A scoping review of influencing factors associated with loneliness in nursing home settings

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Abstract
Older adults residing in nursing home (NH) settings are at risk of loneliness, a complex and multi-dimensional concept that adversely affects health. To effectively identify and address loneliness, it is crucial to enhance the understanding of the social, psychological, cultural, and environmental factors associated with loneliness. A scoping review was conducted to examine the current evidence. Thematic analysis was employed to identify factors influencing (dimensions of) loneliness, which were ranked on proximity to loneliness. Based on 38 research papers, 27 factors related to loneliness were identified, of which 13 were sufficiently representative. A minority of these factors were directly linked to the social, emotional and existential dimensions of loneliness. The most frequently mentioned factors were categorised into the domains of health and functioning, stress-coping, social contact, and relationship quality. Loneliness is best addressed within the immediate social environment of NH settings, and staff play a crucial role in fostering a sense of belonging. Moreover, residents' experiences and needs regarding loneliness and its dimensions must be thoroughly assessed and discussed, particularly for those suffering from dementia. Furthermore, our review emphasises the urgent need for comprehensive, inclusive, and consistent research on loneliness in NH settings.

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