Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-27T21:14:51.395Z Has data issue: false hasContentIssue false

Loneliness among cancer caregivers: A narrative review

Published online by Cambridge University Press:  04 October 2019

Tamryn F. Gray*
Affiliation:
Postdoctoral Research Fellow, Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA02215
Desiree R. Azizoddin
Affiliation:
Postdoctoral Research Fellow, Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA02215
Paula V. Nersesian
Affiliation:
Assistant Professor, Johns Hopkins School of Nursing, Baltimore, MD21205
*
Author for correspondence: Tamryn F. Gray, Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, 375 Longwood Ave, Boston, MA02215. Email: tamryn_gray@dfci.harvard.edu

Abstract

Objective

Providing care to a loved one with cancer places demands on caregivers that result in changes to their daily routines and disruptions to their social relationships that then contribute to loneliness. Though caregivers’ psychosocial challenges have been well studied, loneliness — a determinant of health — has not been well studied in this population. This narrative review sought to describe the current evidence on loneliness among caregivers of cancer patients. We aimed to (1) define loneliness, (2) describe its prevalence, (3) describe the association between loneliness and health outcomes, (4) describe risks and consequences of loneliness among cancer caregivers, (5) identify ways to assess loneliness, and (6) recommend strategies to mitigate loneliness in this unique population.

Method

We used evidence from articles listed in PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, book chapters, and reports. Articles were reviewed for the following inclusion criteria: (1) published in English, (2) caregivers of cancer patients, (3) loneliness as a study variable, and (4) peer-reviewed with no restriction on the timeframe of publication. Caregivers were defined as relatives, friends, or partners who provide most of the care and support for someone with cancer.

Results

Eighteen studies met inclusion criteria and were included in the analysis. Caregivers’ experiences of loneliness can contribute to negative effects on one's social, emotional, and physical well-being. Social support interventions may not be sufficient to address this problem. Existing recommendations to mitigate loneliness include cognitive and psychological reframing, one-on-one and group therapy, befriending, resilience training, and technology-based interventions.

Significance of results

Limited attention to loneliness in cancer caregivers poses a twofold problem that impacts patient and caregiver outcomes. Interventions are critically needed to address loneliness as a determinant of health in caregivers, given their pivotal role in providing care and impacting health outcomes for people with cancer.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

co first-authors.

