Prospective individual and social predictors of changes in adjustment for patients attending a regional cancer service

Abstract

Purpose. This study applied the Social Cognitive Processing (SCP) model to examine whether positive (social support) and negative (social constraints) aspects of the social environment influenced emotional distress, quality of life (QoL), wellbeing and benefit finding after cancer. Methods. Participants were 439 adults at a median of 66 weeks post-diagnosis and 79% of them had completed cancer treatments. Outcome measures and predictors were assessed twice, 6 months apart, and their relationships were analyzed using hierarchical multiple regressions. Results. Participants reported improved physical QoL at re-test. Correlations showed that better outcomes for depression, anxiety, QoL, and wellbeing were associated with higher social support and lower social constraints. In addition, benefit finding correlated with social support but not social constraints. After other predictors were taken into account, lower initial social constraints were modestly associated with improved mental QoL at re-test. Higher social constraints scores also predicted development of clinically significant depression and anxiety. Conclusions. Results provided some support for the SCP model’s prediction that both positive and negative aspects of social environment can contribute to adjustment in people with cancer. Although several findings supported the model, a heterogeneous sample and small effect sizes indicate that replication and further study is needed.