Leisure-time physical activity and perceived stress mediated the impact of social support on depressive symptoms among breast cancer survivors
Bibliographic record
Abstract
Objective: Models of interpersonal behaviours suggest that social support may foster both the reduction in stress and the adoption of health protective behaviours [e.g., leisure-time physical activity (LTPA)], which may improve mental health. Therefore, this study assesses whether change in both perceived stress and LTPA mediate the association between change in social support and change in depression symptoms among breast cancer survivors (BCS). Methods: Adult BCS (N = 199) volunteered for the study. Approximately six months following the completion of systemic treatments, social support, LTPA, perceived stress, pain symptoms, and depressive symptoms were self-reported at the beginning (baseline) and the end (follow-up) of a 6-month period using reliable and valid questionnaires. Given that pain symptoms tend to co-occur with depressive symptoms in BCS, they were controlled in the analysis along with age, education, body mass index, stage of breast cancer and time since diagnosis. Multiple regression analyses were performed using residual change scores. Bias –corrected and –accelerated bootstrap estimates (5000 bootstrap samples) with 95% confidence intervals (BCa 95%CI) were obtained for the mediated effects. Multiple imputation was used to account for lost to follow-up (25%). Results: An increase in social support leaded to a decrease in depressive symptoms. This effect was mediated by change in both LTPA (indirect effect = -0.03 [-0.06, -0.001]) and perceived stress (indirect effect = -0.07 [-0.09, -0.05]). Moreover, the percentage of explained variance in the main model [F(9,189) = 13.02; p < 0.0001] was 38%, and results from multiple imputation and complete cases analysis were similar. Conclusions: Participation in LTPA and reduction in perceived stress are two pathways through which social support contributes to lower depressive symptoms in BCS. Therefore, social support represents a valuable intervention target for improving mental health in the aftermath of breast cancer. Acknowledgments: This study is funded by a CIHR operating grant awarded to Dr. Catherine M. Sabiston (PI) and Dr. Carsten Wrosch (CO-I)
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".