Coexistence of social isolation and loneliness and associated factors among colorectal cancer patients with permanent colostomy: A cross-sectional study.

PURPOSE: To examine the co-occurrence of social isolation and loneliness among colorectal cancer patients with a permanent stoma and its associated factors based on the ICF framework.

METHODS

A convenience sample of 469 patients was recruited from three tertiary Grade A hospitals in Shandong Province between November 2023 and December 2024. Data were collected using questionnaires on demographics, social isolation, loneliness, social participation, stigma, motivation for social connectedness, and family functioning. Multinomial logistic regression was used to identify factors associated with the co-occurrence patterns of social isolation and loneliness.

RESULTS

Social isolation and loneliness were reported by 59.2% and 47.8% of patients, respectively. Four co-occurrence patterns were identified: no social isolation and no loneliness (Class 1, 28.3%), social isolation but no loneliness (Class 2, 23.9%), no social isolation but loneliness (Class 3, 12.4%), and both social isolation and loneliness (Class 4, 35.4%). Higher social participation was associated with lower odds of belonging to all three vulnerable groups. Greater stigma increased the likelihood of belonging to the no social isolation but loneliness and coexistence groups. Higher motivation for social connection reduced the likelihood of belonging to the social isolation but no loneliness and coexistence groups. Better family functioning was associated with lower odds of belonging to the no social isolation but loneliness and coexistence groups.

CONCLUSION

Coexisting social isolation and loneliness was the most common pattern. The findings suggest that future assessment and supportive care should consider the heterogeneity of social isolation-loneliness patterns, with attention to social participation, stigma, motivation for social connectedness, and family functioning.