Factors associated with social alienation in cancer patients: a structural equation modeling approach

Social alienation is an important issue for patients with cancer. However, the interrelationships among factors influencing social alienation in cancer patients have not been sufficiently investigated. The study aimed to clarify the relationships among social alienation, illness perception, fear of cancer progression, and perceived social support in patients with cancer.

A cross-sectional descriptive survey was conducted with 244 cancer patients recruited through convenience sampling from a tertiary hospital in Changsha, China. Data were collected using the General Information Questionnaire, Brief Illness Perception Questionnaire, General Alienation Scale, Fear of Progression Questionnaire-Short Form, and Perceived Social Support Scale.

The findings show that the mean social alienation score among cancer patients was 33.11 ± 7.95. Model fit indices indicated a good fit. Illness perception and perceived social support have a direct and significant negative impact on social alienation, with path coefficients of -0.19 and -0.25, respectively. Fear of cancer progression has a direct and significant positive effect on social alienation, with a path coefficient of 0.45. Additionally, the results of the mediation analysis indicate that illness perception indirectly influences social alienation through its effects on fear of cancer progression and perceived social support; employment status indirectly influences social alienation through illness perception; disease stage indirectly influences social alienation through illness perception and fear of cancer progression.

This suggests that illness perception, fear of cancer progression, and perceived social support are key factors influencing social alienation in cancer patients. These factors exerted both direct and indirect effects on each other and on social alienation.