Exploring the role of social support and adjuvant endocrine therapy use among breast cancer survivors
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Adjuvant endocrine therapy (AET) significantly reduces recurrence and mortality in women with estrogen receptor-positive breast cancer. Adherence to AET is about 50–60% for 5 years, and while numerous studies have identified barriers to AET adherence, few have identified the role of social support as a facilitator. Therefore, the objective of this study is to explore the role of social support during the ongoing management of AET.
We conducted semi-structured in-depth interviews with breast cancer survivors (n = 22) who filled a prescription for AET in the previous 12 months. Women were recruited from Los Angeles, California, and Houston, Texas, between 2014 and 2015. Interview questions prompted discussion about AET and how social support affects AET adherence. We analyzed interview transcripts with a grounded theory approach and grouped social support into four categories (emotional, informational, instrumental, and appraisal), then used a thematic content analysis to identify the sources and delivery of support.
Women described that informational support was provided by medical providers who explained the purpose, benefits, and management of AET. Emotional support in the form of reassurance, communication, and empathy was provided by family, survivorship groups, medical providers, and spirituality/religiosity. Women identified several organizations and exercises that provided them with instrumental and appraisal support in the form of physical and emotional benefits, which was also provided by family, friends, and medical providers.
We identified that social support delivered to breast cancer survivors provided women with educational, physical, and emotional benefits that may play an important role in their continuation of AET.
KeywordsSocial support AET adherence Emotional support Informational support Instrumental support Appraisal support
The authors would like to extend their gratitude to the study participants who provided insight and perspective, and without whom this work would not be possible.
This research was supported by a Ruth L. Kirschstein National Research Service Award for Individual Pre-doctoral Training grant from the National Cancer Institute F31 CA174338 (A Farias, Principal Investigator). This work was also supported in part by a Postdoctoral Fellowship, University of Texas School of Public Health Cancer Education and Career Development Program-National Cancer Institute/NIH Grant R25 CA57712. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.
Compliance with ethical standards
All procedures performed in this study involving human participants were in accordance with ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical approvals were obtained from the University of Washington Institutional Review Board.
Conflict of interest
The authors declare that they have no conflict of interest.
The authors have full control of all primary data and agree to allow the journal to review the data if requested.
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