References

Applebaum, AJ and Breitbart, W (2013) Care for the cancer caregiver: A systematic review. Palliative and Supportive Care 11(3), 231252. https://doi.org/10.1017/S1478951512000594CrossRefGoogle ScholarPubMed
Ayalon, L (2016) Profiles of loneliness in the caregiving unit. Gerontologist 56(2), 201214. https://doi.org/10.1093/geront/gnu046CrossRefGoogle ScholarPubMed
Azizoddin, DR, Zamora-Racaza, G, Ormseth, SR, et al. (2017) Psychological factors that link socioeconomic status to depression/anxiety in patients with systemic lupus erythematosus. Journal of Clinical Psychology in Medical Settings 24, 302315. https://doi.org/10.1007/s10880-017-9505-zCrossRefGoogle ScholarPubMed
Balaam, MC (2015) A concept analysis of befriending. Journal of Advanced Nursing 71(1), 2434. https://doi.org/10.1111/jan.12553CrossRefGoogle ScholarPubMed
Balfe, M, O'Brien, K, Timmons, A, et al. (2016) The unmet supportive care needs of long-term head and neck cancer caregivers in the extended survivorship period. Journal of Clinical Nursing 25(11–12), 15761586. https://doi.org/10.1111/jocn.13140CrossRefGoogle ScholarPubMed
Beller, J and Wagner, A (2018) Disentangling loneliness: Differential effects of subjective loneliness, network quality, network size, and living alone on physical, mental, and cognitive health. Journal of Aging and Health 30(4), 521539. https://doi.org/10.1177/0898264316685843CrossRefGoogle ScholarPubMed
Berkman, L, Glass, T, Brissette, I, et al. (2000) From social integration to health: Durkheim in the new millennium. Social Science & Medicine 51(6), 843857.CrossRefGoogle ScholarPubMed
Bevan, JL and Pecchioni, LL (2008) Understanding the impact of family caregiver cancer literacy on patient health outcomes. Patient Education and Counseling 71(3), 356364. https://doi.org/10.1016/j.pec.2008.02.022CrossRefGoogle ScholarPubMed
Bevans, M and Sternberg, EM (2012) Caregiving burden, stress, and health effects among family caregivers of adult cancer patients. JAMA 307(4), 398403. https://doi.org/10.1001/jama.2012.29CrossRefGoogle ScholarPubMed
Biegel, DE, Sales, E and Schulz, R (1991) Family caregiving in chronic illness: Alzheimer's disease, cancer, heart disease, mental illness, and stroke. Thousand Oaks, CA, US: Sage Publications, Inc.Google Scholar
Cacioppo, JT and Hawkley, LC (2009) Perceived social isolation and cognition. Trends in Cognitive Sciences 13(10), 447454. https://doi.org/10.1016/j.tics.2009.06.005.PerceivedCrossRefGoogle ScholarPubMed
Cacioppo, JT, Hawkley, LC, Berntson, GG, et al. (2002) Do lonely days invade the nights? Potential social modulation of sleep efficiency. Psychological Science 13(4), 384387.CrossRefGoogle ScholarPubMed
Cacioppo, JT, Hughes, ME, Waite, LJ, et al. (2006) Loneliness as a specific risk factor for depressive symptoms: Cross-sectional and longitudinal analyses. Psychology and Aging 21(1), 140151. https://doi.org/10.1037/0882-7974.21.1.140CrossRefGoogle ScholarPubMed
Cacioppo, JT, Hawkley, LC and Thisted, RA (2010) Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study. Psychology and Aging 25(2), 453463. https://doi.org/10.1037/a0017216CrossRefGoogle ScholarPubMed
Cacioppo, S, Grippo, AJ, London, S, et al. (2015) Loneliness: Clinical import and interventions. Perspectives on Psychological Science 10(2), 238249. https://doi.org/10.1111/ajt.13087.TIM-1CrossRefGoogle ScholarPubMed
Cattan, M, White, M, Bond, J, et al. (2005) Preventing social isolation and loneliness among older people: A systematic review of health promotion interventions. Ageing and Society 25(1), 4167. https://doi.org/10.1017/S0144686X04002594CrossRefGoogle Scholar
