Understanding the Effects of Sociodemographic Factors, Cancer-related Factors, BMI, and Social Support on the Health-Related Quality of Life of Cancer Survivors: A Report from the American Cancer Society's Study of Cancer Survivors-II (SCS-II) Open Access

Westby, Ruth Patricia (2014)

Permanent URL: https://etd.library.emory.edu/concern/etds/sj139254p?locale=en
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Abstract

Guided by the Stress and Coping Theory, this quantitative study assessed the main and interactive effects of BMI and social support on the health-related quality of life (HRQoL) of male and female cancer survivors but adapted the framework to take the main and interactive effects of race, and other sociodemographic factors, into account as well. A cross-sectional survey, entitled the Study of Cancer Survivors II (SCS-II), was administered by the American Cancer Society to identify HRQoL issues among female breast, colorectal, prostate, bladder, skin melanoma, and uterine cancer survivors at two, five, and ten years post-diagnosis. In this study, data from 1,767 cancer survivors was included in final bivariate and multiple linear regression models. Two-step multiple linear regressions were conducted separately to assess the physical and mental HRQoL of male and female cancer survivors. Step-one of the model included sociodemographic factors, cancer-related factors, BMI, and social support while step-two added bivariate BMI, social support, and race interaction terms into the model. Results provided mixed support for various sociodemographic factors that were significantly correlated with the physical and mental HRQoL of each gender, with breast cancer the only cancer-related factor to be significant (physical HRQoL of female survivors). BMI was found to have significant main effects for physical HRQoL across gender while social support was found to have significant main effects on both physical and mental HRQoL across gender. Race moderated the relationship between social support and physical HRQoL among female cancer survivors and between BMI and mental HRQoL for both genders. No evidence was found to support the buffering hypothesis of the Stress and Coping Theory. The results of this study contribute a unique gender- and racial-specific perspective to cancer survivorship research and warrant continued study of racial differences for alterable correlates of HRQoL. Future research may be able to expand these findings to provide justification for potentially important HRQoL interventions targeting modifiable behavioral and psychosocial factors among particular subgroups of cancer survivors.

Table of Contents

Table of Contents

Chapter 1: Introduction ...................................................................................1

Background and Significance .............................................................................1 Study Purpose... ............................................................................................4 Theoretical Framework. ...................................................................................5 Research Aims...............................................................................................7

Chapter 2: Literature Review ............................................................................8

Introduction..................................................................................................8

Physical HRQOL among Cancer Survivors ............................................................9

Mental HRQOL among Cancer Survivors. ............................................................11

Race and HRQOL among Cancer Survivors. ........................................................12

BMI and HRQOL among Cancer Survivors. .........................................................13

Social support and HRQOL among Cancer Survivors. ...........................................15

Theoretical Framework. ................................................................................17 Summary...................................................................................................18

Chapter 3: Methodology ................................................................................19

Introduction................................................................................................19 Participants and Procedure. ...........................................................................20 Measures...................................................................................................22

Sociodemographic Characteristics. ..................................................................22

Cancer-related Factors. ................................................................................22

BMI...........................................................................................................23

Social Support. ............................................................................................23

HRQOL.......................................................................................................23 Statistical Analysis. ......................................................................................24

Chapter 4: Results .......................................................................................25

Study Participants.. .....................................................................................25

Multicollinearity and Variable Inclusion .............................................................26

Physical HRQOL. ..........................................................................................28

Bivariate Analyses. ......................................................................................28

Multivariate Analyses. ..................................................................................30

Mental HRQOL.............................................................................................33

Bivariate Analyses .......................................................................................33

Multivariate Analyses ...................................................................................37

Chapter 5: Discussion ............................................................................,.....40

Introduction...............................................................................................40 Theoretical Framework. ...............................................................................40

Aim 1: Sociodemographic and Cancer-Related Factors on HRQOL. ........................43

Physical HRQOL..........................................................................................43

Mental HRQOL............................................................................................44

Aim 2: Main Effects of BMI and Social Support on HRQOL ...................................46

Physical HRQOL ..........................................................................................46

Mental HRQOL. ...........................................................................................47

Aim 3: Bivariate Interactive Effects of BMI, Social Support, and Race on HRQOL ....47

Physical HRQOL. .........................................................................................47

Mental HRQOL. ...........................................................................................48

Conclusions...............................................................................................49 Strengths & Limitations ...............................................................................51 Strengths.................................................................................................51 Limitations................................................................................................51

Implications and Recommendations for Future Research. ...................................52

References...............................................................................................55

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