Being a volunteer encountering older people’s loneliness and existential loneliness: alleviating loneliness for others and oneself

Exploring perinatal loneliness as a key social determinant of perinatal mental ill health in the UK: findings from a multidisciplinary consensus statement exercise that mapped knowledge about measurement, prevalence, antecedents, impacts and interventions, and agreed future priorities for research, policy and practice

OBJECTIVES

New parents are at increased risk of loneliness, which adversely affects parental and infant health and well-being and has been linked to an increased likelihood of parental mental illness. In the UK, perinatal mental illness is estimated to cost £8.1bn a year, predominantly due to lasting poor health and developmental consequences for children. The purpose of this consensus statement is to determine the state of this research field, highlighting key issues for researchers, policymakers and those responsible for perinatal mental health services and interventions. We will also highlight knowledge gaps to be addressed in future perinatal loneliness research.

DESIGN, SETTING AND PARTICIPANTS

The Parental Loneliness Research Group held six online meetings between October 2023 and May 2024, attended by academics and practitioners from the UK and USA. Attendees conducted a mapping exercise by appraising published, unpublished and ongoing perinatal loneliness research. The findings were shared with advisory groups, including parents with lived experience of loneliness. A consensus statement was then drafted, reflecting existing knowledge and gaps in the current evidence about the experience of perinatal loneliness in the first 1001 days.

RESULTS

A consensus about the definitions, measurement, prevalence, antecedents, impacts and interventions relevant to perinatal loneliness is outlined. Gaps in the literature are highlighted.

CONCLUSIONS

Despite emerging research into perinatal loneliness, it is hard to determine prevalence due to limited analyses of national survey data. Recommendations for future research include secondary data analysis; prioritising equality, diversity and inclusion; reconsidering solutions to perinatal loneliness through a social justice lens; co-producing interventions, and rigorous evaluation of existing interventions.

Adolescents' Experiences of Existential Loneliness Regarding Receiving and Providing Support

Among adolescents, loneliness is common. One kind of loneliness, existential loneliness, is understood as a painful part of the human condition. During adolescence, existential loneliness has been shown to be challenging to navigate independently. Therefore, this study aimed to explore Swedish adolescents' experiences of existential loneliness regarding receiving and providing support. This study had an exploratory qualitative design based on focus group discussions (n = 9) comprising 30 Swedish adolescents (median age 18). The data was analysed inductively using thematic analysis. The adolescents' experiences of existential loneliness regarding receiving and providing support were represented in four themes: Wanting to face existential loneliness alone, but seeking relief and support when needed; Wanting to share the experiences, but not knowing how or being afraid to bare the vulnerability; Wanting to share the experiences, but nobody is there; Supporting friends by trying to be there, but feeling insecure. In conclusion, knowledge of existential loneliness and a sensitivity to adolescents' personal needs is crucial. Supporting and being there for adolescents may increase their ability to encounter ̶ their own or others' ̶ experiences of existential loneliness, which could be promotive for their well-being and personal growth.

Exploring the relationship between loneliness and volunteering amongst Australian adults: a cross-sectional study

BACKGROUND

Alleviating loneliness and fostering social connections and a sense of belonging are essential for individuals' well-being in the aftermath of the COVID-19 pandemic. Volunteering has emerged as a potential strategy to prevent or alleviate loneliness among adults. To gain insights into factors that can reduce or protect against loneliness, it is important to consider multi-dimensional measures of loneliness and motivations to volunteer. This study aimed to understand which variables predict Australian volunteers' social, family, and romantic loneliness.

METHODS

From October 2021 to January 2022, a cross-sectional online survey was administered to a sample of Australian adults with volunteering experience. The survey collected demographic information and used validated measures to assess social, family, and romantic loneliness and volunteer motivation. Bivariate and multivariate analyses were conducted to examine the association between loneliness and motivations for volunteering.

RESULTS

Of the 1723 individuals who accessed the survey link, 160 participants completed the survey. The average age of respondents was 59.87 years (SD 12.3). The majority were female (77.5%), married or partnered (70.6%), and had ten or more years of volunteering experience (62.1%). Overall, participants reported low to moderate levels of loneliness across social (M = 12.1; SD = 5.3), family (M = 11.3; SD = 6.7), and romantic (M = 14.8; SD = 8.3) dimensions. Social motivation for volunteering was negatively associated with social and romantic loneliness, while enhancement and protective motivations were positively associated with family and romantic loneliness. Age and rurality were not significantly associated with any dimension of loneliness.

