Deckx Laura, van den Akker Marjan, Buntinx Frank
Department of General Practice, KU Leuven, Kapucijnenvoer 33, Bus 7001, 3000 Leuven, Belgium.
Department of General Practice, KU Leuven, Kapucijnenvoer 33, Bus 7001, 3000 Leuven, Belgium; Department of Family Medicine, Maastricht University, CAPHRI - School for Public Health and Primary Care, Peter Debeyeplein 1, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Eur J Oncol Nurs. 2014 Oct;18(5):466-77. doi: 10.1016/j.ejon.2014.05.002. Epub 2014 Jun 30.
To systematically review the literature on the severity and risk factors for loneliness in adult cancer patients.
We systematically reviewed quantitative studies addressing loneliness in cancer patients. Exclusion criteria were absence of a validated loneliness questionnaire, and studies that focused on loneliness determined by specific circumstances, and not cancer in general (e.g. appearance concerns, cultural and language barriers, requiring palliative care). We searched PsycINFO, CINAHL, Embase, Cochrane Library, and Pubmed in compliance with the predefined in- and exclusion criteria. The search, quality appraisal, and data extraction were performed by two independent reviewers. Weighted mean scores were calculated by using random effects adjusted inverse variance weighting.
We included 15 studies. In 13 studies the UCLA loneliness scale was used (range 20-80; higher scores indicate higher loneliness). The weighted mean loneliness score was 38.26 (95% CI: 35.51-41.00), which corresponds to moderate loneliness. Time since diagnosis was positively associated with degree of loneliness. Other cancer-related factors, such as cancer site, treatment type, or stage of disease were not associated with loneliness. The non-cancer related determinants of loneliness in cancer patients that emerged from our review were being unmarried (people who have never been married, are widowed or divorced), and lack of psychological or social support.
Our findings suggest that the level of loneliness rises with increasing time after cancer diagnosis. Furthermore, social functioning emerged as a consistent theme, for which it was shown that lack of social support was associated with increasing levels of loneliness.
系统回顾关于成年癌症患者孤独感的严重程度及危险因素的文献。
我们系统回顾了针对癌症患者孤独感的定量研究。排除标准为缺乏经过验证的孤独感问卷，以及聚焦于由特定情况而非一般癌症导致的孤独感的研究（例如外貌担忧、文化和语言障碍、需要姑息治疗）。我们按照预定义的纳入和排除标准检索了PsycINFO、CINAHL、Embase、Cochrane图书馆和Pubmed。检索、质量评估和数据提取由两名独立评审员进行。采用随机效应调整后的逆方差加权法计算加权平均得分。
我们纳入了15项研究。13项研究使用了加利福尼亚大学洛杉矶分校孤独感量表（范围为20 - 80；得分越高表明孤独感越强）。加权平均孤独感得分为38.26（95%置信区间：35.51 - 41.00），这对应于中度孤独感。确诊后的时间与孤独感程度呈正相关。其他与癌症相关的因素，如癌症部位、治疗类型或疾病阶段，与孤独感无关。我们的综述中出现的癌症患者孤独感的非癌症相关决定因素是未婚（从未结婚、丧偶或离婚的人）以及缺乏心理或社会支持。
我们的研究结果表明，癌症诊断后的时间越长，孤独感水平越高。此外，社会功能是一个一致的主题，研究表明缺乏社会支持与孤独感水平的增加有关。
