SOMEONE TO LIVE FOR - SOCIAL WELL-BEING, PARENTHOOD STATUS, AND DECISION-MAKING IN ONCOLOGY

Purpose: Little is known about the influence of social factors on trea tment preferences and desire for aggressive cancer therapy. The presen t study assessed subjective and objective social indicators in patient preferences for treatment. Methods: Cancer patients (N = 296) with di verse diagnoses and stages read sets of hypothetical vignettes describ ing patients with early-stage and advanced disease. in the first set, patients made decisions about treatment acceptance given varying level s of either increasing cure or extending survival, In the second set, the point at which patients shifted preferences from mild to severe tr eatment to improve likelihood of 1-year survival (switch point) was th e dependent measure, We assessed the impact of quality-of-life (QL) do mains measured by the Functional Assessment of Cancer Therapy-General (FACT-G), having children, marital status, and living arrangements on treatment preferences and switch points. Results: The Social Well-Bein g (SWB) subscale of the FACT-G predicted both treatment acceptance (P = .007) and switch point (P = .043) in the advanced-disease vignettes, with lower SWB associated with less aggressive preferences. Children living at home was likewise associated with more aggressive intent bot h in treatment preferences (P = .003, advanced-disease vignette) and s witch point (P < .001 and P = .001 for early- and advanced-disease vig nettes, respectively), Living with others predicted more aggressive in tent in the advanced-disease vignette (P = .03). Marital status did no t predict either treatment acceptance or switch point. Conclusion: Pos itive social well-being, as well as having children living at home, pr edicted patient willingness to accept aggressive treatment, Willingnes s to receive aggressive treatment may explain or mediate previously re ported salutory effects of social support on cancer outcomes. (C) 1995 by American Society of Clinical Oncology.