Organization of psychosocial factors associated with worry about acquiring SARS-CoV-2 among women undergoing cancer treatment: an empirical network comparison approach

Abstract

Objectives:

Pandemic-induced anxiety can have adverse mental and somatic health consequences on cancer patients (CP). This study aimed to (1) explore the intricate relationships between worry related to potential SARS-CoV-2 infection, COVID-19 perception, sociodemographic factors, and the perceived effectiveness of lockdown measures and (2) investigate if these relationships differ between cancer patients and individuals without a history of cancer (IWHC).

Methods:

We conducted a cross-sectional quantitative study in France between December 1 and 14, 2020. Network analysis was employed on a sample of 1889 women, including 282 cancer patients and 1607 noncancer individuals.

Results:

Our findings indicate that CP were 20% more likely to express worry than IWHC. Anxiety is embedded within a complex network involving sociodemographic, cognitive, and emotional factors. The emotional components related to COVID-19 perception were found to play a crucial role. The networks for both groups were observed to be identical.

Conclusions:

Our study underscores the heightened vulnerability of cancer patients to pandemic-induced anxiety, emphasizing the crucial role of emotional components related to COVID-19 perception. The observed similarities in the anxiety network between cancer patients and those without a history of cancer suggest that universal approaches might be effective across groups.

Implications:

Utilizing the Causal Attitude Network Model, we propose potential methods for managing and reducing individual anxiety levels.

Keywords:

• anxiety reduction
• cancer
• network analysis
• psychosocial correlates
• woman

Acknowledgments

We want to thank Yannick Morvan, Camille Vansimaeys, and Quentin Barillot for our numerous exchanges on the theoretical-methodological approach to network analysis. Our thanks also go to the whole RAR2C project team and, of course, to everyone who accepted to answer our questionnaire.

Disclosure Statement

The authors have no funding or conflicts of interest to disclose.

Geolocation information

The research presented here concerns people living in France.

Authors’ contributions

Conceptualization: R. Mabire-Yon, A Le Bonniec, A. Siméone, M. Préau. Investigation: R. Mabire-Yon. Formal analysis: R. Mabire-Yon. Writing - Original Draft: R. Mabire-Yon, A Le Bonniec. Writing - Review & Editing: R. Mabire, A Le Bonniec, A. Siméone, M. Préau. Funding acquisition: M. Préau.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. The processing of personal data by the Seintinelles association relating to the constitution and management of a panel of people for research has been examined by the CNIL’s health division under no. 1688474. The study received a favorable opinion from the Inserm Ethical Evaluation Committee no. 20-682 on April 14, 2020.

Data availability

The datasets generated and/or analyzed in the course of this study are not publicly available due to rules imposed by the “Commission Nationale de l’Informatique et des Libertés” (CNIL; i.e., French data protection authority) but are available from the corresponding author upon reasonable request after authorization from the CNIL.

Consent to participate

Informed consent was obtained from all individual participants included in the study. Organization of psychosocial factors associated with worry about acquiring SARS-CoV-2 among women undergoing cancer treatment: an empirical network comparison approach.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Notes

1 To go out, only the following reasons were valid: a business trip (in case of impossibility of telecommuting), a health reason, shopping, a family emergency, childcare, an individual physical activity (close to home), to attend an exam, to go to a judicial or administrative summons or to walk a pet.

2 With reinforced sanitary protocols (the mandatory wearing of masks from 6-year old, in particular).

3 At the level of an attitude network, entropy designates the degree of alignment of evaluative reactions. To use Dalege’s example,30 the attitude towards snakes has a low entropy when all the ERs in its network are negative (e.g., snakes are considered useless and dangerous). Conversely, the entropy level would be higher if one of the ERs was positive and the other negative (e.g., snakes considered useful but dangerous).

4 If the nodes are cities, and the edges are roads connecting these cities, the “weight” of an edge would be like the amount of traffic between two cities. A higher weight means more traffic, which could be interpreted as a stronger relationship between the two cities. In a similar way, in a network model, a higher weight between two nodes means there is a stronger relationship between the two variables those nodes represent. This could mean that a change in one variable is likely to result in a significant change in the other variable. Conversely, a lower weight means there is a weaker relationship. A change in one variable might not result in a significant change in the other variable. It is important to note that the weight does not tell us about the direction of the relationship (i.e., whether one variable increases or decreases as the other changes), just the strength of the relationship. Also, the weight does not tell us about causality.

Additional information

Funding

This work was supported by the French National Research Agency and Cancéropôle CLARA – Lyon – France.