Loneliness as a mediator of the relationship of social cognitive variables with depressive symptoms and quality of life in lung cancer patients beginning treatment

Abstract

Objective Loneliness, or the discrepancy between perceived and desired level of social connectedness, is an understudied but important psychosocial factor in cancer patients. The current study investigated the relationship between loneliness, depressive symptoms, quality of life, and social cognitive variables (eg, stigma, social constraint, and cancer‐related negative social expectations), and explored loneliness as a mediator of the relationship between social cognitive variables and depressive symptoms and quality of life in lung cancer patients beginning treatment. Methods Patients within 3 months of beginning treatment for lung cancer completed measures of loneliness, depressive symptoms, quality of life, and social cognitive variables. Correlational, chi‐square, and hierarchical regression analyses evaluated relationships among variables. Bias‐corrected bootstrapping methods estimated the indirect effect and 95% confidence interval for mediation models. Results Participants (n = 105, M = 65.5 years, 55% female) endorsed low to moderate levels of loneliness. Greater loneliness was associated with greater depressive symptoms and worse quality of life (P's < .001), and loneliness explained unique variance in depressive symptoms (F = 10.18, P < .001, ΔR2 = .06, Total R2 = .35) and quality of life (F = 19.55, P < .001, ΔR2 = .05, Total R2 = .52) after controlling for significant covariates. Greater stigma, social constraint, and cancer‐related negative social expectations were associated with greater loneliness and depressive symptoms and worse quality of life (P's < .001). Loneliness partially mediated the relationship of social cognitive variables with depressive symptoms and quality of life. Conclusions Beyond its direct impact on clinically relevant outcomes, the experience of loneliness may be a mechanism by which social cognitive factors influence depressive symptoms and quality of life in lung cancer patients.

Behavioral and psychosocial responses of people receiving treatment for advanced lung cancer during the COVID‐19 pandemic: A qualitative analysis

“…However, these emotions may be particularly challenging for patients with a history of anxiety or depression, or who are already experiencing heightened distress related to cancer. Greater loneliness has been associated with worse quality of life and greater depressive symptomology in lung cancer patients, highlighting the potential negative consequences of COVID‐19‐related isolation for patient wellbeing 9 . Clinicians should regularly screen for symptoms of distress and loneliness using brief, validated measures 10 and continue to refer patients to psychosocial services when appropriate.…”

Perspectives of cancer patients during the COVID‐19 outbreak in Israel: The long‐term implications on support and well‐being in an exploratory qualitative study

“…A paper published recently by oncologists presents the psychological challenges cancer patients have faced during the pandemic, including loneliness, fear, conflicts regarding treatment, feeling helpless, frustration, anger, sadness and depression (Garutti et al, 2020 ). Loneliness has been associated with a decrease in quality of life and depressive symptoms in lung cancer patients (Hyland et al, 2019 ).…”

Influence of loneliness and social isolation on the diagnosis and treatment of Japanese patients with advanced lung cancer: a prospective cohort study

“…western countries (5)(6)(7)(8)(9)(10). However, this is the first study conducted in East Asia, especially in the field of lung cancer.…”

“…A systematic review indicated that social isolation and loneliness were associated with higher mortality rates, regardless of whether they were linked to underlying medical conditions (5). Hyland et al also reported that loneliness might be a manifestation of depressive symptoms and low quality of life (6). Social isolation also has mental and physical effects.…”