Loneliness and its associated factors among patients with cancer in China: a sequential explanatory mixed-methods study

Loneliness is prevalent among patients with cancer in China and exerts adverse effects on both physical and mental health. This study aims to investigate the prevalence of loneliness and its associated factors, as well as to explore patients’ lived experiences, to inform clinical practice. A sequential explanatory mixed-methods design was adopted, incorporating a cross-sectional survey of 240 inpatients from oncology and general surgery departments of large-scale tertiary hospitals, along with descriptive phenomenological interviews conducted with 18 patients scoring ≥ 20 on the loneliness scale. Quantitative results revealed an average loneliness score of 19.13 ± 6.26, with 83.8% of patients experiencing moderate to severe loneliness. Multiple regression analysis identified introversion, absence of caregivers, disease duration > 3 years, low social support, depression, negative social expectations, and passive coping as significant predictors (P < 0.001). Qualitative analysis identified three main themes—experiences of loneliness, influencing factors (internal and external), and coping strategies—comprising seven subthemes. The findings underscore the importance of identifying high-risk patients and implementing targeted interventions, encouraging emotional expression, and providing supportive channels to mitigate loneliness.