CONCLUSIONS

Loneliness is a multifaceted and intricate experience that impacts individuals socially and emotionally. This study's findings confirmed that having protective and enhancement motives to volunteer was associated with increased loneliness. Social motives to volunteer were associated with a tendency to have lower levels of loneliness, possibly due to the positive impact of building and maintaining social relationships through volunteering. Understanding these associations is necessary to ensure that volunteering activities align with each person's unique needs and motivations.

Exploration and practice of humanistic education for medical students based on volunteerism

Humanistic education aims to promote educated people's practical and conscious activities to enhance their humanity, cultivate ideal personalities, and realize personal and social values, to develop a humanistic spirit. The advancement of higher education in China has led to the proposal to strengthen scientific and humanistic education integration. Medicine is between science and humanities, shouldering the important task of training senior medical personnel, the quality of medical students will affect the quality of future medical and health work; thus, medical students must explore and practice humanistic education. Promoting and practicing volunteerism is a specific act of constructing spiritual civilization in the whole society, and it is also considered beneficial for improving citizens' sense of responsibility and dedication. Medical students' practice of volunteerism and help in society is a precise manifestation of humanistic care. This review summarizes medical students' exploration and practice of humanistic education in volunteering.

A support nurse may strengthen the participation of patients with low socio-economic status in treatment pathways of head and neck cancer: A theory-based evaluation

AIM

To test and evaluate a support nurse intervention within the head and neck cancer (HNC) pathway.

BACKGROUND

Even though interventions aiming to support patients with a low socio-economic status have been a focus for development and implementation in several countries, research still shows that these patients often have unmet needs and encounter challenges in communicating with health professionals during their treatment pathways. Furthermore, support interventions are few in Denmark and none of the existing interventions target patients with HNC receiving radiation therapy of whom the majority have a low socio-economic status and therefore potentially carry a high risk of being challenged during their treatment pathways.

DESIGN

A theory-based evaluation was used as framework. A support nurse intervention was designed to offer patients with a low socio-economic status help and support in the initial part of the HNC pathway. Eleven patients were included in the trial period.

METHODS

The evaluation of the intervention was based on interviews, a questionnaire survey and field notes.

RESULTS

The expected outputs were achieved, thus: (1) the patients felt supported and assisted, (2) the support nurse was capable of supporting, helping and accompanying the patients, (3) the patients were informed as relevant and understood the information provided. Unexpected outputs were that the support nurse was capable of co-ordinating the pathway in line with the patient's needs and that she facilitated the interaction between patients and health professionals.

CONCLUSIONS

Support for patients with a low socio-economic status improves their ability to engage in their cancer treatment pathway. This, in turn, increases their preparedness for participation and, hence, strengthens their choice of treatment.

REPORTING METHOD

This study is reported using consolidated guideline for reporting interventions Template for intervention description and replication (TIDieR checklist). We used theory-based evaluation as described by Peter Dahler-Larsen.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

"It's a feeling of complete disconnection": experiences of existential loneliness from youth to older adulthood

BACKGROUND

Existential loneliness is a feeling which stems from a sense of fundamental separation from others and the world. Although commonly mentioned in the loneliness literature, there is relatively little empirical work on this construct, and existing work tends to focus on older and seriously ill individuals. The present study aimed to understand how people experience existential loneliness without specific constraints on precipitating factors like illness or age.

METHODS

A qualitative online survey collected data from 225 adults aged 16 to 72 years old. Participants were asked to write about their experiences of existential loneliness and how these experiences compared to non-existential loneliness. Data were analysed using reflexive thematic analysis.

RESULTS

Of 225 participants, 51% knew the meaning of "existential loneliness" upon accessing the survey and in total, 83% had experienced existential loneliness. 93% of these participants had also experienced loneliness that was not existential in nature. 175 participants provided qualitative data regarding their experiences of existential loneliness, from which four themes were identified: Existential loneliness is (1) A deeper form of loneliness, and (2) A feeling of deep disconnection, in which (3) Cognitive evaluations and negative emotions are central elements, and (4) Stress and mental health issues are perceived as relevant factors.

CONCLUSIONS

Existential loneliness is a deeply rooted and impactful form of loneliness which involves feelings of profound separateness. This aspect of loneliness is deserving of further attention. Future research directions are suggested.

