title: Social provision and loneliness among older people suffering from chronic physical illness. A mixed-methods approach.
abstract: OBJECTIVE
  To describe and compare the perceived social provision for a group reporting never feeling lonely with that of a group reporting feeling lonely and to explore the meaning of loneliness.
  
  
  METHODS
  Participants (N = 101) were recruited from geriatric wards. Inclusion criteria were as follows: aged 65 years or more, the absence of dementia, one or more chronic physical disorders and plans to be discharged from the hospital to their home. The mean age was 81.3 years (range: 65-96 years), 68% were women, and 66% lived alone.
  
  
  METHODS
  Assessments of social provisions and loneliness were collected by a subjective report using the Social Provision Scale (SPS), and the Montgomery-Aasberg Depression Rating Scale (MADRS) was used to assess depression. The participants were also asked whether they felt lonely and were then asked to describe the meaning of loneliness if they had indicated feeling lonely. Narratives were then condensed by the participants into short sentences.
  
  
  RESULTS
  Seventy-five per cent of the participants reported feeling lonely, of these 54% were living alone, and 18% identified with depression. Three subscales of SPS scores were significantly lower in the lonely group: attachment (p < 0.001), a sense of reliable alliance (p = 0.001) and the obtaining of guidance (p = 0.01). The overall view of the experience of loneliness was dominated by emptiness and negative emotions. The following themes were identified: Emotions were dominated by sadness, anxiety and restlessness, anger and guilt. Relationships were dominated by being left alone, being confined and feeling useless. Existential dimensions were characterised by emptiness, endless boredom, isolation and the potential for change.
  
  
  CONCLUSIONS
  The study shows that loneliness is prevalent among older people suffering from chronic physical illness and confirms the complexity of the concept. A mixed-methods design contributed to nuanced and detailed information about the meaning of loneliness.
authors.affiliation: Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway; Department of Public Health, Hedmark University College, Elverum, Norway.
authors.forename: Kari
authors.initials: K
authors.lastname: Kvaal
authors.forename: Anne-Grethe
authors.initials: AG
authors.lastname: Halding
authors.forename: Kari
authors.initials: K
authors.lastname: Kvigne
mesh_terms: D000369:Aged, 80 and over; D002908:Chronic Disease / Q000523:psychology*; D005260:Female; D006801:Humans; D008132:Loneliness; D008297:Male; D012934:Social Isolation
keywords: Montgomery-Aasberg Depression Rating Scale; Social Provision Scale; chronic physical disorders; depression; inpatients; loneliness; mixed methods; narratives; older people