Health-related quality of life, social support and social capital of mothers of children with cancer

Abstract

Background/Objectives: The diagnosis of childhood cancer is particularly stressful with adverse health effects for all the family. Social support and the wider social context can act as buffer, perhaps as long as the support provided is appropriate (stressor-specific hypothesis). Aim: Investigate the health-related quality of life (HRQoL) of Greek-Cypriot mothers of children with cancer (MCC) and assess its association with perceived social support and social capital, as compared to mothers of healthy children (MHC). Design/Methods: A descriptive comparative and correlational study of HRQoL (SF-36 survey) with 52 MCC (93% response) from the only paediatric oncology referral center on the island compared to 208 mothers of age/gender matched healthy children in the absence of population norms. In each group, the magnitude of the association of HRQoL with perceived social support (MOS-SSS) and social capital (SCQ) was assessed and compared in linear regression models. Results: Significantly reduced scores on the SF-36 Mental Health Component and all four domains (effect sizes -0.4 to -0.7 SD, p<0.01) were observed among MCC. While social support was positively associated with mental health among MHC (1.62 95% CI=1.02, 2.23 per 10 unit increase in social support score), no similar association was observed in MCC (0.08 95% CI=-1.16, 1.32); p for effect modification=0.03. A similar picture emerged in terms of social capital. In contrast, there was a strong association of social support and social capital with Physical Health in both study groups, and somewhat stronger among MCC. Conclusion: Whilst in the general population HRQoL is positively associated with social support and social capital, the potential protective effect among MCC appears to be restricted to the physical, and not mental health, which is particularly poor. There is need to design and evaluate psychosocial programs targeted to the individual needs of these families in an integrated framework which combines professional and informal support.