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Increased Loneliness Among Patients With Cancer During the COVID-19 Pandemic May Affect Symptom Burden


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Loneliness and social isolation have been significant problems for the general population during the COVID-19 pandemic, but for patients with cancer, these issues were particularly acute, likely due to isolation and social distancing, according to a recent study published by Miaskowski et al in the journal Cancer.

"We found that oncology patients were experiencing a deep sense of loneliness," said first author Christine Miaskowski, RN, PhD, a Professor in the UCSF School of Nursing. "For these patients, the burden of their symptoms is extremely high, and oncology clinicians can suggest a number of strategies to help them. Patients should be encouraged to maintain contact with family and friends, and structure their daily routines when possible—through outdoor activities, for example—as well as to maintain a healthy diet and sufficient sleep. These suggestions might mitigate some of the negative effects of loneliness."

More Findings on Loneliness From the Survey

The survey, administered in late May 2020, evaluated the severity of loneliness, social isolation, and related symptoms—such as anxiety, depression, fatigue, sleep disturbance, cognitive dysfunction, and pain—in a sample of 606 patients with cancer.

KEY POINTS

  • 53% were categorized as the lonely group, which was higher than the range reported prior to the pandemic (32% to 47%).
  • The lonely group was significantly more likely to be younger than the nonlonely group, and less likely to be married or partnered. They also had a higher number of comorbidities and were more likely to report a diagnosis of depression and back pain.
  • Lower levels of household income were associated with higher levels of loneliness.

Altogether, 53% were categorized as the lonely group, which was higher than the range reported prior to the pandemic (32% to 47%). About a third had moderately high degrees of loneliness, and 5.3% reported high levels of depression.

The lonely group was significantly more likely to be younger than the nonlonely group, and less likely to be married or partnered. They also had a higher number of comorbidities and were more likely to report a diagnosis of depression and back pain.

Older patients reported lower levels of loneliness, while patients aged 50 to 59 reported higher levels. The researchers believe older adults adapted their need for social contact to available opportunities.

Lower levels of household income were associated with higher levels of loneliness. The authors suggested that people at higher incomes have "more opportunities to engage in social activities and reciprocate in social relationships."

Nearly 83% of the patients in the lonely group suffered from breast cancer, a third were currently in cancer treatment, and a quarter had metastatic disease. Nearly 92% of the participants were female—as a result, no conclusions could be drawn about sex differences, the authors said.

Primarily, the participants were White, well-educated, and had an annual income exceeding $60,000. As such, the authors said, their findings may not fit all patients with cancer, and symptoms could be higher in patients who are socioeconomically disadvantaged.

Disclosure: For full disclosures of the study authors, visit acsjournals.onlinelibrary.wiley.com.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
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