Larsson Helena, Rämgård Margareta, Bolmsjö Ingrid
Faculty of Health and Society, Department of Care Science, Malmö University, SE 205 06, Malmö, Sweden.
Department of Health and Society, Kristianstad University, SE 291 88, Kristianstad, Sweden.
BMC Geriatr. 2017 Jul 10;17(1):138. doi: 10.1186/s12877-017-0533-1.
In order to better understand people in demanding medical situations, an awareness of existential concerns is important. Studies performed over the last twenty years conclude that when dying and death come closer, as in the case with older people who are stricken by infirmity and diseases, existential concerns will come to the fore. However, studies concerning experiences of existential loneliness (EL) are sparse and, in addition, there is no clear definition of EL. EL is described as a complex phenomenon and referred to as a condition of life, an experience, and a process of inner growth. Listening to someone who knows the older person well, as significant others often do, may be one way of learning more about EL.
This study is part of a larger research project on EL, the LONE study, where EL is explored through interviews with frail older people, their significant others and health care professionals. The aim of this study was to explore frail older (>75) persons' EL, as interpreted by their significant others. The study is qualitative and based on eighteen narrative interviews with nineteen significant others of older persons. The data was analysed using Hsieh and Shannon's conventional content analysis.
According to the interpretation of significant others, the older persons experience EL (1) when they are increasingly limited in body and space, (2) when they are in a process of disconnecting, and (3) when they are disconnected from the outside world.
The result can be understood as if the frail older person is in a process of letting go of life. This process involves the body, in that the older person is increasingly limited in his/her physical abilities. The older person's long-term relationships are gradually lost, and finally the process entails the older person's increasingly withdrawing into him- or herself and turning off the outside world. The result of this study is consistent with previous research that has shown that EL is a complex phenomenon, but the implications of this research include a deepened understanding of EL. In addition, the study highlights the interpretations of significant others.
为了更好地理解处于高要求医疗情境中的人们，认识到存在性关切很重要。过去二十年进行的研究得出结论，当死亡临近时，比如在受疾病和体弱困扰的老年人身上，存在性关切就会凸显出来。然而，关于存在性孤独（EL）体验的研究很少，此外，对于EL也没有明确的定义。EL被描述为一种复杂的现象，被称作一种生活状态、一种体验以及内心成长的过程。像重要他人经常做的那样，倾听非常了解老年人的人的讲述，可能是更多了解EL的一种方式。
本研究是关于EL的一个更大研究项目——孤独研究（LONE study）的一部分，在该项目中，通过对体弱老年人、他们的重要他人以及医护人员进行访谈来探究EL。本研究的目的是探讨重要他人所理解的体弱老年人（年龄>75岁）的EL。该研究是定性研究，基于对19位老年人的18位重要他人进行的叙述性访谈。使用谢和香农的传统内容分析法对数据进行分析。
根据重要他人的理解，老年人在以下情况下会体验到EL：（1）他们在身体和空间上越来越受限；（2）他们处于一种脱离的过程中；（3）他们与外部世界断开联系。
该结果可以理解为体弱老年人正处于一个对生活放手的过程。这个过程涉及身体，因为老年人的身体能力越来越受限。老年人的长期关系逐渐丧失，最后这个过程导致老年人越来越自我封闭并与外部世界隔绝。本研究结果与之前表明EL是一种复杂现象的研究一致，但该研究的意义包括对EL有了更深入的理解。此外，该研究突出了重要他人的理解。
