Available online 27 March 2024, 151623

Author links open overlay panel, , , , , AbstractObjectives

To describe cancer survivors’ and care partners’ perceived stress and social support during the COVID-19 pandemic and assess the feasibility of audio diaries for assessing role-related needs and resources.

Methods

Participants (N = 51; n = 28 survivors, n = 23 care partners) recorded three monthly audio diaries reporting stress and support experiences. Diaries were transcribed and content-analyzed using a hybrid approach. Stress-related content was inductively coded, and social support content was deductively coded by type (instrumental, information, emotional, companionship, appraisal; κ = 0.75) then inductively coded. Descriptive statistics summarized sociodemographic data and compared coding frequencies by role. We developed narrative summaries of stress and support categories and selected quotes for contextual detail.

Results

Cancer-related stressors were most prevalent (28.8%), followed by work (26.8%), family (23.1%), social isolation (13.4%), and finances (8.0%). While no significant difference in reporting frequency was observed between roles, cancer-related stress was more prevalent for survivors while work-related stress was mentioned more by care partners. Emotional support was the most prevalent support type (32.1%), followed by companionship (25.3%), appraisal (17.9%), instrumental (16.67%), and informational support (8%). Survivors reported more appraisal support than care partners (χ2 = 6.48, df = 1, P = .011) and more support for self-care, while care partners expressed more other-oriented concerns and focused more on managing responsibilities and interactions outside the household.

Conclusions

The pandemic complicated and intensified role-based stressors already present in the survivorship context. Our findings highlight the importance of informal social support networks, particularly when access to formal services is limited, and suggest that audio diaries can be an effective tool for assessing support needs and resources.

Implications for Nursing Practice

Nurses and healthcare providers should tailor social support assessments to address the distinct support needs and individual resources of cancer survivors and their care partners. This is especially critical in contexts that limit access to care and formal services.

Section snippetsImpact of COVID-19 Pandemic on Cancer Survivors and Care Partners

The onset of the COVID-19 pandemic in the United States introduced a host of unanticipated challenges and constraints on daily life, including changes in routine social interaction patterns, that attenuated connection and support for many people across populations.29 Recent studies suggest that having adequate social support played a protective role for cancer survivors during the pandemic.30 Health and safety concerns and social isolation, however, increased while routine access to multiple

Study Purpose

We sought to better understand the stress and social support needs experienced by cancer survivors and their care partners during the pandemic, including whether there were any role-based differences in stress and support and how these were expressed. Specifically, we described survivors’ and care partners’ main sources of stress and support from October 2020 through April 2021 and examined similarities and differences in prevalent concerns. We used audio diaries, a novel approach to capturing

Methods

We conducted a prospective mixed methods study examining characteristics of support interactions within the social networks of cancer survivor and care partner dyads during the pandemic. We measured participants’ social network data at baseline, collected their reports of interactions with network members over 10 weeks, and participants completed monthly audio diaries. The diaries also helped us better understand the function of participants’ support systems by providing important context and

Demographics

Most participants who opted to contribute diaries were White (n = 49 [96%]), non-Hispanic (n = 47 [92%]), women (n = 30 [59%]), and the spouse or partner of the other dyad study participant (n = 30 [59%]). All had at least some college education, and the average age was 44.7 years (range = 19-76, SD = 18.04). Table 1 presents demographics for the sample by role.

Diary Completion Rate

Of the 64 participants in the prospective network interaction study, 51 (79.9%) opted into recording audio diaries (n = 28, 87.5% of

Discussion

Our main purpose was to describe and compare prevalent stressors experienced by cancer survivors and their care partners during the COVID-19 pandemic when access to more formal sources of support, and thus ways of assessing needs, was limited. We also sought to describe support resources within their social networks, including types of support and the relationships and dynamics in which support was enacted. We examined survivor and care partner experiences in relation to each other, including

Conclusion

During the COVID-19 pandemic, cancer survivors and their care partners experienced shared sources of stress, with role-based distinctions that pointed to different support needs. Survivors’ predominantly faced cancer-related stress whereas care partners focused more on managing external responsibilities and reported significantly less appraisal support. These stressors, exacerbated by limited access to providers and other formal support services, highlight the crucial role of personal social

CRediT authorship contribution statement

Kristin G. Cloyes: Writing – review & editing, Writing – original draft, Supervision, Resources, Project administration, Methodology, Investigation, Funding acquisition, Formal analysis, Data curation, Conceptualization. Kelly J. Mansfield: Writing – review & editing, Writing – original draft, Project administration, Investigation, Formal analysis. Sarah E. Wawrzynski: Writing – review & editing, Writing – original draft, Formal analysis. Marilisa Vega: Writing – review & editing, Writing –

Declaration of competing interest

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Sarah Wawrzynski reports financial support was provided by National Institute of Nursing Research. Jacqueline Kent-Marvick reports financial support was provided by National Institute of Nursing Research.

Funding

This work was supported by the University of Utah Immunology, Inflammation and Infections Disease, Vice President of Research Office COVID-19 Special Emphasis Seed Grant. Dr. Mansfied's efforts were supported in part by NIH T32NR013456. Dr Wawrzynski's efforts were supported in part by NINR F31NR018987. Ms. Kent-Marvick's efforts were supported in part by NINR F31NR020431. This study was also supported by the National Center for Advancing Translational Sciences of the National Institutes of

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