Opinion: Social Support is Key to Endometrial Cancer Recovery

Amanda Brink, DNP, APRN, FNP-BC, AOCNP

Oncology nurses provide care at every stage of the cancer journey, from diagnosis to survivorship. While the end of active treatment often brings relief, the transition to survivorship can present new challenges, including uncertainty, lingering physical symptoms, and emotional stress.

By understanding these how social support and physician-patient communication impact quality of life (QOL), oncology nurses can better support patients during this often stressful transition, ultimately improving their quality of life.

Impact of Social Support on Quality of Life in Patients with Endometrial Cancer

Mandato et al. explored the influence of social support and physician-patient communication on QOL and emotional well-being in patients with endometrial cancer during the first year post-surgery. The study examined how different forms of social support (from family, friends, and significant others) and communication quality with healthcare providers affected patients' recovery.

The study included 127 patients, 98 of whom returned completed questionnaires at 1 month and/or 1 year post-surgery. The Short Form-36 (SF-36) and Multidimensional Scale of Perceived Social Support (MSPSS) were used to evaluate emotional well-being and social support, respectively. Clinical factors such as comorbidities, body mass index (BMI), cancer grade, type of surgery, and adjuvant therapies were analyzed in relation to QOL scores.

Patients reporting high social support 1 month after surgery had significantly higher emotional well-being at both 1 month and 1 year post-surgery (P < .05). High perceived social support 1 year post-surgery was associated with better general health scores (P < .05). Family support was linked to higher social functioning scores at one month and fewer emotional limitations at 1 year (P < .05).

Support from significant others at 1 year was associated with improved physical functioning, reduced pain, less fatigue, and better general and emotional well-being (P < .005 for physical functioning; P < .05 for other measures). Additionally, higher social support levels were correlated with fewer medical visits during the year post-surgery.

Conversely, patients with comorbidities, such as hypertension and diabetes, reported higher levels of overall pain 1 year after surgery. Those with a BMI above the median exhibited lower physical functioning and general health scores at one year. Patients with grade 3 endometrial cancer had lower social functioning scores compared to those with grade 2 endometrial cancer, while those with grade 2 endometrial cancer had higher general health scores compared to grade 1 endometrial cancer.

Furthermore, patients who underwent minimally invasive laparoscopy, which uses small incisions, but were converted to laparotomy, a more invasive open surgery with larger incisions, and those with longer surgery durations, reported lower physical function scores at one year. Conversely, longer hospital stays were associated with higher general health scores, and postoperative complications correlated with higher energy and fatigue scores.

Patients who received brachytherapy alone had better physical role functioning compared to those who received both brachytherapy and external beam radiation therapy (EBRT) one-month post-surgery.

Regarding communication during diagnosis, 59.8% of patients had a family member present. The majority (75.3%) received their diagnosis in a gynecological oncology clinic, and 85.6% felt that the time allotted for communication was adequate. Most patients (82.5%) found the communication to be empathetic and supportive, and 91.8% felt their privacy was protected.

Nursing Considerations

Patients with longer hospital stays, often associated with more severe conditions or complications, surprisingly reported higher general health scores one year after surgery. This may reflect a sense of resilience or improved well-being following recovery from more serious health challenges. Additionally, patients who experienced postoperative complications reported higher energy and fatigue scores, indicating that, despite the setbacks, they felt more energetic and vital. These findings suggest that overcoming significant health hurdles may foster a greater sense of vitality and general health in the long term.

This study underscores the vital role of SS and physician-patient communication in improving the QOL and emotional well-being of endometrial cancer patients. Those who felt supported by family, friends, and significant others reported better physical, social, and emotional functioning in the months following surgery. Empathetic, clear communication from healthcare providers also played a key role in helping patients manage their emotional health and navigate the complexities of diagnosis and treatment.

For oncology nurses, these findings highlight the importance of fostering open, empathetic communication with patients. Dedicating time to discussing diagnosis, treatment options, and postoperative care, and involving family members when appropriate, can enhance the support system crucial to patient well-being.

References

1. Mandato VD, Paterlini M, Torricelli F, Rabitti E, Mastrofilippo V, Aguzzoli L. Perceived social support and quality of life in endometrial cancer patients: a longitudinal study. Front Oncol. 2024;14:1447644. Published 2024 Aug 2. doi:10.3389/fonc.2024.1447644