Chopik, WJ (2016) The benefits of social technology use among older adults are mediated by reduced loneliness. Cyberpsychology, Behavior, and Social Networking. https://doi.org/10.1089/cyber.2016.0151CrossRefGoogle ScholarPubMed
Cobb, SC, Etkins, L, Nelson, M, et al. (2016) A comparison of the reactions of caregivers of patients with cancer versus patients with other chronic medical conditions. Oncology Nursing Forum 43(3), 321327. https://doi.org/10.1188/16.ONF.321-327CrossRefGoogle Scholar
Cotten, SR, Anderson, WA and McCullough, BM (2013) Impact of internet use on loneliness and contact with others among older adults: Cross-sectional analysis. Journal of Medical Internet Research 15(2), e39. https://doi.org/10.2196/jmir.2306CrossRefGoogle ScholarPubMed
Cotterell, N, Buffel, T and Phillipson, C (2018) Preventing social isolation in older people. Maturitas 113, 8084. https://doi.org/10.1016/j.maturitas.2018.04.014CrossRefGoogle ScholarPubMed
Creswell, JD, Irwin, MR, Burklund, LJ, et al. (2012) Mindfulness-based stress reduction training reduces loneliness and pro-inflammatory gene expression in older adults: A small randomized controlled trial. Brain, Behavior, and Immunity 26(7), 10951101. https://doi.org/10.1016/j.bbi.2012.07.006CrossRefGoogle ScholarPubMed
De Jong Gierveld, J (1998) A review of loneliness: Concept and definitions, determinants and consequences. Reviews in Clinical Gerontology 8(1), 7380. https://doi.org/10.1017/S0959259898008090CrossRefGoogle Scholar
De Jong Gierveld, J and Kamphuls, F (1985) The development of a Rasch-type Loneliness Scale 9(3), 289299.Google Scholar
De Jong Gierveld, J and Van Tilburg, T (2006) A 6-item scale for overall, emotional, and social loneliness: Confirmatory tests on survey data. Research on Aging 28, 5. https://doi.org/10.1177/0164027506289723Google Scholar
De Jong Gierveld, J and Van Tilburg, T (2010) The De Jong Gierveld short scales for emotional and social loneliness: Tested on data from 7 countries in the UN generations and gender surveys. European Journal of Ageing 7(2), 121130. https://doi.org/10.1007/s10433-010-0144-6CrossRefGoogle Scholar
Deckx, L, Van Den Akker, M, Bulens, P, et al. (2015) Loneliness in patients with cancer: The first year after cancer diagnosis. Psycho-Oncology 24(11), 15211528.CrossRefGoogle ScholarPubMed
DeNiro, DA (1995) Perceived alienation in individuals with residual-type schizophrenia. Issues in Mental Health Nursing 16(3), 185200.CrossRefGoogle ScholarPubMed
Deshields, TL, Rihanek, A, Potter, P, et al. (2012) Psychosocial aspects of caregiving: Perceptions of cancer patients and family caregivers. Supportive Care in Cancer. https://doi.org/10.1007/s00520-011-1092-1CrossRefGoogle ScholarPubMed
Dyal, SR and Valente, TW (2015) A systematic review of loneliness and smoking: Small effects, big implications. Substance Use and Misuse. https://doi.org/10.3109/10826084.2015.1027933CrossRefGoogle ScholarPubMed
Ekwall, AK, Sivberg, B and Hallberg, IR (2005) Loneliness as a predictor of quality of life among older caregivers. Journal of Advanced Nursing. https://doi.org/10.1111/j.1365-2648.2004.03260.xCrossRefGoogle ScholarPubMed
Ferrell, BR, Ervin, K, Smith, S, et al. (2002) Family perspectives of ovarian cancer. Cancer Practice 10(6), 269276. https://doi.org/10.1046/j.1523-5394.2002.106001.xCrossRefGoogle ScholarPubMed
Ferrell, BR, Kravitz, K, Borneman, T, et al. (2018) Family caregivers: A qualitative study to better understand the quality-of-life concerns and needs of this population. Clinical Journal of Oncology Nursing. https://doi.org/10.1188/18.CJON.286-294CrossRefGoogle ScholarPubMed
