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Cancer-related loneliness mediates the relationships between social constraints and symptoms among cancer patients

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Abstract

Cancer patients have high rates of persistent and disabling symptoms. Evidence suggests that social constraints (e.g., avoidance and criticism) negatively impact symptoms, but pathways linking these variables have yet to be identified. This study examined whether cancer-related loneliness (i.e., feeling socially disconnected related to having cancer) mediated the relationships between social constraints and symptoms (i.e., pain interference, fatigue, sleep disturbance, and cognitive complaints) in patients with various cancers (N = 182). Patients (51% female, mean age = 59) were recruited from the Indiana Cancer Registry and completed questionnaires assessing social constraints, cancer-related loneliness, and symptoms. Structural equation modeling was used to evaluate the hypothesized relationships among variables. The model demonstrated good fit. Consistent with our hypothesis, cancer-related loneliness mediated the relationships between social constraints and each symptom. Findings suggest that addressing cancer-related loneliness in symptom management interventions may mitigate the negative impact of social constraints on outcomes.

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Acknowledgements

This project was supported by the American Psychological Association. Rebecca Adams’s work was supported by R25CA117865 (V. Champion, PI) from the National Cancer Institute. Catherine Mosher’s work was supported by the National Cancer Institute under Grants K05CA175048 and K07CA168883. Joseph G. Winger's work was supported by 130526-PF-17-054-01-PCSM from the American Cancer Society. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute. The authors would like to thank the study participants and Madison Stout for her assistance.

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Authors and Affiliations

  1. Department of Pediatrics, Stanford University School of Medicine, 780 Welch Road, MC 5776, Palo Alto, CA, 94304, USA

    Rebecca N. Adams

  2. Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA

    Catherine E. Mosher

  3. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA

    Joseph G. Winger

  4. Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA

    Rafat Abonour & Kurt Kroenke

  5. Regenstrief Institute, Inc., Indianapolis, IN, USA

    Kurt Kroenke

  6. VA HSR&D Center for Health Information and Communication, Indianapolis, IN, USA

    Kurt Kroenke

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  1. Rebecca N. Adams
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Correspondence to Rebecca N. Adams.

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Rebecca N. Adams, Catherine E. Mosher, Joseph G. Winger, Rafat Abonour, and Kurt Kroenke declare that they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Adams, R.N., Mosher, C.E., Winger, J.G. et al. Cancer-related loneliness mediates the relationships between social constraints and symptoms among cancer patients. J Behav Med 41, 243–252 (2018). https://doi.org/10.1007/s10865-017-9892-5

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