Association of social support, spirituality with psychological factors in Iranian breast cancer survivors: An evidence from a cross-sectional study.
Erfaneh Hajian-Tilaki, Karimollah Hajian-Tilaki, Dariush Moslemi and 2 others
PMID 34908246WHAT IT FOUND
Among Iranian breast cancer survivors, higher perceived social support was associated with lower depression and anxiety scores.
Spirituality showed no clear association, and after accounting for other factors neither was associated with fatigue.
Key findings
01Severe fatigue was reported by 44.3% of survivors, compared with severe anxiety in 11.6% and severe depression in 4.0%.
02Higher social support was associated with lower depression and anxiety scores after adjustment: each additional social support score was linked to a 0.06 lower depression score (95% CI -0.09 to -0.03) and a 0.04 lower anxiety score (95% CI -0.07 to -0.01).
03Spirituality showed no significant difference across levels of depression, anxiety or fatigue, and adjusted regression did not show significant associations of social support or spirituality with fatigue.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The cross-sectional design means the study cannot show that social support caused lower depression or anxiety, or that low support caused severe depression. All psychological measures were self-reported, so participants may have exaggerated or under-reported symptoms. The study was single-centre in Iran and excluded people with several serious conditions, recent bereavement or divorce, severe migraine or cognitive impairment, so results may not apply to all breast cancer survivors. Spirituality scores may have lacked variability because the sample had a homogeneous religious background, which could make it harder to detect an association. The authors reported a significant bivariate difference in social support across fatigue levels but no significant adjusted association with fatigue, so the fatigue finding is not clear.
Declared interests
Authors declared no conflict of interest. Funding was from Mazandaran University of Medical Sciences.
The easy way to misread this
Do not conclude that increasing social support or spirituality will reduce depression, anxiety or fatigue. This was a cross-sectional self-report study, so it only shows association; spirituality showed no clear independent association, and the adjusted fatigue association was not significant.