The Relationship between Social Constrains, Social Isolation, Family Environment, Self-Efficacy, and Depressive Symptoms among Breast Cancer Patients in China

Abstract Background: For female breast cancer patients, the psychological status after surgery, especially the social and family psychological related factors, deserves more attention. This study analyzed the influence of social constrain, social support, social isolation, family conflict, family emotion expression on depression. At the same time, this study conducted the relationship between the variables and the mechanism of action. Methods: 522 breast cancer patients finished questionnaires consisting of Self-Rating Depression Scale (SDS), General Self-Efficacy Scale (GSES), Multi-Dimensional Scale of Perceived Social Support (MSPSS), Social Constraints Scale-5(SCS-5), Family Environment Scale(FES), and Lubben Social Network Scale (LSNS-6). Multivariable Logical Regression was used to explore influencing factors. Pearson’s Correlation, Hierarchical Regression and Simple Slope Analysis were conducted to verify the role of self-efficacy. Results: 71.6% of patients had depressive symptoms. Family contradiction (OR=10.086), social constrain (OR=2.522), social isolation (OR=2.507), and high blood glucose (OR=2.156) were risk factors of depressive symptoms. Family emotional expression (OR=0.480), family intimacy (OR=0.235), and self-efficacy (OR=0.246) were protective factors against depressive symptoms. The interactive items interpretation quantity was as follows: Contradiction*Self-efficacy (ΔR2=2.3%, P<0.001), Emotional expression*Self-efficacy (ΔR2=2.6%, P<0.001), Intimacy*Self-efficacy (ΔR2=1.0%, P=0.018), Social constrain*Self-efficacy (ΔR2=1.0%, P=0.008), Social networks*Self-efficacy (ΔR2=1.0%, P=0.010), Blood Glucose*Self-efficacy (ΔR2=0.6%, P=0.023). The influence of independent variables on depressive symptoms were gradually decreased in the low, mean and high groups of self-efficacy. Conclusion: Postoperative Chinese breast cancer survivors reported higher depressive symptoms. Social, family, and physiological factors can affect depressive symptoms, in which self-factor played moderator roles.