The context of care matters: Older people's existential loneliness from the perspective of healthcare professionals—A multiple case study

Sundström, Malin; Blomqvist, Kerstin; Edberg, Anna‐Karin; Rämgård, Margareta

doi:10.1111/opn.12234

Cited by 29 publications

(36 citation statements)

References 29 publications

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“…Previous literature recommends that healthcare professionals use a relation‐centred approach when addressing social isolation and loneliness (Due et al, 2017; Freedman & Nicolle, 2020; Nolan et al, 2001). This can be challenging in hospitalised patients, and some hospital healthcare professionals have described the hospital setting as a stressful place with lack of privacy, which acts as a barrier in detecting appropriate signals from older persons and their existential feelings such as loneliness (Sundström et al, 2019). A few studies have explored general or existential loneliness experienced by older patients and have shown that loneliness is prevalent among older people suffering from chronic physical illnesses during hospitalisation (Kvaal et al, 2014; Sundström et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Older patients’ perspectives and experience of hospitalisation during the COVID‐19 pandemic: a qualitative explorative study

Nielsen

Hansen

Beck

et al. 2021

Int J Older People Nursing

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Background and Objectives The aim of this study was to gain in‐depth knowledge and an increased understanding on how isolation from close relatives and carers, during the COVID‐19 pandemic, impacted older patients during hospitalisation in a Geriatric department. Method We conducted a qualitative study using semi‐structured interviews and a phenomenological‐hermeneutic approach, to get an understanding of the older participants' perspectives and lived experiences. Complete interviews were available for 11 patients—six men and five women, between 69 and 91 years of age. Results The participants' narratives identified several themes. Feeling isolated from and having no contact with close relatives or carers was prominent. The COVID‐19 pandemic created fear and anxiety among hospitalized patients. Relationships with family members and some staff became strained. The transformation from being “a person” to being “a patient” and loss of dignity, autonomy and a “sense of self” were themes identified in the analysis . Although virtual contact can't replace the real world, the use of technology to maintain contact with family and carers, and the need for help from hospital staff in facilitating this contact was deemed important. The environment of care was a prominent theme. The attitude of staff made a difference to how patients felt and some patients expressed a loss of decision‐making capability. The interviews were challenging in some cases because the interviews had to be interrupted or shortened due to ethical considerations around the individual person's needs and condition. Conclusions and implication for practice Our study provided in‐depth knowledge on how older patients experienced hospitalisation during the COVID‐19 pandemic in a Danish hospital. The results emphasise that compassionate care includes a willingness to listen to older patients' narratives and to imagine life as depicted by them. This can lead to better understanding of an individual person's needs and increase the quality of care provided.

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Section: Introductionmentioning

confidence: 99%

Older patients’ perspectives and experience of hospitalisation during the COVID‐19 pandemic: a qualitative explorative study

Nielsen

Hansen

Beck

et al. 2021

Int J Older People Nursing

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“…So far, the impact of context has been analyzed in relation to the narratives from HCPs [56]. The results found differences and similarities among the care contexts concerning the professionals’ views on the origins of EL, the place of care, and the professionals’ own role.…”

Section: Resultsmentioning

confidence: 99%

“…In hospital and palliative care, as in institutional care, the place offered security, whereas in residential care, the place could make older people feel like strangers. Creating relationships was considered an important part of the professionals’ role in all 4 care contexts, although this had different meanings, purposes, and conditions [56]. This study will be completed with a reanalysis of the interviews with the older persons, sorted by context.…”

Section: Resultsmentioning

confidence: 99%

Exploring Existential Loneliness Among Frail Older People as a Basis for an Intervention: Protocol for the Development Phase of the LONE Study

