Department of Global Health & Social Medicine, King's College London, London, United Kingdom.
Department of Interdisciplinary Social Science, Utrecht University, Utrecht, the Netherlands.
Soc Sci Med. 2024 Jan;340:116438. doi: 10.1016/j.socscimed.2023.116438. Epub 2023 Nov 22.
Loneliness is understood as a subjective experience resulting from unmet social relationship expectations. As most loneliness research has been conducted in higher-income-countries, there is limited understanding of loneliness in relation to diverse cultural, economic, and socio-political factors. To address this gap, the present review systematically synthesises existing qualitative studies on the experience of loneliness and social relationship expectations in lower- and middle-income countries (LMICs). Between June and July 2022, six online databases (Embase, Ovid Medline, APA PsycINFO, Global Health, Web of Science, Google Scholar) were searched for peer-reviewed studies from LMICs on loneliness using qualitative methods. There were no restrictions on publication date, language, or study setting. Studies that solely focused on social isolation or were conducted with children (<16 years) were excluded. Risk of bias was assessed with the Critical Appraisal Skills Programme. After deduplication, a total of 7866 records were identified and screened for inclusion, resulting in 24 studies published between 2002 and 2022. The included studies represent data from 728 participants in 15 countries across West Africa (Ghana, Nigeria, Niger, Mali), East Africa (Uganda, Kenya), North Africa (Egypt), West Asia (Iran), South Asia (India, Pakistan, Sri Lanka) and Southeast Asia (Myanmar, Cambodia, Indonesia, Philippines). Data were analysed combining inductive and deductive coding, summarised using narrative synthesis, and examined by geographical region. Common features of loneliness included rejection, overthinking, and pain. Loneliness was related to depression across regions. Whereas loneliness tended to be distinguished from social isolation in studies from Africa, it tended to be related with being alone in studies from Asia. Poverty and stigma were common barriers to fulfilling social relationship expectations. This review illustrates how loneliness and expectations are contextually embedded, with some expectations possibly being specific to a certain culture or life stage, having implications for assessment of and interventions for loneliness worldwide.
孤独感被理解为一种由于未满足的社会关系期望而产生的主观体验。由于大多数孤独感研究都是在高收入国家进行的，因此对与不同文化、经济和社会政治因素相关的孤独感了解有限。为了解决这一差距，本综述系统地综合了现有关于低收入和中等收入国家（LMICs）孤独感和社会关系期望的定性研究。2022 年 6 月至 7 月，使用定性方法在六个在线数据库（Embase、Ovid Medline、APA PsycINFO、Global Health、Web of Science、Google Scholar）中搜索了来自 LMICs 的关于孤独感的同行评议研究。对出版物日期、语言或研究地点没有限制。仅关注社会孤立或仅对儿童（<16 岁）进行的研究被排除在外。使用批判性评估技能计划评估偏倚风险。在重复项被扣除后，共确定了 7866 条记录，并对其进行了纳入筛选，最终纳入了 2002 年至 2022 年期间发表的 24 项研究。这些纳入的研究代表了来自 15 个国家的 728 名参与者的数据，这些国家分布在西非（加纳、尼日利亚、尼日尔、马里）、东非（乌干达、肯尼亚）、北非（埃及）、西亚（伊朗）、南亚（印度、巴基斯坦、斯里兰卡）和东南亚（缅甸、柬埔寨、印度尼西亚、菲律宾）。使用归纳和演绎编码相结合的方法对数据进行分析，使用叙述性综合方法进行总结，并按地理位置进行检查。孤独感的共同特征包括被拒绝、过度思考和痛苦。孤独感与整个地区的抑郁有关。虽然在非洲的研究中，孤独感往往与社会孤立有所区别，但在亚洲的研究中，孤独感往往与独处有关。贫困和耻辱感是满足社会关系期望的常见障碍。本综述说明了孤独感和期望是如何在情境中相互关联的，其中一些期望可能是特定于某种文化或生活阶段的，这对全球范围内孤独感的评估和干预具有重要意义。
