Chinese Colorectal Cancer (CRC) patients’ social relationship quality and negative affect

Abstract

PURPOSE: This study examined how social resources in Chinese CRC patients influence early psychological adaptation. METHODS: CRC patients newly referred to a tertiary oncology unit completed measures of relationship quality (ChSRQS), which measures intimacy in family relations (IFR), commitment to family relations (CFR), and quality of friendships (QF); perceived social support (PSS), and optimism (C-LOT-R). Additional medicoclinical and demographic data were gathered. Outcome was measured at Baseline (T1) and three-month follow-up (T2) by levels of negative affect indicated by the Hospital Anxiety and Depression Scales (HADS). RESULTS: 212 CRC patients of mean age 64.5 years, comprised 39% women, 78% married, 75% of at least elementary education and 17% were still employed. Most (85%) had received surgical resection and 31% had a stoma: approximately 20% each had stages I-IIIA, IIIB, IIIC and IV disease respectively. A mean of 36 days had passed since diagnosis. At 3 months follow-up, outcome data were available of 141 respondents. HADS-A scores indicated 25% had anxiety, while HADS-D scores indicated 31% had depression: 15% were comorbid for both. Positive correlations were seen between optimism, PSS and relationship quality. While ChSRQS, optimism and PSS were negatively correlated with HADS-D scores at T1, by T2 only ChSRQS CFR subscale score optimism and PSS were significantly related to HADS-D. Relationship quality was unassociated with HADS-A scores at either T1 or T2, while PSS was associated with HADS-A at T1 but not T2. After multivariate adjustment including PSS, CFR and IFR scores were inversely associated with T2 HADS-D score. CONCLUSION: Commitment and intimacy in family relationships was enduringly associated with lower depression in this cohort of Chinese CRC patients independent of perceived social support. Social relationship quality was unassociated with anxiety. RESEARCH IMPLICATIONS: Research on Chinese cancer patients should adjust for family relationship quality. CLINICAL IMPLICATIONS: Chinese patients with poor family relationships are more likely to be depressed, independent of perceived levels of social support.