Types of Voluntary Work and Influence of Participation for Older Volunteers: A Systematic Review of Qualitative Studies

This systematic review synthesized findings on socio-demographic characteristics of older adults who engaged in formal volunteering, types of voluntary work for engagement, and the outcomes resulting from different types of voluntary work participation. Studies published in peer-reviewed journals were identified from six electronic databases. Studies were included if they: (1) involved a study sample of adults aged 65 and older or had a mean age of 65 , (2) reported any type of formal voluntary work at any setting, and (3) reported at least one influence of voluntary work on volunteers. Older adults who were female, married, retired, and have a higher education, fair health, and more volunteering experience participated in voluntary work. The majority of older volunteers preferred to volunteer in a community setting, and they most commonly participated in healthcare or social care related voluntary work. The older volunteers perceived positive influences mostly related to health-relatedoutcomes or helping knowledge and skills.

Senior volunteers: addressing loneliness in times of COVID-19

Volunteering in old age plays an important role in addressing feelings of loneliness, but little research has been conducted on the impact of engaging in volunteering activities during the COVID-19 pandemic. This study investigates the longitudinal impact of volunteering on feelings of loneliness. We analyzed data from 31,667 adults aged 50 years and older in the Survey of Health, Ageing and Retirement in Europe (SHARE), across three consecutive waves (one before the pandemic and two during the COVID-19 pandemic). Binary logistic regression analyses were conducted for loneliness, using volunteering and several control variables as independent variables, and found that even after controlling for previous loneliness, volunteering has a protective effect against experiencing feelings of loneliness. Those who participated in volunteering activities before or during the second pandemic period had a lower risk of loneliness during the second pandemic period. Volunteering during the second pandemic period, before and during the second pandemic period, and during all three periods measured in the study was negatively associated with the odds of feeling lonely. Encouraging volunteering among older adults can be a useful strategy to prevent loneliness during future emergency situations like the COVID-19 outbreak.

The Relationship Between Volunteering and the Occurrence of Loneliness Among Older Adults: A Longitudinal Study with 12 Years of Follow-Up

Informed by the social model of health promotion, this study examined the association between formal volunteering and the occurrence of loneliness among older adults over 12 years of follow-up and whether the association differs by gender. Data came from the Health and Retirement Study (2006-2018). The study sample included 5,000 individuals aged 60 and over who did not experience loneliness in 2006. Self-reported participation in formal volunteer work was classified into three levels: (0) no volunteering, (1) less than 100 hours of volunteering per year, and (2) more than 100 hours of volunteering per year. Cox regression was used to examine the relationship between volunteering level and the onset of loneliness during the 12 years of follow-up. Volunteering more than 100 hours per year was associated with a lower risk of loneliness compared to non-volunteers (HR = 0.55, p = .008). This protective effect was not observed for those who volunteered less than 100 hours per year (HR = 0.84, p = .246). The benefits of volunteering in mitigating loneliness did not differ by gender. Engagement in moderate to high levels of volunteering can protect against loneliness. More volunteering programs can be offered to older adults to reduce loneliness in later life.

Sensor-based assessment of social isolation in community-dwelling older adults: a scoping review

Social isolation (SI) is a state of low social interaction with peers associated with various adverse health consequences in older adults living in the community. SI is most often assessed through retrospective self-reports, which can be prone to recall or self-report biases and influenced by stigma. Ambient and wearable sensors have been explored to objectively assess SI based on interactions of a person within the environment and physiological data. However, because this field is in its infancy, there is a lack of clarity regarding the application of sensors and their data in assessing SI and the methods to develop these assessments. To understand the current state of research in sensor-based assessment of SI in older adults living in the community and to make recommendations for the field moving forward, we conducted a scoping review. The aims of the scoping review were to (i) map the types of sensors (and their associated data) that have been used for objective SI assessment, and (ii) identify the methodological approaches used to develop the SI assessment. Using an established scoping review methodology, we identified eight relevant articles. Data from motion sensors and actigraph were commonly applied and compared and correlated with self-report measures in developing objective SI assessments. Variability exists in defining SI, feature extraction and the use of sensors and self-report assessments. Inconsistent definitions and use of various self-report scales for measuring SI create barriers to studying the concept and extracting features to build predictive models. Recommendations include establishing a consistent definition of SI for sensor-based assessment research and development and consider capturing its complexity through innovative domain-specific features.

