Social Support in Older Lung Cancer Patients

年龄是癌症的唯一最重要的危险因素，社会支持对癌症患者的健康结果和生存至关重要。在有关老年癌症患者的研究中，经常使用社交网络的衡量标准。然而，人们对支持的质量方面知之甚少，例如工具性或情绪性类型以及指令性或非指令性风格，这些类型在老年癌症患者的治疗和康复过程中可能很重要，并易于干预。老年癌症患者可能需要比年轻患者更多的支持或不同类型的支持才能获得积极的结果，如改善生活质量(QOL)和较少的抑郁情绪。老年人可能由于共病或日常生活能力(ADLS)受限而功能受损；身体功能受损与较差的Q0L和抑郁症有关。本研究旨在描述不能手术的非小细胞肺癌患者在化疗期间和之后所获得的支持的各个方面，评估两个年龄组(45岁-与大于或等于65岁)患者在支持、生活质量和抑郁情绪方面的差异，并确定与治疗期间和治疗后的生活质量和抑郁情绪相关的社会支持的各个方面。样本将包括年龄大于或等于45岁的原发、IIIb期或IV期非小细胞肺癌患者，他们在圣路易斯的巴恩斯-犹太医院接受一线治疗。临床数据将包括合并症、TNM分期、治疗类型和治疗反应。在治疗后4-6周和治疗结束后4-6周进行访谈将评估支持的质量方面、感知的支持可用性、支持满意度、社交网络、规模、Q0L抑郁情绪和ADL。预测因素和结果变量的年龄差异将使用方差分析进行检验。分层回归将测试每个社会支持变量在治疗期间和随访期间对生活质量和抑郁情绪的预测效果，并控制重要的协变量。这些发现将增加对IIIb期或IV期NSCLC老年患者的社会支持与生活质量和抑郁情绪关系的了解，并可能导致改善他们的Q0L的方法。

Age is the single most important risk factor for cancer, and social support is important for health outcomes and survival among cancer patients. Measures of social network are often used in studies about older cancer patients. However, little is known about qualitative aspects of support, such as Instrumental or Emotional types and Directive or Non-directive styles, which might be important during treatment and recovery of older cancer patients and amenable to intervention. Older cancer patients may require more support or different kinds of support than younger patients to achieve positive outcomes, such as improved quality of life (QOL) and less-depressed mood. Older adults may have impaired functioning due to co-morbidity or limitations in activities of daily living (ADLs); impaired physical functioning is associated with poorer Q0L and depression. This study seeks to describe aspects of support received by patients with primary, inoperable, non-small cell lung cancer (NSCLC) during and after chemotherapy, assess differences in support, quality of life, and depressed mood between patients in two age groups (45-64 vs. greater than or equal to 65 years), and identify aspects of social support associated with Q0L and depressed mood during and after treatment. The sample will include patients greater than or equal to 45 years old with primary, stage IIIb or stage IV NSCLC receiving chemotherapy at first- line treatment at Barnes-Jewish Hospital in St. Louis. Clinical data will include co-morbidity, TNM stage, type of treatment, and response to therapy. Interviews at 4-6 weeks into therapy and at 4-6 weeks after treatment ends will assess qualitative aspects of support, perceived availability of support, support satisfaction, social network, size, Q0L depressed mood, and ADLs. Age differences in predictor and outcome variables will be tested using analysis of variance. Hierarchical regression will test the predictive effects of each social support variable on both QOL and depressed mood during therapy and at follow-up, controlling for important covariates. Findings will add to the knowledge of social support's relationship with QOL and depressed mood in older patients with stage IIIb or stage IV NSCLC and may lead to ways to improve their Q0L.