School of Nursing, University of California San Francisco, San Francisco, California.
School of Medicine, University of California, San Francisco, California.
Cancer. 2021 Sep 1;127(17):3246-3253. doi: 10.1002/cncr.33603. Epub 2021 Apr 27.
Loneliness and social isolation are significant public health problems that are being exacerbated during the coronavirus disease 2019 pandemic. Little is known about the associations between loneliness and symptom burden in oncology patients before and during the pandemic. Study purposes include determining the prevalence of loneliness in a sample of oncology patients; evaluating for differences in demographic, clinical, and symptom characteristics between lonely and nonlonely patients; and determining which demographic, clinical, and symptom characteristics were associated with membership in the lonely group.
A convenience sample (n = 606) completed online surveys that evaluated the severity of loneliness, social isolation, and common symptoms (ie, anxiety, depression, fatigue, sleep disturbance, cognitive dysfunction, and pain) in oncology patients. Parametric and nonparametric tests were used to evaluate for differences in scores between the lonely and nonlonely groups. Logistic regression analysis was used to determine risk factors for membership in the loneliness group.
Of the 606 patients, 53.0% were categorized in the lonely group. The lonely group reported higher levels of social isolation, as well as higher symptom severity scores for all of the symptoms evaluated. In the multivariate model, being unmarried, having higher levels of social isolation, as well as higher levels of anxiety and depressive symptoms were associated with membership in the lonely group.
Study findings suggest that a significant number of oncology patients are experiencing loneliness, most likely as a result of mandate social distancing and isolation procedures. The symptom burden of these patients is extremely high and warrants clinical evaluation and interventions.
孤独和社会隔离是重大的公共卫生问题,在 2019 年冠状病毒病大流行期间日益加剧。在大流行之前和期间,孤独感与肿瘤患者症状负担之间的关联知之甚少。研究目的包括确定肿瘤患者样本中孤独感的患病率;评估孤独患者和非孤独患者在人口统计学、临床和症状特征方面的差异;并确定哪些人口统计学、临床和症状特征与孤独组有关。
采用便利样本(n=606)完成在线调查,评估肿瘤患者的孤独感、社会隔离和常见症状(即焦虑、抑郁、疲劳、睡眠障碍、认知功能障碍和疼痛)的严重程度。采用参数和非参数检验评估孤独组和非孤独组之间的评分差异。采用逻辑回归分析确定孤独组的危险因素。
在 606 名患者中,53.0%的患者被归类为孤独组。孤独组报告了更高水平的社会隔离,以及所有评估症状的严重程度更高。在多变量模型中,未婚、社会隔离程度较高以及焦虑和抑郁症状水平较高与孤独组的成员身份相关。
研究结果表明,相当数量的肿瘤患者正在经历孤独,这很可能是由于强制性的社交距离和隔离程序所致。这些患者的症状负担极高,需要进行临床评估和干预。