# Perceived Social Support and Depressive Symptoms in AYA Cancer Patients: A Mediation Analysis of Hope Agency and Pathways

## TL;DR

This study finds that the belief in one's ability to achieve goals (agency) explains how social support affects depression in young women with cancer, but not in men.

## Contribution

The study identifies agency as a mediator between social support and depressive symptoms in AYA women with cancer, highlighting gender-specific differences.

## Key findings

- The agency component of hope mediates the relationship between perceived social support and depressive symptoms in AYA women with cancer.
- The pathways component of hope does not mediate the relationship between perceived social support and depressive symptoms in AYA cancer patients.

## Abstract

What are the main findings?
The agency component of hope mediates the relationship between perceived social support (PSS) and depressive symptoms (D) in adolescent/young adult (AYA) women with cancer.The pathways component of hope did not mediate the relationship between PSS and D in AYAs with cancer.

The agency component of hope mediates the relationship between perceived social support (PSS) and depressive symptoms (D) in adolescent/young adult (AYA) women with cancer.

The pathways component of hope did not mediate the relationship between PSS and D in AYAs with cancer.

What are the implications of the main findings?
Given the significantly higher prevalence of depression in AYA women with cancer as compared to men, interventions to enhance agency are an important adjunct to interventions to promote PSS and, in turn, reduce D in AYA women with cancer.Future studies, including qualitative studies, should strive to elucidate the nature of social support’s influence on hope (both agency and pathways), such as whether specific types of social support (emotional, esteem, informational, network, and tangible) are particularly related to hope or agency, or whether AYA women’s unique social connections or specific factors of social support are most influential on agency.

Given the significantly higher prevalence of depression in AYA women with cancer as compared to men, interventions to enhance agency are an important adjunct to interventions to promote PSS and, in turn, reduce D in AYA women with cancer.

Future studies, including qualitative studies, should strive to elucidate the nature of social support’s influence on hope (both agency and pathways), such as whether specific types of social support (emotional, esteem, informational, network, and tangible) are particularly related to hope or agency, or whether AYA women’s unique social connections or specific factors of social support are most influential on agency.

Background/Objectives: Adolescent/young adult (AYA) cancer patients experience a variety of challenges, including higher rates of depressive symptoms (D) than healthy controls. Although various forms of social support (SS) seem to be a protective factor against D, AYAs also experience significant disruptions to SS. Snyder’s hope theory involves two interrelated components: agency (the belief in one’s ability to initiate or sustain action toward a desired goal) and pathways (the belief in one’s ability to produce workable routes to desired goals). Because hope, particularly the agency component, has been linked to both SS and D, it may mediate the relationship between the two. Methods: An online questionnaire was completed by AYA cancer patients (N = 205) in which they self-reported levels of perceived social support (PSS), hope, and D, among other scales and demographic variables. A parallel mediation model was conducted to determine if either or both agency and pathways explain the relationship between PSS and D. Results: Agency mediated the relationship between PSS and D in AYA women with cancer, but not men. Pathways did not mediate the relationship between PSS and D. Conclusions: Given the significantly higher prevalence of depression in women with cancer as compared to men, interventions to enhance agency are an important adjunct to methods to promote PSS in AYA women with cancer.