Chistell Flurina, Stängle Sabrina, Fringer André
Department Internal Medicine, Regional Hospital Surselva, Ilanz, Switzerland.
School of Health Professions, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz, 9, Winterthur, 8400, Switzerland.
BMC Nurs. 2023 May 15;22(1):161. doi: 10.1186/s12912-023-01327-4.
The phenomenon of loneliness is increasing worldwide. Caring relatives (CRs) are at high risk of suffering from loneliness. Although some studies have already investigated the issue of loneliness among CRs, there is a lack of evidence to help understand the experience of loneliness in depth. The aim of this study is to record and analyse the experience of loneliness among CRs of chronically ill people. Specifically, the aim is to develop a conceptual model based on the concepts of social, emotional, and existential loneliness.
A qualitative-descriptive research design with narrative semistructured interviews was chosen. Thirteen CRs-three daughters, six wives and four husbands-participated in the study. The participants were an average of 62.5 years old. The interviews took place from September 2020 to January 2021 and lasted an average of 54 min. The data were analysed inductively using coding. The analysis was carried out in the following three coding phases: initial open coding, axial coding, and selective coding. The central phenomenon was abductively generated from the main categories.
A chronic illness gradually changes the participants' normal lives over time. A feeling of social loneliness is experienced, as their quality of social contacts no longer meets their needs. Thoughts about the future and the question of why are omnipresent can create a feeling of existential loneliness. Lack of communication in the partnership or in the family relationship, the changed personality of the ill person as well as the resulting role shift are stressful. Moments of closeness and tenderness become rare, and a change in togetherness takes place. In such moments, there is a strong feeling of emotional loneliness. Personal needs rapidly fade into the background. One's own life comes to a standstill. Accordingly, loneliness is perceived by the participants to be a stagnant life and is experienced as monotonous and painful. Feelings such as helplessness, powerlessness, frustration, anger, and sadness accompany this loneliness.
The study results show that the feeling of loneliness is present and experienced in a similar way by CRs, regardless of age and relationship to an ill person and that a need for action must derive from this. With the conceptual model, it is possible to offer versatile starting points for nursing practice, such as sensitization, to foster further research into the topic.
孤独现象在全球范围内日益增加。照顾亲属(CRs)面临着较高的孤独风险。尽管一些研究已经调查了照顾亲属中的孤独问题,但仍缺乏深入了解孤独体验的证据。本研究的目的是记录和分析慢性病患者照顾亲属的孤独体验。具体而言,目的是基于社会、情感和存在孤独的概念构建一个概念模型。
选择采用叙事性半结构化访谈的定性描述性研究设计。13名照顾亲属——3名女儿、6名妻子和4名丈夫——参与了研究。参与者平均年龄为62.5岁。访谈于2020年9月至2021年1月进行,平均持续54分钟。使用编码对数据进行归纳分析。分析分以下三个编码阶段进行:初始开放编码、轴心编码和选择性编码。核心现象是从主要类别中归纳得出的。
随着时间的推移,慢性病逐渐改变了参与者的正常生活。由于社交接触的质量不再满足他们的需求,他们体验到了社会孤独感。对未来的思考以及“为什么”这个问题无处不在,可能会产生存在孤独感。伴侣关系或家庭关系中缺乏沟通、患者性格的改变以及由此导致的角色转变都很有压力。亲密和温柔的时刻变得稀少,相处方式发生了变化。在这些时刻,会有一种强烈的情感孤独感。个人需求迅速退居次要地位。自己的生活陷入停滞。因此,参与者将孤独视为一种停滞不前的生活,并体验为单调和痛苦。无助、无力、沮丧、愤怒和悲伤等情绪伴随着这种孤独感。
研究结果表明,无论年龄和与患者的关系如何,照顾亲属都存在孤独感且体验相似,因此必须据此采取行动。借助该概念模型,可以为护理实践提供多种切入点,如提高认识,以促进对该主题的进一步研究。