Rendón Ana María Higuita, Medina Medina Angela, González Carolina Palacio, Gomez John Jairo Vargas, Limonero Joaquim T, Krikorian Alicia
Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana, Medellín, Colombia.
Clinica las Americas/AUNA, Instituto de Cancerologia, Medellin, Colombia.
Support Care Cancer. 2025 May 6;33(6):454. doi: 10.1007/s00520-025-09486-7.
Understanding how different factors contribute to suffering, particularly social ones, enables designing more comprehensive and evidence-based interventions. This study examined the relationship between suffering, loneliness, social interaction, and symptom distress in patients with advanced cancer.
The authors conducted a quantitative, observational, analytical cross-sectional study. Patients with advanced cancer attending a pain and palliative care unit of an oncology institution participated. Assessment instruments included PRISM (suffering), the UCLA Loneliness Scale, the Edmonton Symptom Assessment Questionnaire, and Cohen's Social Network Index (SNI). Univariate, bivariate, and multiple regression analyses were performed.
One-hundred forty-four patients participated, mostly women (68.1%), with a median age of 62 years, and 48.6% lived with a partner. About 75% reported moderate to severe suffering, 33% had clinically significant loneliness, and half reported a large social network and frequent interactions. Fatigue as the most common problem and well-being had a median score of 5. Suffering was significantly correlated with loneliness, pain, fatigue, depression, and anxiety, but not with levels of social interaction. According to the Multiple Regression Analysis, only loneliness showed a positive and significant contribution to suffering.
A high percentage of patients show significant suffering, and almost a third show clinical levels of loneliness. This contrasts with a relatively large social network with frequent interactions and a generally low symptomatic burden. Our findings indicate that loneliness influences the experience of illness, contributing to suffering. Future studies should delve deeper into the relationship between suffering and loneliness.
了解不同因素如何导致痛苦，特别是社会因素，有助于设计更全面且基于证据的干预措施。本研究探讨了晚期癌症患者的痛苦、孤独感、社交互动与症状困扰之间的关系。
作者开展了一项定量、观察性、分析性横断面研究。参与研究的是一家肿瘤机构疼痛与姑息治疗科的晚期癌症患者。评估工具包括PRISM（痛苦量表）、加州大学洛杉矶分校孤独感量表、埃德蒙顿症状评估问卷和科恩社交网络指数（SNI）。进行了单变量、双变量和多元回归分析。
144名患者参与了研究，其中大多数为女性（68.1%），中位年龄为62岁，48.6%的人与伴侣同住。约75%的患者报告有中度至重度痛苦，33%有临床显著的孤独感，一半患者报告社交网络庞大且互动频繁。疲劳是最常见的问题，幸福感的中位得分为5分。痛苦与孤独感、疼痛、疲劳、抑郁和焦虑显著相关，但与社交互动水平无关。根据多元回归分析，只有孤独感对痛苦有正向且显著的影响。
高比例患者存在显著痛苦，近三分之一患者有临床水平的孤独感。这与社交网络相对庞大、互动频繁以及总体症状负担较低形成对比。我们的研究结果表明，孤独感会影响疾病体验，导致痛苦。未来研究应更深入地探究痛苦与孤独感之间的关系。