Gardiner, C, Geldenhuys, G and Gott, M (2018) Interventions to reduce social isolation and loneliness among older people: An integrative review. Health and Social Care in the Community 26(2), 147157. https://doi.org/10.1111/hsc.12367CrossRefGoogle ScholarPubMed
Gerst-Emerson, K and Jayawardhana, J (2015) Loneliness as a public health issue: The impact of loneliness on health care utilization among older adults. American Journal of Public Health 105(5), 10131019. https://doi.org/10.2105/AJPHCrossRefGoogle ScholarPubMed
Given, BA, Given, CW and Kozachik, S (2001) Family support in advanced cancer. CA: A Cancer Journal for Clinicians 51(4), 213231. https://doi.org/10.3322/canjclin.51.4.213Google ScholarPubMed
Given, BA, Given, CW and Sherwood, P (2012) The challenge of quality cancer care for family caregivers. Seminars in Oncology Nursing. https://doi.org/10.1016/j.soncn.2012.09.002CrossRefGoogle ScholarPubMed
Glajchen, M (2009) Role of family caregivers in cancer pain management. In Eduardo D. Bruera and Russell K. Portenoy (eds), Cancer Pain: Assessment and Management, 2nd ed.New York, NY: Cambridge University Press, pp. 597607.Google Scholar
Golden, J, Conroy, RM, Bruce, I, et al. (2009) Loneliness, social support networks, mood and wellbeing in community-dwelling elderly. International Journal of Geriatric Psychiatry 24(7), 694700. https://doi.org/10.1002/gps.2181CrossRefGoogle ScholarPubMed
Gray, TF, Nolan, MT, Clayman, ML, et al. (2019) The decision partner in healthcare decision-making: A concept analysis. International Journal of Nursing Studies 92, 7989. https://doi.org/10.1016/j.ijnurstu.2019.01.006CrossRefGoogle ScholarPubMed
Grygiel, P, Humenny, G and Rebisz, S (2019) Using the De Jong Gierveld Loneliness Scale with early adolescents: Factor structure, reliability, stability, and external validity. Assessment 26(2), 151165. https://doi.org/10.1177/1073191116682298CrossRefGoogle Scholar
Hartke, RJ and King, RB (2003) Telephone group intervention for older stroke caregivers. Topics in Stroke Rehabilitation. https://doi.org/10.1310/RX0A-6E2Y-BU8J-W0VLCrossRefGoogle ScholarPubMed
Hawkley, LC and Cacioppo, JT (2003) Loneliness and pathways to disease. Brain, Behavior, and Immunity 17(Suppl 1), S98S105. https://doi.org/10.1016/S0889-1591(02)00073-9CrossRefGoogle ScholarPubMed
Hawkley, LC and Cacioppo, JT (2010) Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine 40(2), 123. https://doi.org/10.1088/1367-2630/15/1/015008.FluidCrossRefGoogle ScholarPubMed
Hawkley, LC, Masi, CM, Berry, JD, et al. (2006) Loneliness is a unique predictor of age-related differences in systolic blood pressure. Psychology and Aging 21(1), 152164. https://doi.org/10.1037/0882-7974.21.1.152CrossRefGoogle ScholarPubMed
Hawkley, LC, Thisted, RA and Cacioppo, JT (2009) Loneliness predicts reduced physical activity: Cross sectional and longitudinal analyses. Health Psychology 28(3), 354363. https://doi.org/10.1037/a0014400.LonelinessCrossRefGoogle Scholar
Hayley, AC, Downey, LA, Stough, C, et al. (2017) Social and emotional loneliness and self-reported difficulty initiating and maintaining sleep (DIMS) in a sample of Norwegian University students. Scandinavian Journal of Psychology 58(1), 9199. https://doi.org/10.1111/sjop.12343CrossRefGoogle Scholar
Higginson, IJ, Gao, W, Jackson, D, et al. (2010) Short-form Zarit Caregiver Burden Interviews were valid in advanced conditions. Journal of Clinical Epidemiology 63(5), 535542. https://doi.org/10.1016/j.jclinepi.2009.06.014CrossRefGoogle ScholarPubMed
