A Conceptual Review of Loneliness in Adults: Qualitative Evidence Synthesis.

Louise Mansfield,Norma Daykin,Catherine Meads,Christina Victor,Jack Lane,Karen Gray,Alan Tomlinson,Alex Golding

doi:10.3390/ijerph182111522

Abstract

The paper reports an evidence synthesis of how loneliness is conceptualised in qualitative studies in adults. Using PRISMA guidelines, our review evaluated exposure to or experiences of loneliness by adults (aged 16+) in any setting as outcomes, processes, or both. Our initial review included any qualitative or mixed-methods study, published or unpublished, in English, from 1945 to 2018, if it employed an identified theory or concept for understanding loneliness. The review was updated to include publications up to November 2020. We used a PEEST (Participants, Exposure, Evaluation, Study Design, Theory) inclusion criteria. Data extraction and quality assessment (CASP) were completed and cross-checked by a second reviewer. The Evidence of Reviews of Qualitative Research (CERQual) was used to evaluate confidence in the findings. We undertook a thematic synthesis using inductive methods for peer-reviewed papers. The evidence identified three types of distinct but overlapping conceptualisations of loneliness: social, emotional, and existential. We have high confidence in the evidence conceptualising social loneliness and moderate confidence in the evidence on emotional and existential loneliness. Our findings provide a more nuanced understanding of these diverse conceptualisations to inform more effective decision-making and intervention development to address the negative wellbeing impacts of loneliness.

Highlights

Most of us will encounter loneliness at some point in our lives
137 published studies and 18 grey literature reports are included in this systematic review, providing 155 sources of evidence conceptualising loneliness: 116 qualitative studies in journal articles and 7 book chapters; 14 mixed-methods studies; and 18 grey literature reports
We found only two published studies focussed on the link between emotional loneliness in young people living with a parent with cancer [139]; children of Holocaust survivor parents, [149])

Summary

Introduction

Most of us will encounter loneliness at some point in our lives. Some philosophers argue that loneliness is a universal human experience [1,2]. This experience may be momentary or protracted, occur frequently or rarely, and vary in intensity. Loneliness is characterised as a homogeneous, static, and/or linear experience that is quantitatively accessible (i.e., we can measure it), and it is understood as a problem about which ‘something’ can and should be done to prevent or cure it [3]. Most notably loneliness and social isolation, and living alone, aloneness, and solitude are often conflated despite not being linguistically, empirically, or conceptually interchangeable.

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Discussion

Conclusion