Cancer patients and their network: the meaning of the social network and social interactions for quality of life.

A lot of research is carried out on the subject of social relations and quality of life. One should find at least some indication for an association between the social environment and quality of life of cancer patients; will interventions be appropriate and well-considered? But until now, less has been known about the association between the social network of cancer patients and their quality of life. In this study, the way in which the patients' network can effect their quality of life is examined. Two patient groups are distinguished: a group of cancer patients recently treated for their cancer by surgery and a group treated by chemotherapy (n = 108 and n = 109) and these are compared with a disease-free group of cancer patients (n = 192). Although an association between network, social relations and quality of life is found, only a small part of the variation in quality of life can be explained by this social component. It seems that the cancer itself and the cancer treatment mainly affect the patients' quality of life and that the impact of the social environment is less significant.

The distinction between affect and cognition in the quality of life of cancer patients--sensitivity and stability.

The distinction between affect and cognition has been put forward to clarify the lack of differences found in studies describing quality of life under deteriorated circumstances, such as serious illness. In the study reported here, cancer patients under treatment (n = 201) were compared with a random sample from the normal population (n = 200). As hypothesized, the affective component of life quality turned out to be more severely impaired than the cognitive component. Besides, it was investigated which factors contribute to the affective and the cognitive component of the quality of life of cancer patients under treatment. In cancer patients affect proved more strongly related to the physical domain. Cognition on the other hand was more strongly related to coping resources, especially personality characteristics like the level of self-esteem. It is concluded that an affective measure of quality of life is more sensitive to change in patients. The stability of life quality is attributed to the rather strong relation the affective and the cognitive component both have to coping resources.

Quality of life in bone tumor patients comparing limb salvage and amputation of the lower extremity.

In 33 long-term survivors of lower extremity bone cancer quality-of-life data were studied following limb salvage compared to amputation. Self-report questionnaires, semistructured interviews and visual analog scales were used to measure psychoneurotic and somatical distress, activities of daily living, self-esteem, and adjustment to illness. Fourteen patients with limb salvage (age 13-56 years, median 24) and 19 patients with an amputation (age 21-53 years, median 27) were evaluated 2-17 years (median 10 years) after surgery. The differences between the two groups were not statistically significant. However, physical complaints were reported more often by limb salvage patients, whereas the amputees showed a trend toward lower self-esteem and isolation in social life, due to their disability. Both groups felt equal diminution of quality of life and disability as measured on the visual analog scale. These findings could support the cosmetic advantage of limb salvage compared to amputation.

The social experiences of cancer patients under treatment: a comparative study.

As part of a larger study on the quality of life of cancer patients under treatment, the positive and negative experiences in social interaction have been examined as compared to those of a control group (nonpatients, n = 201). Two patient groups were included: 109 patients who had recently undergone surgery and 108 patients receiving chemotherapy. The respondents returned a mailed questionnaire. Contrary to the assumptions based on a review from the literature, cancer patients appear to have more positive and fewer negative social experiences than a random sample from the 'normal' population. Even under more severe medical circumstances (a poor prognosis or heavy chemotherapy, a large number of chemotherapy cycles, poor progress after surgery) the poorer the patients, medically speaking, the more help and support they perceive. The results of this study do not support the idea of stigmatization. The personality characteristics, neuroticism and self-esteem are especially important for the having of positive and negative experiences in social interaction. Positive social experiences show a relationship with self-esteem and negative social experiences show a relationship with neuroticism.