Holt-Lunstad, J, Smith, TB and Layton, JB (2010) Social relationships and mortality risk: A meta-analytic review. PLoS Medicine 7(7), e1000316. https://doi.org/10.1371/journal.pmed.1000316CrossRefGoogle ScholarPubMed
Holt-Lunstad, J, Smith, TB, Baker, M, et al. (2015) Loneliness and social isolation as risk factors for mortality. Perspectives on Psychological Science 10(2), 227237. https://doi.org/10.1177/1745691614568352CrossRefGoogle ScholarPubMed
Holt-Lunstad, J and Smith, TB (2016) Loneliness and social isolation as risk factors for CVD: Implications for evidence-based patient care and scientific inquiry. Heart 102(13), 987989. https://doi.org/10.1136/heartjnl-2015-309242CrossRefGoogle ScholarPubMed
Holtslander, L and Duggleby, W (2010) The psychosocial context of bereavement for older women who were caregivers for a spouse with advanced cancer. Journal of Women & Aging 22(2), 109124.CrossRefGoogle ScholarPubMed
Holwerda, TJ, Deeg, DJH, Beekman, ATF, et al. (2014) Feelings of loneliness, but not social isolation, predict dementia onset: Results from the Amsterdam Study of the Elderly (AMSTEL). Journal of Neurology, Neurosurgery, and Psychiatry 85(2), 135142. https://doi.org/10.1136/jnnp-2012-302755CrossRefGoogle Scholar
Hudson, P and Payne, S (2011) Family caregivers and palliative care: Current status and agenda for the future. Journal of Palliative Medicine. https://doi.org/10.1089/jpm.2010.0413CrossRefGoogle ScholarPubMed
Hughes, ME, Waite, LJ, Hawkley, LC, et al. (2004) A short scale for measuring loneliness in large surveys: Results from two population-based studies. Research on Aging 26(6), 655672. https://doi.org/10.1177/0164027504268574CrossRefGoogle Scholar
Hunt, GG, Longacre, ML, Kent, EE, et al. (2016) Cancer caregiving in the U.S.: An intense, episodic, and challenging care experience. Retrieved from: https://www.caregiving.org/wp-content/uploads/2016/06/CancerCaregivingReport_FINAL_June-17-2016.pdf.Google Scholar
Iecovich, E (2016) Do caregiving burden and satisfaction predict loneliness in older care recipients? Aging and Mental Health 20(4), 441449. https://doi.org/10.1080/13607863.2015.1020413CrossRefGoogle ScholarPubMed
Jaremka, LM, Fugundes, CP, Peng, J, et al. (2013) Loneliness promotes inflammation during acute stress. Psychological Science 24(7), 115. https://doi.org/10.1177/0956797612464059.LonelinessCrossRefGoogle ScholarPubMed
Jaremka, LM, Andridge, RR, Fagundes, CP, et al. (2014) Pain, depression, and fatigue: Loneliness as a longitudinal risk factor. Health Psychology 33(9), 948957. https://doi.org/10.1037/a0034012CrossRefGoogle ScholarPubMed
Kawachi, I and Berkman, LF (2001) Social ties and mental health. Journal of Urban Health 78(3), 458467.CrossRefGoogle ScholarPubMed
Kent, EE, Rowland, JH, Northouse, L, et al. (2016) Caring for caregivers and patients: Research and clinical priorities for informal cancer caregiving. Cancer. https://doi.org/10.1002/cncr.29939CrossRefGoogle ScholarPubMed
Kim, Y and Schulz, R (2008) Family caregivers’ strains: Comparative analysis of cancer caregiving with dementia, diabetes, and frail elderly caregiving. Journal of Aging and Health 20(5), 483503. https://doi.org/10.1177/0898264308317533CrossRefGoogle ScholarPubMed
Kurina, LM, Knutson, KL, Hawkley, LC, et al. (2011) Loneliness is associated with sleep fragmentation in a communal society. Sleep 34(11), 15191526. https://doi.org/10.5665/sleep.1390CrossRefGoogle Scholar
La Grow, S, Neville, S, Alpass, F, et al. (2012) Loneliness and self-reported health among older persons in New Zealand. Australasian Journal on Ageing 31(2), 121123. https://doi.org/10.1111/j.1741-6612.2011.00568.xCrossRefGoogle ScholarPubMed
