Does one person provide it all? Defining the social support of women with cancer

Abstract

8611 Background: Medical care encourages the appointment of a health care proxy in the event the patient cannot make decisions and it is assumed that this same person will serve other critical roles for the patient. Yet, this assumption that a patient truly relies on the same person for various supportive roles has never been formally evaluated. We hypothesized that there may be a large proportion of women with cancer who do not rely on the same person to be their primary support (PS), to participate in health care decision making as proxy (HCP), and serve as an emergency contact (EC). In order to evaluate this we conducted a questionnaire over a six-month period for women treated in the Program in Women’s Oncology (PWO). Methods: Patients seen at the PWO for a cancer diagnosis were invited to participate in a four part survey on social supports. Demographic data including age, race, cancer diagnosis, date of diagnosis, and current status were collected by chart review. Categorical variables were analyzed using Fisher’s Exact Test or Chi-square analysis. Results: Over 6 months, 224/228 women (98%) agreed to participate. The median age was 58 (range, 30–85). 138 (62%) had breast cancer, 78 (35%) had a gynecologic cancer, and 8 (3.5%) had a non-gyn/non-breast tumor (6/8 colorectal). 66% were married, 8% had a partner, and 26% did not identify a partner. In this sample, 43% did not name the same person as EC, PS, and HCP. 75% named the EC as HCP, 68% EC as PS, and 62% PS as HCP (p<0.05). Of married women (n=147) only 60% named their spouse to all three roles. Divorced women were not as likely to name a partner to one of these roles as were single women with partners. When asked to define primary support, women had diverse perspectives spanning the emotional, physical, intimate, and spiritual dimensions. Age did not appear to be a significant predictor of how these questions were answered. Conclusions: This study demonstrates the complex social support structures of women with cancer. Understanding these relationships may help to enable more effective patient-centered interventions designed to improve quality of care and ultimately the quality of life of cancer survivors. No significant financial relationships to disclose.