Existential Loneliness Among Older People from the Perspective of Health Care Professionals: A European Multicenter Study

Abstract

Introduction

Health care professionals (HCPs) encounter different forms of loneliness in their work. It is essential that they have the courage, skills, and tools to deal with loneliness, in particular with existential loneliness (EL) which relates to meaning in life and the fundamentals of living and dying.

Aim

The aim of this study was to investigate HCPs’ views on loneliness among older people and their understanding, perception, and professional experience of EL in older people.

Materials and Methods

In all, 139 HCPs from five European countries participated in audio-recorded focus group and individual interviews. The transcribed materials were locally analyzed using a predefined template. The participating countries’ results were then translated, merged, and inductively analyzed using conventional content analysis.

Results

Participants described different forms of loneliness – a negative form that is unwanted and causes suffering, and a positive form where solitude is desired and sought. The results showed that the HCPs’ knowledge and understanding of EL varied. The HCPs mainly related EL to different types of loss, eg loss of autonomy, independence, hope, and faith, and to concern alienation, guilt, regret and remorse, and concerns about the future.

Discussion and Conclusions

The HCPs expressed a need to improve their sensitivity and self-confidence to engage in existential conversations. They also stated the need to increase their knowledge and understanding of aging, death, and dying. Based on these results, a training program aimed to increase knowledge and understanding of older people’s situation has been developed. The program includes practical training in conversations about emotional and existential aspects, based on recurrent reflections on the topics presented. The program is available at: www.aloneproject.eu.

Keywords:

• older people
• health care professionals
• existential loneliness
• qualitative
• multicenter study

Abbreviations

EL, existential loneliness; HCP, health care professional.

Data Sharing Statement

Original data will not be shared for reasons of confidentiality.

Ethics Approval and Informed Consent

The study was conducted in line with the Helsinki Declaration. The voluntariness of participation was emphasized, as were confidentiality and the risks, burden, and benefits of the research. All participants provided written informed consent prior to participation. Study approval by the national ethics boards in the respective countries was applied for and obtained where required in terms of national legislation. As the interviews neither targeted vulnerable groups nor collected personal details, ethical permission was not required in Italy, Romania, Poland, or Lithuania. The interviews in Sweden were part of a larger study; therefore, ethical approval was applied for and granted by the Lund Ethical Review Board (ref 2014/652).

Consent for Publication

No images or videos are included in the paper.

Acknowledgments

We are most grateful to the health care professionals who participated in this study, for taking the time and generously sharing their experiences. We are also grateful to Malin Sundström, Kerstin Blomqvist, and Margareta Rämgård for collecting data in Sweden, and to Ina Valeckienė for collecting data in Lithuania. We also wish to thank Proper English for revising the language.

Author Contributions

The study was designed in collaboration between the five participating sites. The first author had the main responsibility for the cross-cultural analysis of the results and the drafting of the paper. All authors made a significant contribution to the work reported, whether in the conception, study design, execution, acquisition of data, or analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors have no competing interests to declare for this work.

Additional information

Funding

This work has been funded by the European Union under the Erasmus+ Programme as part of the project “Innovative Health Professionals Training Program on Existential Loneliness among Older People”, ALONE (project No. 2019-1-PL01-KA202-064933). The European Commission support for the production of this publication does not constitute an endorsement of the contents, which reflect the views only of the authors, and the Commission cannot be held responsible for any use which may be made of the information contained herein.