Lester, H, Mead, N, Graham, CC, et al. (2012) An exploration of the value and mechanisms of befriending for older adults in England. Ageing and Society 32(2), 307328. https://doi.org/10.1017/S0144686X11000353CrossRefGoogle Scholar
Lim, KK and Chan, A (2016) Association of loneliness and healthcare utilization among older adults in Singapore. Geriatrics & Gerontology International, 110. https://doi.org/10.1111/ggi.12962Google Scholar
Longacre, ML, Applebaum, AJ, Buzaglo, JS, et al. (2018) Reducing informal caregiver burden in cancer: Evidence-based programs in practice. Translational Behavioral Medicine 8(2), 145155. https://doi.org/10.1093/tbm/ibx028CrossRefGoogle ScholarPubMed
Luo, Y, Hawkley, LC, Waite, L, et al. (2012) Loneliness, health, and morality in old age: A national longitudinal study. Social Science & Medicine 74(6), 907914. https://doi.org/10.1016/j.socscimed.2011.11.028.LonelinessCrossRefGoogle Scholar
Lynn, J (2014) Strategies to ease the burden of family caregivers. JAMA 311(10), 10211022.CrossRefGoogle ScholarPubMed
MacLeod, S, Musich, S, Hawkins, K, et al. (2016) The impact of resilience among older adults. Geriatric Nursing 37(4), 266272. https://doi.org/10.1016/j.gerinurse.2016.02.014CrossRefGoogle ScholarPubMed
MacLeod, S, Musich, S, Parikh, RB, et al. (2018) Examining approaches to address loneliness and social isolation among older adults. Journal of Aging and Geriatric Medicine. https://doi.org/10.4172/2576-3946.1000115CrossRefGoogle Scholar
Mahendran, R, Lim, HA, Tan, JYS, et al. (2017) Evaluation of a brief pilot psychoeducational support group intervention for family caregivers of cancer patients: A quasi-experimental mixed-methods study. Health and Quality of Life Outcomes 15(1), 17.CrossRefGoogle ScholarPubMed
Marsland, AL, Long, KA, Howe, C, et al. (2013) A pilot trial of a stress management intervention for primary caregivers of children newly diagnosed with cancer: Preliminary evidence that perceived social support moderates the psychosocial benefit of intervention. Journal of Pediatric Psychology. https://doi.org/10.1093/jpepsy/jss173CrossRefGoogle ScholarPubMed
Martina, CMS and Stevens, NL (2006) Breaking the cycle of loneliness? Psychological effects of a friendship enrichment program for older women. Aging and Mental Health. https://doi.org/10.1080/13607860600637893CrossRefGoogle ScholarPubMed
Masi, CM, Chen, H-Y, Hawkley, LC, et al. (2011) A meta analysis of interventions to reduce loneliness. Personality and Social Psychology Review 15(3), 219266. https://doi.org/10.1177/1088868310377394.ACrossRefGoogle ScholarPubMed
Matthews, K and Gallo, LC (2011) Psychological perspectives on pathways linking socioeconomic status and physical health. Annual Review of Psychology 62, 501530. https://doi.org/10.1146/annurev.psych.031809.130711CrossRefGoogle ScholarPubMed
McDade, TW, Hawkley, LC and Cacioppo, JT (2006) Psychosocial and behavioral predictors of inflammation in middle-aged and older adults: The Chicago Health, Aging, and Social Relations Study. Psychosomatic Medicine 68(3), 376381. https://doi.org/10.1097/01.psy.0000221371.43607.64CrossRefGoogle ScholarPubMed
Mead, N, Lester, H, Chew-Graham, C, et al. (2010) Effects of befriending on depressive symptoms and distress: Systematic review and meta-analysis. British Journal of Psychiatry 196(2), 96101. https://doi.org/10.1192/bjp.bp.109.064089CrossRefGoogle ScholarPubMed
Miller, C and Kapp, S (2015) Informal carers and wound management: An integrative literature review. Journal of Wound Care 24(11), 489490. 492, 494–497.CrossRefGoogle Scholar
