Academic journal article Iranian Journal of Public Health

The Relationship between Social Support and Quality of Life: Evidence from a Prospective Study in Chinese Patients with Esophageal Carcinoma

Academic journal article Iranian Journal of Public Health

The Relationship between Social Support and Quality of Life: Evidence from a Prospective Study in Chinese Patients with Esophageal Carcinoma

Article excerpt


Esophageal cancer has been well known to be a common disease in China and generally causes higher health care costs and crude mortality rate of 37.39/1 00,000 after age and gender adjustments (1-2). Many epidemiological studies showed the high incidence and mortality from cancer of the esophagus among the inhabitants around Triprovincial (Henan, Hebei and Shanxi) region in North China (3-4). The optimum management in carcinoma of the esophagus is systematic in selection, which is based on critical assessments of the patient's general health, disease stage and consequent responses to intervention. Although various rates and mortality in treatments were reported in different surveys, 5-year survival after surgery arranges between 10% and 30% (5-6).

In China, despite effective early detection and new treatment methods have increased the number of esophagus cancer survivors in recent years, esophagus cancer continues to be lethal among the suspected population in Henan, Hebei and Shanxi regions especially the city of Linzhou and its subsidiary counties. The prospective study on the assessment of quality of life (QOL) among the patients with esophageal carcinoma indicated a negative impact of esophagectomy on QOL and this effect is transient for patients who survive for two or more years (7). Unfortunately, survivorship is often associated with lingering fears and adjustment problems such as extreme pain, dumping syndrome, reflux symptoms, aphonia, worrying about social functioning, and unbidden thoughts about the cancer and its treatment. Such quality of life concerns have led to an increasing interest among health care teams in the identification of factors that affect long-term adjustment.

According to Lepore's model of social constraints and cognitive processing of traumatic events, people with cancer will feel socially constrained and more likely to be distressed by intrusive thought about their disturbed condition (8-9). It is necessary for social health network to disclose patient's thoughts and feelings, copy behaviors and psychological adjustment to experience specifically a transaction or exchange of social-emotional resources towards the well-being enhancement. The concept of social support has been used in many studies involved health problems and treatment particularly in cancer (10-13). As a major influencing factor in emotional adaption onto severe diseases, adequate social support provides perceived feeling that captivates someone by sharing worries or problems. Effective support from social assets and perceived support has been connected to low levels of anxiety and depression, prompt social adjustment and elevated self-esteem. Accurate data pertinent to the impact of social support on short and long term QOL can inform patients and health care team in management decisions.

The purpose of this study was to examine the relationship between social support and QOL using a valid cancer specific questionnaire in a cohort of Chinese patients with esophageal carcinoma treated in the city of Linzhou in Henan.

Materials and Methods

Between February 2010 and May 2012, 1422 patients with squamous cell carcinoma and adenocarcinoma of the esophagus underwent esophagectomy at the high-EC prevalence region-the cities of Linzhou and Xinxiang. All tumors were staged by the TNM classification system of the American Joint Committee (14) and computed tomography and/or magnetic resonance imaging were used exclude distant metastases. To be eligible for the health study, subjects had to have the carcinoma at stage I or II (A and B) of the esophagus, survived postoperatively for 3 months and currently were at home care were eligible for the study. Additionally, to be feasible for the social support evaluation and QOL process, those eligible subjects need to be able to understand or communicate for the content of the questionnaire, have no concurrent malignancies, have no serious cognitive and psychological disorders. …

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