“…Data from 37 (80.4%) studies described psychosocial outcomes of living with HL [ 39 , 41 – 47 , 49 – 51 , 53 , 54 , 56 – 59 , 61 , 63 – 70 , 72 – 75 , 77 – 80 , 82 – 84 ].Overall, HL was suggested to have negative impacts on social activity , participants’ emotional and physical well-being , and quality of life . Difficulty participating in social activities was a recurring theme and was discussed in 21 studies [ 41 , 42 , 44 , 45 , 50 , 51 , 54 , 56 – 59 , 61 , 64 – 66 , 69 , 70 , 72 , 73 , 75 , 79 ].Participants reported frequently withdrawing from social activities or declining to participate due to difficulties with hearing and listening (nine studies),[ 41 – 43 , 49 , 57 , 58 , 65 , 66 , 72 ] and 20 studies reported participants’ experiences of social isolation [ 41 – 46 , 49 , …”