The Influence of Social Network Size, Composition and Function on Psychological Outcomes of Pediatric Cancer Caregiving: Relationships across Time and around Periods of Distress

儿童癌症是儿童和患有癌症儿童的父母因疾病死亡的头号原因。 出现焦虑、痛苦、抑郁和创伤后应激症状的风险很大。访问社交网络 儿童癌症患儿父母的支持缓冲心理调适 感知社会支持较低的人更有可能经历不确定、焦虑、抑郁和 创伤后应激症状。然而，一个问题是，以前的研究通常依赖于全球衡量标准 父母对获得支持的看法，留下了关于确切特征的重要问题 关于改善父母心理结果的支持网络，没有得到回应。在此R01计划中， 由一位新的和早期的调查员进行的研究，我们将使用预期的纵向社交网络数据 和生态瞬时评估(EMA)，以捕获围绕压力的日常网络体验 处理事件，以检查多个级别上的网络特征(自我、改变、联系)如何塑造对 支持性资源和父母的心理结果。在目标1中，我们将收集前瞻性的纵向数据 用于检查父母的社交网络特征如何演变的网络数据(例如，大小，组成， 在线/离线)随时间推移，以及网络特征和访问特定种类之间的关系 支持资源(例如，信息、情感、有形)随时间的变化。我们还将研究 获得特定类型支持与父母压力、焦虑、积极情感和 随着时间的推移会产生负面影响。在目标2中，我们将使用每日EMA数据来解释网络激活的动力学 特应激治疗中的经历，以及网络激活与父母的关系 焦虑、压力、积极的情感和消极的情感。这些发现将通过以下方式在概念上取得重大进展 (1)澄清与访问不同类型的支持相关的网络属性；以及(2) 描述与改善父母心理有关的网络投入模式 适应儿科癌症。我们在方法上的创新设计结合了预期的纵向 网络数据和EMA，以捕获围绕应激性治疗事件的日常网络体验，并将 能够检查社交网络特征中人与人之间和人内的关联 以及父母的焦虑、压力、积极情感和消极情感。通过完善对网络的理解 与改善父母心理结果相关的特征，来自拟议计划的发现 通过识别符合以下条件的网络特征配置文件，研究将具有很高的翻译意义 与父母的焦虑、压力、消极情绪和积极情绪有关。这些发现将为 完善临床干预措施以改善癌症护理的心理适应的证据基础。我们的 研究结果还将通过确定哪些类型的支持服务最多，为支持性护理计划提供信息 不能通过个人网络获得特定类型支持的父母需要。

Childhood cancer is the number one cause of death by disease in children, and parents of children with cancer are at significant risk for symptoms of anxiety, distress, depression, and posttraumatic stress. Access to social support buffers psychological adjustment for parents of children diagnosed with pediatric cancer, and parents who have lower perceived social support are more likely to experience uncertainty, anxiety, depression, and post traumatic stress symptoms. A problem, however, is that previous studies typically rely on global measures of parents' perceptions of access to support, leaving important questions regarding the precise characteristics of support networks that improve parental psychological outcomes unanswered. In this R01 program of research by a new and early stage investigator we will use both prospective longitudinal social network data and Ecological Momentary Assessment (EMA) to capture daily network experiences surrounding stressful treatment events to examine how network characteristics at multiple levels (ego, alter, ties) shape access to supportive resources and parental psychological outcomes. In Aim 1 we will collect prospective longitudinal network data to examine how parents' social network characteristics evolve (e.g. size, composition, online/offline) over time, and how the relationship between network characteristics and access to specific kinds of supportive resources (e.g. informational, emotional, tangible) changes over time. We will also examine the association between access to specific kinds of support and parental stress, anxiety, positive affect and negative affect over time. In Aim 2 we will use daily EMA data to explicate the dynamics of network activation during especially stressful treatment experiences, and the relationship between network activation and parents' anxiety, stress, positive affect, and negative affect. Findings will make significant conceptual advances through (1) clarifying the network properties that are associated with access to different kinds of support and (2) characterizing the patterns of network engagement that are associated with improved parental psychological adaptation to pediatric cancer. Our methodologically innovative design combines both prospective longitudinal network data and EMA to capture daily network experiences surrounding stressful treatment events, and will enable examination of between-person and within-person associations among social network characteristics and parental anxiety, stress, positive affect and negative affect. By refining understanding of the network characteristics associated with improved parental psychological outcomes, findings from the proposed program of research will have high translational significance by identifying profiles of network characteristics that are associated with parental anxiety, stress, negative affect, and positive affect. These findings will provide the evidence base to refine clinical interventions to improve psychological adjustment to cancer caregiving. Our findings will also inform supportive care programs by identifying which kinds of support services are most needed for parents that are not able to access particular types of support through personal networks.