Spirituality and connectedness may improve loneliness at the end-of-life
1. In this scoping review, several factors predisposed adults to loneliness at the end-of life, including inadequate spiritual supports and withdrawal from social networks.
2. In addition, interventions facilitating spirituality, connectedness, and social interactions helped to alleviate loneliness.
Evidence Rating Level: 1 (Excellent)
Loneliness is an important concern clinically as it increases symptom burden in patients, especially at the end-of-life. Many situations that can precipitate loneliness, such as loss of social roles and fear of death, are common at the end-of-life. However, the impact of loneliness on the end-of-life experience has not been clearly explored. As a result, the objective of the present scoping review was to synthesize the available research on loneliness at the end-of-life in patients.
Of 5237 identified records, 23 (n=7540 participants) studies were included from various databases from January 2001 to July 2022. Studies were included if they investigated loneliness in adults who had a life-limiting or terminal illness. Studies were excluded if their focus was on social isolation with no distinction made for loneliness, or if participants were under the age of 18 years. The review was performed using PRISMA-ScR guidelines. The primary outcome was the factors associated with loneliness at the end of life.
The results demonstrated that factors such as withdrawal from social networks, an inability to share emotions, and inadequate spiritual supports contributed to feelings of loneliness. In addition, interventions that facilitated spirituality and connectedness were found to be effective in alleviating loneliness but were not studied in clinical trials. Despite these results, the study was limited by the absence of a quality assessment, which may have affected the strength of the results. Nonetheless, the present study suggested that social and spiritual supports may help alleviate loneliness in patients at the end-of-life.
Click to read the study in Journal of Clinical Nursing
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