University of Arizona College of Nursing, Tucson, Arizona, USA.
University of Arizona Cancer Center, Tucson, Arizona, USA.
Cancer. 2023 Oct 1;129(19):2946-2965. doi: 10.1002/cncr.34934. Epub 2023 Jul 25.
Social isolation and connectedness are social determinants of health that have demonstrated effects on cancer-related outcomes. These constructs have been systematically evaluated among pediatric and older adult cancer populations. In this review, the authors evaluated the prevalence, correlates, and psychosocial implications of social isolation and connectedness among young adult (YA) cancer survivors aged 18-39 years.
Peer-reviewed articles published in English before June 2021 were identified from database searches and included articles' reference lists according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Included articles described studies that assessed social isolation and/or connectedness among YA cancer survivors.
In total, 5094 unique records were identified; 4143 were excluded after title/abstract screening, and 907 were excluded after full-text review. Forty-four articles were included. Few studies used validated measures or directly assessed social isolation or connectedness. Social isolation was similarly prevalent among YAs and older cancer survivors and noncancer populations. Demographic, clinical, and behavioral risk and protective factors for social isolation were identified. Social isolation was related to worse psychological well-being, whereas social connectedness was often, but not always, related to better psychological well-being.
This growing literature underscores the relevance of social isolation and connectedness as important health determinants among YA cancer survivors. The identified risk and protective factors can identify YAs who especially may benefit from screening for social isolation. Future studies are needed that directly, reliably, and validly evaluate social isolation and connectedness to inform the development of interventions to decrease isolation and increase connectedness.
社会隔离和联系是健康的社会决定因素，已证明对癌症相关结局有影响。这些结构已在儿科和老年癌症人群中进行了系统评估。在本综述中，作者评估了 18-39 岁年轻癌症幸存者中社会隔离和联系的流行率、相关性和心理社会影响。
根据 PRISMA（系统评价和荟萃分析的首选报告项目）指南，从数据库搜索中确定了发表在英语中的同行评审文章，并根据包括文章的参考文献列表。纳入的文章描述了评估年轻癌症幸存者社会隔离和/或联系的研究。
总共确定了 5094 条独特的记录；4143 条在标题/摘要筛选后被排除，907 条在全文审查后被排除。有 44 篇文章被纳入。很少有研究使用经过验证的测量方法或直接评估社会隔离或联系。社会隔离在年轻人和老年癌症幸存者以及非癌症人群中同样普遍。确定了社会隔离的人口统计学、临床和行为风险和保护因素。社会隔离与较差的心理健康有关，而社会联系通常但并非总是与更好的心理健康有关。
这一不断增长的文献强调了社会隔离和联系作为年轻癌症幸存者重要健康决定因素的相关性。确定的风险和保护因素可以识别出特别可能受益于社会隔离筛查的年轻人。需要进一步的研究，直接、可靠和有效地评估社会隔离和联系，为减少隔离和增加联系的干预措施的发展提供信息。
