June 15, 2016

Cancer survivors who have been treated with stem cell transplants generally need to rely on their partner, family, friends and others for a successful recovery. Some survivors have negative attitudes about using their social network, however, and that reluctance may be decreasing their quality of life.

These negative attitudes, collectively referred to as “negative social network orientation,” are the subject of a study co-authored by two researchers from the UNC Gillings School of Global Public Health.

Yael Symes

Yael Symes

Dr. Christine Rini

Dr. Christine Rini

Christine Rini, PhD, research associate professor, and Yael Symes, MSPH, doctoral student, both with the Department of Health Behavior at the Gillings School, also are members of UNC’s Lineberger Comprehensive Cancer Center. Their findings were published in the June 2016 issue of the journal Annals of Behavioral Medicine.

To learn more about the health consequences that can occur when survivors avoid relying on their social network during recovery, the researchers examined the association between 255 survivors’ social network orientation and their health-related quality of life.

The investigators found that having a more negative social network orientation – and therefore being less willing to use available social resources – was associated with having a lower quality of life.

Earlier research has shown that having a negative orientation is associated with having a smaller social network, less perceived support and fewer positive social interactions. Rini and Symes found these established associations in their study, but also looked at whether they could explain the link between negative social network orientation and lower health-related quality of life.

They found that transplant survivors who prefer not to use their social resources have worse quality of life in part because they expect low levels of support and often experience support as negative when they do receive it.

Because relying on others for help promotes better recovery from cancer treatment, the implications of this research suggest that transplant survivors with a negative orientation comprise a subgroup at special risk for poor outcomes.

Interventions to improve the health-related quality of life in these patients would likely focus on changing both their negative expectations about the social support available to them and their negative appraisals of the support they receive.

“In my work with stem cell transplant survivors, I noticed that some expressed discomfort with having to rely on their caregivers and others during recovery,” Rini says. “It struck me that it’s common to assume that getting more support after treatment is better for all survivors. Our findings draw attention to a subgroup of survivors who may need a different approach to help them recover after treatment.”

As alternatives, Rini suggests survivors could benefit from support from sources outside their immediate social network, such as support from fellow survivors. This kind of support may be available in support groups or through treatment centers.

This broader approach to social support, she explains, might help offset survivors’ concerns over reciprocity and place less psychological strain on both patients and caregivers.


Gillings School of Global Public Health contact: David Pesci, director of communications, (919) 962-2600 or dpesci@unc.edu


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