Creating a supportive environment: social support, basic psychological needs, and social well-being among older cancer survivors

Thesis (Ph.D.)--University of Rochester. Margaret Warner Graduate School of Education and Human Development, 2018.The study outlined in this dissertation seeks to examine, from the perspective of selfdetermination theory (SDT, Deci & Ryan, 1985, 2000; Ryan & Deci, 2017), the contribution of social support and satisfaction of basic psychological needs in predicting social well-being among older cancer survivors. According to SDT, well-being is predicted on the basis of environmental conditions in which an individual is nested, by satisfying the basic psychological needs for autonomy, competence, and relatedness (Deci & Ryan, 2000). In recent years, the rise in the number of cancer survivors among older adults has generated interest in exploring not only the impact of cancer treatment, but also concerns related to the psychosocial aspects of cancer survivorship (Ernstmann et al., 2009; Feuerstein, 2007), which look at how psychological factors and the surrounding social environment influence the behavior and well-being of cancer survivors (Zimmermann, 2015). The sample for this study was derived from the third wave of the National Survey of Midlife Development in the United States (MIDUS) collected from 2013 to 2014 (Ryff et al., 2015). Participants consisted of 376 cancer survivors over 60 years old who have completed cancer treatment. The present study used three subscales from Ryff’s (1989) Psychological Wellbeing Scale (i.e., autonomy, environmental mastery, and positive relations with others), which closely resemble SDT’s concept of basic psychological needs (i.e., autonomy, competence, and relatedness), to examine cancer survivor’s need satisfaction. Toward that end, a panel of expert raters examined the items and exploratory factor analysis and confirmatory factor analyses were carried out to confirm the construct comparability and the factorial validity of these three subscales from Ryff’s (1989) Psychological Well-being Scale. Further, the present study also included the Social Support Scale (Walen & Lachman, 2000) to measure the quality of social support received by participants from their families and friends. Keyes’ (1998) Social Well-being Scale to examine cancer survivors’ appraisals of their own well-being and functioning in society (Keyes & Shapiro, 2004) was also employed. Data were analyzed using bivariate correlation and hierarchical regression analysis to determine the impact of social support and satisfaction of the three basic psychological needs on cancer survivors’ social well-being. The results of this study suggested that social support from family members and friends was a significant predictor of social well-being. Satisfaction of the basic psychological needs for competence and relatedness were also significant predictors of social well-being. Interestingly, the association between satisfaction of the three basic psychological needs and social well-being was found to be independent of social support from family members and friends. These results were discussed in terms of the various initiatives which look at older cancer survivors’ psychosocial well-being