Edberg¹,

Bolmsjö²

2019

JMIR Res Protoc

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Background International research concerning end-of-life issues emphasizes the importance of health care professionals (HCPs) being prepared to deal with existential aspects, like loneliness, in order to provide adequate care. The last phase of life is often related to losses of different kinds, which might trigger feelings of isolation in general and existential loneliness (EL) in particular. There is a large body of research concerning loneliness among older people in general, but little is known about the phenomenon and concept of EL in old age. Objective This study aims to describe the framing, design, and first results of the exploratory phase of an intervention study focusing on EL among older people: the LONE study. This stage of the study corresponds to the development phase, according to the Medical Research Council framework for designing complex interventions. Methods The LONE study contains both theoretical and empirical studies concerning: (1) identifying the evidence base; (2) identifying and developing theory through individual and focus group interviews with frail older people, significant others, and HCPs; and (3) modeling process and outcomes for the intervention. This project involves sensitive issues that must be carefully reviewed. The topic in itself concerns a sensitive matter and the study group is vulnerable, therefore, an ethical consciousness will be applied throughout the project. Results The results so far show that EL means being disconnected from life and implies a feeling of being fundamentally separated from others and the world, whether or not one has family, friends, or other close acquaintances. Although significant others highlighted things such as lack of activities, not participating in a social environment, and giving up on life as aspects of EL, the older people themselves highlighted a sense of meaningless waiting, a longing for a deeper connectedness, and restricted freedom as their origins of EL. The views of HCPs on the origin of EL, the place of care, and their own role differed between contexts. Conclusions The studies focusing on identifying the evidence base and developing theory are published. These results will now be used to identify potential intervention components, barriers, and enablers for the implementation of an intervention aimed at supporting HCPs in encountering EL among older people. International Registered Report Identifier (IRRID) RR1-10.2196/13607

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“…prerequisites for addressing existential issues and needs in home, residential, hospital, and palliative care, according to a multiple case study by Sundström, Blomqvist, Edberg, and Rämgård (2019). Time constraints were seen as hindering, as were professionals' discomfort in discussing existential concerns and inability to address older persons' existential needs.…”

Section: Introductionmentioning

confidence: 99%

Existentiell ensamhet hos sköra äldre personer: Vårdpersonals och volontärers erfarenheter och behov av stöd

Sundström¹

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Existentiella frågor är frågor som handlar om att vara människa, att känna mening, hopp och tillit, om livet och döden. Frågor som inte har några självklara svar. Existentiella samtal är samtal om existentiella frågor. Existentiell ensamhet definieras som en djupare känsla av ensamhet och en ofrånkomlig del av livet. Den existentiella ensamheten kan uppstå i olika situationer, trots att personen har nära relationer och omges av andra människor. LONE-studien är det projekt som avhandlingen är en del av. LON står för loneliness (ensamhet) och E står för existential (existentiell). LONE-studien presenteras närmare i metodavsnittet. Sköra äldre personer definieras i LONE-studien och i denna avhandling som personer som är 75 år och äldre och som är i behov av varaktig vård och omsorg. Skörhet hos äldre personer är i denna avhandling förknippad med fysisk skörhet som hänger samman med åldrandets sjukdomar, och utesluter inte att personen har andra styrkor och inre kraft. Volontär är en person som erbjuder sina tjänster frivilligt utan att kräva någon betalning, oftast organiserat genom en frivilligorganisation. Volontärerna kallas ibland för frivilliga, ideella eller aktiva medlemmar. Vårdkontext är den miljö där vården sker, men är också en plats. I denna avhandling ingår vårdkontexterna hemvård/hemtjänst, särskilt boende, sjukhus, palliativ vård, primärvård och ambulanssjukvård. Vårdpersonal är i den här avhandlingen personer som i sin profession, oavsett vårdkontext, profession, funktion eller uppgift, vårdar äldre personer. Kallas också personal eller formella vårdare i avhandlingen.

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The context of care matters: Older people's existential loneliness from the perspective of healthcare professionals—A multiple case study

Cited by 29 publications

References 29 publications

Older patients’ perspectives and experience of hospitalisation during the COVID‐19 pandemic: a qualitative explorative study

Older patients’ perspectives and experience of hospitalisation during the COVID‐19 pandemic: a qualitative explorative study

Exploring Existential Loneliness Among Frail Older People as a Basis for an Intervention: Protocol for the Development Phase of the LONE Study

Existentiell ensamhet hos sköra äldre personer: Vårdpersonals och volontärers erfarenheter och behov av stöd

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