Asia-Pacific journal of oncology nursing · 2026
Social alienation among people with bladder cancer: A combined structural equation modeling and fuzzy-set qualitative comparative analysis.
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Yang Yixuan, Han Lu, Li Jie, Xue Jun, Wang Ting, Zhao Qiuzhi, Xie Cui, Wang Jiaping, Wang Xue, Fu Li
Аннотация
OBJECTIVE: People with bladder cancer may experience social alienation, which is associated with adverse psychosocial outcomes. This study investigates the complex factors and configurations associated with this condition.
METHODS: In this single-center cross-sectional study, 260 patients with bladder cancer from a Chinese tertiary hospital completed measures of family resilience, peer support, psychological distress, negative social expectations, and social alienation. Data were analyzed using structural equation modeling (SEM) and fuzzy-set qualitative comparative analysis (fsQCA).
RESULTS: SEM showed that family resilience (Estimate = -0.337, P = 0.001) and peer support (Estimate = -0.284, P = 0.022) were negatively associated with social alienation, whereas psychological distress (Estimate = 0.137, P = 0.049) and negative social expectations (Estimate = 0.278, P = 0.004) were positively associated with social alienation. Psychological distress and negative social expectations contributed to several indirect associations. The fsQCA identified no single necessary condition (all necessity consistencies < 0.90) and six configurations associated with high social alienation (overall solution consistency = 0.911, overall solution coverage = 0.54; configuration consistencies = 0.951-0.96), grouped into two broad profiles characterized by limited socioeconomic resources with negative social expectations, or psychological distress with limited expressive peer support.
CONCLUSIONS: Social alienation among patients with bladder cancer is characterized by multiple combinations of interpersonal and psychological conditions. These findings may inform profile-based assessment and the development of supportive-care hypotheses, but longitudinal and intervention studies are required before causal or treatment conclusions can be drawn.
METHODS: In this single-center cross-sectional study, 260 patients with bladder cancer from a Chinese tertiary hospital completed measures of family resilience, peer support, psychological distress, negative social expectations, and social alienation. Data were analyzed using structural equation modeling (SEM) and fuzzy-set qualitative comparative analysis (fsQCA).
RESULTS: SEM showed that family resilience (Estimate = -0.337, P = 0.001) and peer support (Estimate = -0.284, P = 0.022) were negatively associated with social alienation, whereas psychological distress (Estimate = 0.137, P = 0.049) and negative social expectations (Estimate = 0.278, P = 0.004) were positively associated with social alienation. Psychological distress and negative social expectations contributed to several indirect associations. The fsQCA identified no single necessary condition (all necessity consistencies < 0.90) and six configurations associated with high social alienation (overall solution consistency = 0.911, overall solution coverage = 0.54; configuration consistencies = 0.951-0.96), grouped into two broad profiles characterized by limited socioeconomic resources with negative social expectations, or psychological distress with limited expressive peer support.
CONCLUSIONS: Social alienation among patients with bladder cancer is characterized by multiple combinations of interpersonal and psychological conditions. These findings may inform profile-based assessment and the development of supportive-care hypotheses, but longitudinal and intervention studies are required before causal or treatment conclusions can be drawn.