Alleviating the burden: The impact of interpersonal and digital communication on depressive symptoms in cancer survivors.

Abstract

Depression is common among cancer survivors, yet communication processes that may alleviate or exacerbate distress remain underexplored. Guided by the Ecological Model of Communication in Medical Encounters, this study examines how interpersonal and digital communication are associated with depressive symptoms among cancer survivors. Data were drawn from the 2024 Health Information National Trends Survey (HINTS 7) and included 827 cancer survivors. Depressive symptoms was the outcome. Communication variables included talking about health concerns with friends and family, patient-centered communication (PCC) with healthcare providers, and online support group engagement. Two weighted binary logistic regression models were fitted to explore the objective. In the unadjusted model, higher levels of PCC and talking about health with friends and family were associated with lower odds of depressive symptoms, whereas frequent online support engagement was associated with higher odds. In the adjusted model, PCC remained protective (aOR = 0.47, 95% CI [0.30, 0.74], p = .003), while frequent online engagement remained associated with higher odds of depressive symptoms (aOR = 3.21, 95% CI [1.13, 9.11], p = .036). Fair or poor self-rated health was the strongest predictor (aOR = 7.86, 95% CI [3.18, 19.44], p < .001). Income below $20 K, younger age, and being 2-5 years post-diagnosis were also significant. Clinical communication is an essential resource for cancer survivors' mental health. While communication-based social support may be beneficial in everyday contexts, the extent of online engagement among cancer survivors needs more guidance and attention for better mental health outcomes.