Mitchell, G and Pistrang, N (2011) Befriending for mental health problems: Processes of helping. Psychology and Psychotherapy: Theory, Research and Practice 84(2), 151169. https://doi.org/10.1348/147608310X508566CrossRefGoogle ScholarPubMed
Murray, SA, Kendall, M, Boyd, K, et al. (2010) Archetypal trajectories of social, psychological, and spiritual wellbeing and distress in family care givers of patients with lung cancer: Secondary analysis of serial qualitative interviews. BMJ. https://doi.org/10.1136/bmj.c2581CrossRefGoogle ScholarPubMed
Musich, S, Wang, SS, Kraemer, S, et al. (2017) Caregivers for older adults: Prevalence, characteristics, and health care utilization and expenditures. Geriatric Nursing. https://doi.org/10.1016/j.gerinurse.2016.06.017CrossRefGoogle ScholarPubMed
Nersesian, PV, Han, HR, Yenokyan, G, et al. (2018) Loneliness in middle age and biomarkers of systemic inflammation: Findings from Midlife in the United States. Social Science & Medicine 209(July), 174181. https://doi.org/10.1016/j.socscimed.2018.04.007CrossRefGoogle ScholarPubMed
Northouse, L, Williams, A, Given, B, et al. (2012) Psychosocial care for family caregivers of patients with cancer. Journal of Clinical Oncology 30(11), 12271234.CrossRefGoogle ScholarPubMed
Oldham, L, Kristjanson, LJ, Ng, C, et al. (2006) Female relatives'experiences of testicular cancer. Australian Journal of Cancer Nursing 7(1), 1824.Google Scholar
O'Luanaigh, C, O'Connell, H, Chin, AV, et al. (2012) Loneliness and vascular biomarkers: The Dublin Healthy Ageing Study. International Journal of Geriatric Psychiatry 27(1), 8388. https://doi.org/10.1002/gps.2695CrossRefGoogle ScholarPubMed
Penning, MJ, Liu, G and Chou, PHB (2014) Measuring loneliness among middle-aged and older adults: The UCLA and De Jong Gierveld Loneliness Scales. Social Indicators Research 118(3), 11471166. https://doi.org/10.1007/s11205-013-0461-1CrossRefGoogle Scholar
Peplau, LA and Perlman, D (1982) Perspectives on loneliness. In Peplau, L and Perlman, D (eds.), Loneliness: A Sourcebook of Current Theory, Research and Therapy, New York: John Wiley and Sons, pp. 118.Google Scholar
Perlman, D and Peplau, LA (1981) Toward a social psychology of loneliness. In Duck, R and Gilmour, R (eds.), Personal Relationships in Disorder, London: Acade, pp. 3156. Retrieved from: http://www.peplaulab.ucla.edu/Peplau_Lab/Publications_files/Perlman%26Peplau81.pdf.Google Scholar
Perlman, D and Joshi, P (1987) The revelation of loneliness. Journal of Social Behavior & Personality 2(2), 6376.Google Scholar
Petitte, T, Mallow, JA, Barnes, ER, et al. (2015) A systematic review of loneliness and common chronic physical conditions in adults. Open Psychology Journal 8(Suppl 2), 113132. https://doi.org/10.2174/1874350101508010113.ACrossRefGoogle ScholarPubMed
Piil, K, Nordentoft, S, Larsen, A, et al. (2019) Bereaved caregivers of patients with high-grade glioma: A systematic review. BMJ Supportive & Palliative Care 9(1), 2633.CrossRefGoogle ScholarPubMed
Platt, L (2009) Social activity, social isolation and ethnicity. The Sociological Review 57(4). https://doi.org/doi.org/10.1111/j.1467-954X.2009.01867.xCrossRefGoogle Scholar
Price, B (2015) Approaches to counter loneliness and social isolation. Nursing Older People 27(7), 3139. https://doi.org/10.7748/nop.27.7.31.e722CrossRefGoogle ScholarPubMed
Radloff, LS (1977) The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement 1(3), 385401.CrossRefGoogle Scholar
Ritchwood, TD, Ebesutani, CK, Chin, EG, et al. (2017) The loneliness questionnaire: Establishing measurement invariance across ethnic groups. Assessment 24(6), 798809. https://doi.org/10.1177/1073191115625799CrossRefGoogle ScholarPubMed
