Loneliness and symptom burden in oncology patients during the COVID‐19 pandemic

Abstract

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Loneliness among adolescents and young adults with cancer during the COVID-19 pandemic: a cross-sectional survey

“…We identified that nearly half of the participants (52.2%) met the criteria for loneliness using the UCLA Loneliness Scale. Although this proportion is comparable to a prior study conducted on older adults with cancer during this pandemic, it is higher than the loneliness prevalence of 21–41% reported by pre-pandemic studies conducted among adults with cancer [ 18 , 19 , 26 , 27 ]. This proportion is also substantially higher than the 29% prevalence of loneliness reported among young adults (18–39 years) during the COVID-19 pandemic by a survey conducted by the Centre for Addiction and Mental Health (CAMH) in November 2020 in Canada [ 28 ].…”

“…The presence of high degrees of loneliness and social isolation has been a longstanding issue in AYAs with cancer, but the rising rates during the pandemic as highlighted by our study demonstrate the particular vulnerability of this population to the situations that limit their ability to maintain social connectivity [ 18 , 19 , 26 , 27 ]. As most AYAs with cancer live 50–60 years past their cancer diagnosis with current treatment regimens, and that self-reported loneliness has been associated with increased morbidity and mortality, it is concerning that so many AYAs with cancer identified as lonely in our study [ 9 , 15 ].…”

“…Both before and during the pandemic, being unmarried or unpartnered was identified as a significant risk factor for loneliness among individuals with cancer [ 13 , 19 ]. This association was held in our study, with participants not currently in a relationship being two times more likely to experience loneliness than those in a relationship.…”

“…A recent study of adults with cancer from the USA also identified that 53% were feeling lonely during this pandemic. However, the older age of the study population (median age = 62.7 years) and the inclusion of mostly females with breast cancer limited the generalizability of that study to AYAs with cancer, who have different social and developmental needs and cancer types and treatments compared to older adults [ 18 , 19 ]. Quantifying loneliness experienced by AYAs with cancer and determining which AYAs with cancer are at greater risk of experiencing loneliness during this pandemic can provide vital information to address this unmet need.…”

Post‐traumatic stress symptomatology and adjustment of medical oncology practice during the COVID‐19 pandemic among adult patients with cancer in a day care hospital

“…30 A 5-point Likert scale is used to rate each item from 0 (no problem) to 4 (very severe problem). The total score ranges from 0 to 28 and is interpreted as follows: absence of insomnia (0-7), subthreshold insomnia (8)(9)(10)(11)(12)(13)(14), moderate insomnia (15)(16)(17)(18)(19)(20)(21), and severe insomnia (22)(23)(24)(25)(26)(27)(28).…”