Perceived Social Support as a Mediator Between Coping Strategies and Health–Related Quality of Life in Cancer Survivorship: An Explanatory Sequential Study
DOI:
https://doi.org/10.5281/zenodo.22587413Keywords:
cancer survivorship, coping strategies, perceived social support, health-related quality of life, explanatory sequential mixed methods, Filipino cancer survivorsAbstract
This study examined whether perceived social support mediated the relationship between coping strategies and health-related quality of life (HRQoL) among Filipino cancer survivors and explored the psychological and social experiences that explained the quantitative findings. An explanatory sequential mixed-methods design (QUAN→qual) was employed. In the quantitative phase, 108 adult cancer survivors (M age = 51.60 years) receiving care at a tertiary Department of Health-retained government hospital in Metro Manila were recruited through purposive sampling. The Multidimensional Scale of Perceived Social Support, Brief COPE, and SF-36 were administered. Descriptive statistics, Shapiro-Wilk tests, Spearman’s rho, and mediation analysis with 5,000 bias-corrected bootstrap resamples in AMOS were used. Ten participants from the quantitative sample joined the qualitative phase, where semi-structured interviews were analyzed thematically and integrated with the quantitative results. Religion (M = 3.787), acceptance (M = 3.741), and self-distraction (M = 3.745) were among the most frequently used coping strategies. Perceived social support was high overall, with family support highest (M = 26.16). HRQoL scores were higher for general health (M = 68.96) and social functioning (M = 66.20) but low for role-physical (M = 22.69) and role-emotional functioning (M = 20.99). Overall coping was not significantly related to physical or mental HRQoL. Coping significantly predicted perceived social support (B = 5.272, p = .001), but the indirect effect on HRQoL through perceived social support was not significant (B = -0.748, p = .882; 95% CI [-12.329, 11.218]). Five qualitative themes explained the findings: waves of emotions; adaptive and maladaptive coping; perceived social support; systemic barriers and financial constraints; and physical, psychological, and social challenges. The findings indicate that interpersonal support alone may be insufficient to improve HRQoL when financial and healthcare-system barriers remain substantial, underscoring the need for integrated physical, psychosocial, spiritual, and practical survivorship care.
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