Deeply lonely in the borderland between childhood and adulthood - Experiences of existential loneliness as narrated by adolescents

BACKGROUND

Adolescence is associated with different feelings and experiences that can negatively affect adolescents' health and well-being. In the transition between childhood and adulthood, experiences of loneliness are common. A deep form of loneliness is described as existential loneliness. Studies among adults have shown that existential loneliness often arises in connection with transitions and is related to suffering, but may lead to positive experiences when acknowledged and addressed. Therefore, the aim of this study was to explore adolescents' experiences of existential loneliness.

METHODS

This was an exploratory-descriptive qualitative study based on narrative interviews with 16 adolescents (median age 17.5). The data were analysed inductively using qualitative content analysis.

FINDINGS

Existential loneliness among adolescents was related to experiences of social exclusion and "in-betweenness". To alleviate their suffering, the adolescents tried to avoid burdensome feelings and thoughts, and they chose between sharing or not sharing their inner lives with someone else.

CONCLUSIONS

It is important to support adolescents' sense of belonging, and they may need assistance in dealing with existential loneliness, as well as with finding constructive and healthy ways of recuperating from the suffering. Professionals need knowledge of existential loneliness to promote adolescents' existential health and well-being.

Volunteering and loneliness in older adults: A parallel mediation model

OBJECTIVES

This study aimed to examine the relationship between participation in volunteer work and loneliness among older adults, and to explore the mediating role of perceived control and perceived social self-efficacy in this association.

METHOD

This study was developed as a secondary data analysis using the data sampled from the 2016 Health and Retirement Study in USA. The sample comprised 9,944 individuals aged between 65 and 107 years (mean = 75.94, SD = 7.70; 59.4% females). Using a multi-item survey questionnaire, frequent participation in volunteer youth work and charity work, loneliness, perceived control, and social self-efficacy were assessed. To examine the mediating effects of perceived control and social self-efficacy on the association between volunteer work and loneliness, the bootstrapping technique was performed.

RESULTS

Two forms of volunteer works, namely, volunteer youth work and charity work, significantly predicted perceived control, social self-efficacy, and lower levels of loneliness. Perceived control and social self-efficacy appeared to significantly mediate the relationship between volunteer activities and loneliness.

CONCLUSION

The study's findings put forward a need to develop policy provisions that facilitate supporting systems and organizations for life-long education and recruitment of older volunteers. Community-based organizations should create and promote volunteer opportunities in older adults, thereby alleviating later-life loneliness.

Palliative care volunteer roles in Nordic countries: qualitative studies-systematic review and thematic synthesis

BACKGROUND

Given limited palliative care resources, volunteers can be viewed as essential. To better understand the contribution of volunteers, it is useful to look at their roles in care systems with high level of financed public welfare, such as those found in Nordic countries.

AIM

To develop research-based knowledge of experiences related to volunteer roles in palliative care in Nordic countries with similar welfare systems.

DESIGN

Systematic review and thematic synthesis of qualitative studies.

DATA SOURCES

Cinahl, APA PsycInfo, SocINDEX, Idunn, Cristin, SwePub, SweMed+, Doria and Danish Research Database from 2005 to 2020.

ELIGIBILITY CRITERIA

Qualitative peer-reviewed studies reporting first-hand experience of volunteers in palliative care in hospital, community (homecare and nursing home) and hospice settings (hospice institution and hospice home care); English abstract and available full text.

RESULTS

Of 1521 citations, 11 articles were included in the review: seven Norwegian articles, three Swedish articles and one Danish article. Three overall themes emerged from analysis: (1) volunteers offered something different than professionals, (2) volunteering took place in professionals' domain, (3) volunteers were motivated by personal gains.

CONCLUSION

Volunteers provide valuable support to patients and next of kin that differs from professionals' support. Volunteers are motivated by direct interaction with patients and next of kin. Opportunities for interactions depend on the healthcare setting and professionals' understandings of volunteers' role. Formal training of volunteers is limited and supportive available professionals important to volunteers. Professionals' understandings of volunteers' role should be improved to strengthen volunteers' role in palliative care in Nordic countries.

PROSPERO REGISTRATION NUMBER

CRD42020222695.

A Conceptual Review of Loneliness in Adults: Qualitative Evidence Synthesis

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.