Loneliness, spiritual well-being, and death perception, as well as their risk factors in urological cancer patients

Abstract

Cancer patients commonly suffer from loneliness, poor spiritual status, and fear of death; however, these evaluations are rarely revealed in urological cancer patients. Thus, this study aimed to assess the loneliness, spiritual well-being, and death perception, as well as their risk factors in urological cancer patients. A total of 324 urological (including renal, bladder, and prostate) cancer patients and 100 healthy controls were included. The University of California and Los Angeles loneliness scale (UCLA-LS), functional assessment of chronic illness therapy-spiritual well-being (FACIT-Sp), and death attitude profile-revised (DAP-R) scores were evaluated. The results showed that the UCLA-LS score was higher, but the FACIT-Sp score was lower in urological cancer patients than in healthy controls. According to the DAP-R score, fear of death, death avoidance, and approaching death acceptance were elevated, but neutral acceptance was lower in urological cancer patients than in healthy controls. Among urological cancer patients, the UCLA-LS score was highest but the FACIT-Sp score was lowest in bladder cancer patients; regarding the DAP-R score, fear of death and death avoidance were highest, but approaching death acceptance was lowest in bladder cancer patients. Interestingly, single/divorced/widowed status, bladder cancer diagnosis, higher pathological grade, surgery, systemic treatment, and local treatment were independent factors for higher UCLA-LS score or lower FACIT-Sp score. In conclusion, urological cancer (especially bladder cancer) patients bear increased loneliness and reduced spiritual well-being; they also carry higher fear of death, death avoidance, and approaching death acceptance but lower neutral acceptance of death.

Factors Influencing Social Isolation among Cancer Patients: A Systematic Review

“…The other study conducted on 100 older adults with cancer, showed that patients who lived alone had significantly higher loneliness scores than the others [73]. Additionally, results from seven studies showed that marital status might impact the social isolation of patients with cancer [53,57,59,66,67,71,73]. The results illustrated that married patients would experience lower feelings of isolation, while patients who were single would be more likely to experience social isolation.…”

“…However, there is currently a lack of scholarly consensus on this particular aspect. For example, there were significantly different scores of loneliness in a research of urological cancer patients [71]. The possible explanation is that some bladder cancer patients even need to carry urine pouches throughout their lives, while prostate and renal cancer patients do not need to carry urine pouches.…”

“…According to our review, different cancer diagnoses and disease stages could influence the scores of social isolations. For example, one study on urological cancer patients demonstrated that bladder cancer patients had significantly higher scores of loneliness than prostate and renal cancer patients [71]; the other study on ovarian cancer revealed that patients with late-stage disease had the highest levels of feelings of isolation [57]. As demonstrated by five studies, treatment type and stage might impact the extent of social isolation.…”

“…As demonstrated by five studies, treatment type and stage might impact the extent of social isolation. Three studies on colorectal cancer patients, breast cancer survivors, and urological cancer patients that depicted patients with temporary enterostomy [69], undergoing radical mastectomy [67] or accepting systemic treatment [71], respectively, had higher scores of subjective or objective social isolation. And the results of two studies revealed that patients in the treatment phase of surgery and chemotherapy were more likely to experience subjective or objective social isolation [10,68].…”

The chain mediating effect of spiritual well‐being and anticipatory grief between benefit finding and meaning in life of patients with advanced lung cancer: Empirical research quantitative

“…By sharing this connection with others, patients can find support and understanding in intimate relationships, infusing life with deeper meaning. Additionally, spiritual well‐being also involves reflection on life's purpose and values (Xia et al., 2023 ). Patients may re‐evaluate their life goals during the late stages of lung cancer, pondering the meaning of their existence in this world.…”