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

儿童癌症是儿童疾病死亡的头号原因， 出现焦虑、痛苦、抑郁和创伤后压力症状的风险很大。获得社会 支持缓冲被诊断患有儿科癌症的儿童的父母和父母的心理调整 那些感知社会支持较低的人更容易经历不确定性，焦虑，抑郁， 创伤后应激障碍然而，一个问题是，以前的研究通常依赖于全球措施， 父母对获得支持的看法，留下了关于确切特征的重要问题， 支持网络，改善父母的心理结果没有答案。在这个R 01计划中， 由一个新的和早期阶段的调查研究，我们将使用前瞻性的纵向社会网络数据， 和生态瞬时评估（EMA），以捕捉日常网络体验周围的压力 治疗事件，以检查多个层面的网络特征（自我，改变，关系）如何塑造获得 支持资源和父母的心理结果。在目标1中，我们将收集前瞻性纵向 网络数据，以检查父母的社交网络特征如何演变（例如，大小，组成， 在线/离线）随着时间的推移，以及网络特性与访问特定种类之间的关系如何 支持性资源（如信息、情感、有形）随时间的变化。我们亦会研究 获得特定类型支持与父母压力、焦虑、积极情感和 负面影响随着时间的推移。在目标2中，我们将使用每日EMA数据来解释网络激活的动态 在特别紧张的治疗经验，以及网络激活和父母之间的关系， 焦虑、压力、积极情绪和消极情绪。研究结果将通过以下方式取得重大的概念性进展： (1)澄清与获得不同类型支持相关的网络属性，以及（2） 描述了与改善父母心理健康相关的网络参与模式， 适应儿科癌症。我们的创新设计方法结合了前瞻性的纵向和纵向 网络数据和EMA，以捕获围绕压力治疗事件的日常网络体验，并将 能够检查社交网络特征之间的人与人之间的关联 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，拟议计划的结果 的研究将具有很高的转化意义，通过确定网络特征的配置文件， 与父母的焦虑、压力、消极情感和积极情感有关。这些发现将提供 以证据为基础，完善临床干预措施，以改善癌症患者的心理适应。我们 研究结果还将通过确定哪种支持服务最受欢迎， 对于无法通过个人网络获得特定类型支持的父母来说，这是必要的。

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.