Loneliness, loss, and social support among cognitively intact older people with cancer, living in nursing homes – a mixed-methods study

Figures & data

Figure 1 Schematic overview of quantitative–qualitative mixed-methods design for testing and refuting already developed concepts.

Notes: The left pathway illustrates the core component of the project (quantitative deductive drive). The right pathway illustrates the supplemental components of the project (qualitative inductive drive). The point of interface is the position at which the core and the supplemental components meet. The “results” refers to write-up of the core component findings with the addition of results of the supplemental components.

Table 1 Overview of categories, subthemes, and themes in qualitative analyses

Categories	Subthemes	Themes
Meaningless life	Feelings of inner pain	Experiencing loneliness
Not thriving
Feeling sad
Loss of important others	Feelings of loss
Loss of health
Loss of home
Overlooked	Feeling small
Marginalized
No one cares
Someone to care about	The importance of being engaged	Decreasing loneliness
The outside world
Something to do
Family	The significance of contact with other people
The nurses and care workers
Use telephone
Radio and television	The importance of occupying oneself
Read newspaper and books

Table 2 Personal characteristics of the 60 respondents in the Bergen Nursing Home Study 2004–2005

Characteristic	With cancer (n=60) Number (%)
Sexa
Men	21 (35.0)
Women	39 (65.0)
Age (years)b
65–74	3 (5.0)
75–84	24 (40.0)
85–94	28 (46.7)
≥95	5 (8.3)
Marital statusb
Married or cohabiting	18 (30.0)
Unmarried	8 (13.3)
Divorced	4 (6.7)
Widowed	30 (60.1)
Educationb
Primary school	22 (36.7)
<3 years after primary school	31 (51.7)
≥3 years after primary school	7 (11.7)
Groll’s index (FCIc)
FCI ≥1	53 (88.3)
FCI=0	7 (11.7)
Cancer
Breast	12 (20.0)
Colorectal	12 (20.0)
Prostate	7 (11.7)
Other	34 (56.7)

Notes:

a Student’s t-test.

b Chi-square test.

c FCI, 0–18.

Abbreviation: FCI, Functional Comorbidity Index.

Table 3 Logistic regression models for loneliness and for the SPS for nursing home residents

	Unadjusteda			Fully adjustedb			Final modelc
	Odds ratioa	95% CIb	P-value	Odds ratioa	95% CIb	P-value	Odds ratioa	95% CIb	P-value
Sex			0.956
Women	1	Reference		1	Reference	0.669
Men	0.97	(0.33, 2.8)		0.87	(0.11, 31.55)
Age (years)			0.829			0.407
65–74	1	Reference		1	Reference
75–84	3.0	(0.15, 59.80)		0.01	(0.00, 2.55)
85–94	1.27	(0.18, 9.02)		0.01	(0.00, 2.27)
≥95	0.9	(0.14, 6.78)		0.01	(0.00, 5.01)
Education			0.711			0.200
Primary school	1	Reference		1	Reference
<3 years after primary school	2.03	(0.33, 13.15)		0.22	(0.33, 1.52)
≥3 years after primary school	2.06	(0.35, 12.28)		0.07	(0.00, 1.64)
Marital status			0.043			0.048			0.022
Married or cohabiting	1	Reference		1	Reference		1
Unmarried	6.07	(1.67, 22.12)		0.05	(0.00, 1.99)		0.16	(0.02, 1.22)
Divorced	1.40	(0.27, 7.15)		0.55	(0.1, 25.99)		0.18	(0.01, 4.06)
Widowed	0.78	(0.71, 8.52)		0.01	(0.00, 0.25)		0.11	(0.02, 0.53)
Groll’s index	1.19	(0.80, 1.79)	0.394	2.84	(1.19, 6.76)	0.019
Social provision scaled
Attachment	0.97	(0.92, 1.31)	0.284	1.05	(0.70, 1.59)	0.830
Social integration	0.97	(0.95, 1.30)	0.196	0.87	(0.96, 1.08)	0.403
Reassurance of worth	1.55	(1.10, 2.14)	0.008	2.26	(1.30, 3.91)	0.004	1.64	(1.16, 2.35)	<0.001
Nurturance	1.12	(0.93, 1.32)	0.246	0.83	(0.55, 1.25)	0.371

Notes:

a Unadjusted for sex, age group, educational level, marital status, comorbidity;

b fully adjusted for sex, age group, educational level, marital status, comorbidity;

c final model adjusted for sex, age group, educational level, marital status, comorbidity;

d SPS 4–16, higher score better score. P-value is derived from likelihood ratio test. The bold values are the significant outcomes.

Abbreviations: CI, confidence interval; SPS, Social Provisions Scale.