Rokach, A, Findler, L, Chin, J, et al. (2013) Cancer patients, their caregivers and coping with loneliness. Psychology, Health and Medicine 18(2), 135144. https://doi.org/10.1080/13548506.2012.689839CrossRefGoogle ScholarPubMed
Rook, KS and Sorkin, DH (2003) Fostering social ties through a volunteer role: Implications for older-adults’ psychological health. The International Journal of Aging and Human Development 57(4), 313337.CrossRefGoogle ScholarPubMed
Rosenberg, PB (2016) Loneliness as a marker of brain amyloid burden and preclinical Alzheimer disease. JAMA Psychiatry 73(12), 12371238. https://doi.org/10.1001/jamapsychiatry.2016.2688CrossRefGoogle ScholarPubMed
Routasalo, PE, Savikko, N, Tilvis, RS, et al. (2006) Social contacts and their relationship to loneliness among aged people — A population-based study. Gerontology 52(3), 181187. https://doi.org/10.1159/000091828CrossRefGoogle ScholarPubMed
Russell, DW (1996) UCLA Loneliness Scale (Version 3): Reliability, validity, and factor structure. Journal of Personality Assessment 66(1), 2040. https://doi.org/10.1207/s15327752jpa6601_2CrossRefGoogle ScholarPubMed
Russell, DW, Peplau, LA and Ferguson, ML (1978) Developing a measure of loneliness. Journal of Personality Assessment 42(3), 290294. https://doi.org/10.1207/s15327752jpa4203_11CrossRefGoogle ScholarPubMed
Russell, DW, Peplau, LA and Cutrona, CE (1980) The revised UCLA Loneliness Scale: Concurrent and discriminant validity evidence. Journal of Personality and Social Psychology 39(3), 472480.CrossRefGoogle ScholarPubMed
Şahin, ZA and Tan, M (2012) Loneliness, depression, and social support of patients with cancer and their caregivers. Clinical Journal of Oncology Nursing 16(2), 145149. https://doi.org/10.1188/12.CJON.145-149CrossRefGoogle ScholarPubMed
Saito, T, Kai, I and Takizawa, A (2012) Effects of a program to prevent social isolation on loneliness, depression, and subjective well-being of older adults: A randomized trial among older migrants in Japan. Archives of Gerontology and Geriatrics 55(3), 539547. https://doi.org/10.1016/j.archger.2012.04.002CrossRefGoogle ScholarPubMed
Sand, L and Strang, P (2006) Existential loneliness in a palliative home care setting. Journal of Palliative Medicine 9(6), 13761387. https://doi.org/10.1089/jpm.2006.9.1376CrossRefGoogle Scholar
Savikko, N, Routasalo, P, Tilvis, RS, et al. (2005) Predictors and subjective causes of loneliness in an aged population. Archives of Gerontology and Geriatrics 41(3), 223233. https://doi.org/10.1016/j.archger.2005.03.002CrossRefGoogle Scholar
Secinti, E, Rand, KL, Johns, SA, et al. (2018) Social correlates of mental health in gastrointestinal cancer patients and their family caregivers: Exploring the role of loneliness. Supportive Care in Cancer. https://doi.org/10.1007/s00520-018-4467-8Google ScholarPubMed
Segrin, C, Badger, TA and Sikorskii, A (2019) A dyadic analysis of loneliness and health-related quality of life in Latinas with breast cancer and their informal caregivers. Journal of Psychosocial Oncology 37(2), 213227. https://doi.org/10.1080/07347332.2018.1520778CrossRefGoogle ScholarPubMed
Shaffer, K, Benvengo, S, Zaleta, A, et al. (2019) Feasibility and acceptability of distress screening for family caregivers at a cancer surgery center. Oncology Nursing Forum 46(2), 159169. https://doi.org/10.1188/19.ONF.159-169Google Scholar
Shankar, A, McMunn, A, Banks, J, et al. (2011) Loneliness, social isolation, and behavioral and biological health indicators in older adults. Health Psychology 30(4), 377385. https://doi.org/10.1037/a0022826CrossRefGoogle ScholarPubMed
Shapira, N, