513-5521.
doi: 10.1007/s00520-021-06136-6. Epub 2021 Mar 15.

Relationship between social support, physical symptoms, and depression in women with breast cancer and pain

Hannah M Fisher  1 , Joseph G Winger  2 , Shannon N Miller  2 , Arianna N Wright  2 , Jennifer C Plumb Vilardaga  2 , Catherine Majestic  2 , Sarah A Kelleher  2 , Tamara J Somers  2
Affiliations
Randomized Controlled Trial

Relationship between social support, physical symptoms, and depression in women with breast cancer and pain

Hannah M Fisher et al. Support Care Cancer. 2021 Sep.

Abstract

Purpose: Fatigue and pain are common among women with breast cancer, and often related to depressive symptoms. Social support may influence levels of fatigue, pain interference, and depressive symptoms. We tested a theory-based, structural model examining the relationship between social support (i.e., emotional and instrumental) and depressive symptoms via fatigue and pain interference in women with breast cancer.

Methods: Women (N = 327) with stages I-III breast cancer were enrolled in a randomized trial investigating a behavioral pain intervention. Measures of social support, fatigue, pain interference, and depressive symptoms were completed at enrollment. Data were analyzed using structural equation modeling to test direct and indirect pathways relating social support, fatigue, pain interference, and depressive symptoms.

Results: Our model evidenced good fit. Significant direct effects emerged linking higher levels of emotional support with lower levels of fatigue (β = -.30), pain interference (β = -.32), and depressive symptoms (β = -.31). More instrumental support was significantly associated with more depressive symptoms (β = .11), but not fatigue or pain interference. Higher levels of fatigue (β = .30) and pain interference (β = .34) were significantly related to higher levels of depressive symptoms. More emotional support related to less depressive symptoms via lower levels of fatigue (β = -.09) and pain interference (β = -.11).

Conclusion: Women reporting higher levels of emotional support endorsed fewer depressive symptoms, and that relationship was driven by lower levels of fatigue and pain interference. Our results highlight novel pathways that healthcare professionals can leverage to optimize social support topics in psychosocial interventions targeting breast cancer symptoms. This model should be replicated using longitudinal data.

Keywords: Breast cancer; Depression; Emotional support; Fatigue; Instrumental support; Pain interference.

PubMed Disclaimer

Conflict of interest statement

Competing interests The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Structural model. Note. Pain severity, age, cancer stage, receipt of surgery and/or adjuvant treatment during a week before baseline assessment, functional status, and use of antidepressant and pain medication were included as covariates; paths not shown for simplicity. Standardized parameter estimates are shown. Dashed lines indicate non-significant paths; solid lines indicate significant paths; *p < .05; ***p < .001
See this image and copyright information in PMC

References

    1. DeSantis CE et al. (2019) Breast cancer statistics, 2019. CA Cancer J Clin 69(6):438–451 - PubMed
    1. Runowicz CD, Leach CR, Henry NL, Henry KS, Mackey HT, Cowens-Alvarado RL, Cannady RS, Pratt-Chapman ML, Edge SB, Jacobs LA, Hurria A, Marks LB, LaMonte SJ, Warner E, Lyman GH, Ganz PA (2016) American Cancer Society/American Society of Clinical Oncology breast cancer survivorship care guideline. J Clin Oncol 34(6):611–635 - PubMed
    1. Bamonti PM, Moye J, Naik AD (2018) Pain is associated with continuing depression in cancer survivors. Psychol Health Med 23(10):1182–1195 - PMC - PubMed
    1. Abrahams HJG, Gielissen MFM, Verhagen CAHHVM, Knoop H (2018) The relationship of fatigue in breast cancer survivors with quality of life and factors to address in psychological interventions: a systematic review. Clin Psychol Rev 63:1–11 - PubMed
    1. Brown LF, Kroenke K (2009) Cancer-related fatigue and its associations with depression and anxiety: a systematic review. Psychosomatics 50(5):440–447 - PMC - PubMed

Publication types

LinkOut - more resources