Contributors to and Correlates of Loneliness in Lung Cancer Patients

• Main Author: Hyland, Kelly A.
• Format: Others
• Published: Scholar Commons 2018
• Subjects: Depression; Psycho-oncology; Quality of Life; Stigma; Clinical Psychology
• Online Access: https://scholarcommons.usf.edu/etd/7308; https://scholarcommons.usf.edu/cgi/viewcontent.cgi?article=8505&context=etd

Background Loneliness, or the perceived discrepancy between the quantity and quality of ones’ actual social relationships and desired level of connectedness, is a potentially important psychosocial factor in lung cancer patients. The purpose of the current study was to investigate the relationship of loneliness to depressive symptoms, quality of life, and social-cognitive variables and to explore the role of loneliness in mediating relationships between social-cognitive variables and depressive symptoms and quality of life. Finally, the study examined whether loneliness predicted change over time in depressive symptoms and quality of life. Methods Lung cancer patients were recruited from the Moffitt Cancer Center Thoracic Oncology Clinic to complete two study questionnaires via hard copy or online. Participants completed measures of loneliness (UCLA V3), depressive symptoms, (CES-D) and quality of life (FACT-L) at baseline and 30 days later. Participants also completed measures of demographic characteristics and social-cognitive variables, including cancer-related stigma (CLCSS), cancer-related negative social expectations (CNSES), social constraint (SCS), avoidant coping (CRI – avoidant coping), and beliefs about one’s ability to cope with cancer (CBI-B) at baseline. Clinical characteristics were assessed via medical record review. Results Participants (n = 109) reported a low to moderate level of loneliness (M = 33.8), and 38% reported clinically significant (CES-D > 16) depressive symptoms. Quality of life in the current study (M = 98.1) was consistent with normative FACT-L data collected from a sample of lung cancer patients. Loneliness was positively correlated with depressive symptoms (r = .44) and negatively correlated with quality of life (r = -.59). In addition, loneliness was positively correlated with social-cognitive variables in the expected directions and social-cognitive variables were related to depressive symptoms and quality of life in the expected directions (p’s < .001). Mediation analyses yielded evidence for partial mediation, with loneliness mediating the relationships of social-cognitive variables with depressive symptoms and quality of life for nine of the ten models tested. The exception was findings showing that loneliness did not mediate the relationship between beliefs about one’s ability to cope with cancer and depressive symptoms. Loneliness at Time 1 predicted additional variance in depressive symptoms at Time 2 (Β = .38, Adj R2 = .31) after accounting for depressive symptoms at Time 1, but loneliness at Time 1 did not account for additional variance in quality of life at Time 2 after accounting for quality of life at Time 1. Conclusions Results suggest that consideration of loneliness is important in order to understand differences in depressive symptoms and quality of life in lung cancer patients. Beyond its direct impact on clinically relevant outcomes, the experience of loneliness may be the mechanism by which social-cognitive factors influence depressive symptoms and quality of life. Investigation of the relationship between stigma and loneliness in the context of lung cancer is particularly novel and warrants further exploration.