Journal of evaluation in clinical practice · 2025
Post-Surgery Loneliness and Its Influencing Factors in Elderly Patients With Breast Cancer: A Cross-Sectional Study.
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Lin Xian, Zhang Ying, Zhang Ruiying, Yang Shuai, Wang Lei, Shen Yanfeng, Sun Yuhang, Chen Cheng, Li Jie, Hao Xianjie
Аннотация
OBJECTIVE: To investigate the status of postoperative loneliness and factors influencing it in elderly patients with breast cancer.
METHODS: The questionnaire survey was conducted between 1 January 2022 and 31 October 2024 in our hospital to screen 229 elderly patients with breast cancer after surgery who met the inclusion criteria. The patients' general information was collected, and their General Alienation Scale, Fear of Disease Progression Scale (short form; FoP-Q-SF), 10-item Connor-Davidson Resilience Scale (CD-RISC10), Social Support Scale (PSSS), Social Constraints Scale (SCS) and General Self-Efficacy Scale (GSES) scores were compared.
RESULTS: Univariate analysis showed that the differences in social detachment scores among patients of different age groups, marital status, education level, per capita monthly income and surgical modality and whether or not they were receiving chemotherapy were significant (p < 0.001). Multifactorial analysis showed that age group, marital status, surgical modality and chemotherapy as well as their FoP-Q-SF, CD-RISC10, PSSS and SCS scores were all associated with loneliness in elderly patients with breast cancer. Structural equation modelling showed that social support (p < 0.001) and mental toughness (p < 0.001) negatively predicted social alienation, and social constraints (p < 0.001) and fear of disease progression (p < 0.001) positively predicted social alienation. Moreover, mental toughness (p < 0.001) and social support (p < 0.001) negatively predicted fear of disease progression. Social constraints negatively influenced mental toughness (p < 0.001), and social support positively influenced mental toughness (p < 0.001).
CONCLUSION: Loneliness in elderly patients with breast cancer is at a moderate level and needs to be improved by further research. Mental toughness, fear of disease progression, a history of chemotherapy and social constraints are influential factors in loneliness.
METHODS: The questionnaire survey was conducted between 1 January 2022 and 31 October 2024 in our hospital to screen 229 elderly patients with breast cancer after surgery who met the inclusion criteria. The patients' general information was collected, and their General Alienation Scale, Fear of Disease Progression Scale (short form; FoP-Q-SF), 10-item Connor-Davidson Resilience Scale (CD-RISC10), Social Support Scale (PSSS), Social Constraints Scale (SCS) and General Self-Efficacy Scale (GSES) scores were compared.
RESULTS: Univariate analysis showed that the differences in social detachment scores among patients of different age groups, marital status, education level, per capita monthly income and surgical modality and whether or not they were receiving chemotherapy were significant (p < 0.001). Multifactorial analysis showed that age group, marital status, surgical modality and chemotherapy as well as their FoP-Q-SF, CD-RISC10, PSSS and SCS scores were all associated with loneliness in elderly patients with breast cancer. Structural equation modelling showed that social support (p < 0.001) and mental toughness (p < 0.001) negatively predicted social alienation, and social constraints (p < 0.001) and fear of disease progression (p < 0.001) positively predicted social alienation. Moreover, mental toughness (p < 0.001) and social support (p < 0.001) negatively predicted fear of disease progression. Social constraints negatively influenced mental toughness (p < 0.001), and social support positively influenced mental toughness (p < 0.001).
CONCLUSION: Loneliness in elderly patients with breast cancer is at a moderate level and needs to be improved by further research. Mental toughness, fear of disease progression, a history of chemotherapy and social constraints are influential factors in loneliness.