The Feasibility and Acceptability of LISTEN for Loneliness.

Laurie A Theeke,Jennifer A Mallow,Elliott Theeke,Emily R Barnes

doi:10.4236/ojn.2015.55045

Abstract

PurposeThe purpose of this paper is to present the initial feasibility and acceptability of LISTEN (Loneliness Intervention using Story Theory to Enhance Nursing-sensitive outcomes), a new intervention for loneliness. Loneliness is a significant stressor and known contributor to multiple chronic health conditions in varied populations. In addition, loneliness is reported as predictive of functional decline and mortality in large samples of older adults from multiple cultures. Currently, there are no standard therapies recommended as effective treatments for loneliness. The paucity of interventions has limited the ability of healthcare providers to translate what we know about the problem of loneliness to active planning of clinical care that results in diminished loneliness. LISTEN was developed using the process for complex intervention development suggested by the Medical Research Council (MRC) [1] [2].MethodsFeasibility and acceptability of LISTEN were evaluated as the first objective of a longitudinal randomized trial which was set in a university based family medicine center in a rural southeastern community in Appalachia. Twenty-seven older adults [(24 women and 3 men, mean age: 75 (SD 7.50)] who were lonely, community-dwelling, and experiencing chronic illness, participated. Feasibility was evaluated by tracking recruitment efforts, enrollment, attendance to intervention sessions, attrition, and with feedback evaluations from study personnel. Acceptability was assessed using quantitative and qualitative evaluation data from participants.ResultsLISTEN was evaluated as feasible to deliver with no attrition and near perfect attendance. Participants ranked LISTEN as highly acceptable for diminishing loneliness with participants requesting a continuation of the program or development of additional sessions.ConclusionsLISTEN is feasible to deliver in a primary healthcare setting and has the potential to diminish loneliness which could result in improvement of the long-term negative known sequelae of loneliness such as hypertension, depression, functional decline, and mortality. Feedback from study participants is being used to inform future trials of LISTEN with consideration for developing additional sessions. Longitudinal randomized trials are needed in varied populations to assess long-term health and healthcare system benefits of diminishing loneliness, and to assess the potential scalability of LISTEN as a reimbursable treatment for loneliness.

Highlights

Diminishing loneliness has the potential to improve overall behavioral health by decreasing the risk for the development of depression [3] which could have major healthcare system benefits
Loneliness is a biopsychosocial stressor, associated with a physiological stress response [4] that is linked to multiple chronic conditions [5]-[7]
Since loneliness is rising as a health priority, it is critical that healthcare providers have access to effective interventions that could be employed in both community and clinical settings

Summary

Introduction

Diminishing loneliness has the potential to improve overall behavioral health by decreasing the risk for the development of depression [3] which could have major healthcare system benefits. The majority of intervention studies for loneliness have evaluated the effectiveness of interventions that were designed to target the social aspects of loneliness [19]-[23] and emphasized enhancement of social skills, support, or integration. These interventions have included having participants engage in new activities as treatment for loneliness such as volunteerism [24] and friendship enrichment programs [22]

Objectives

Results

Conclusion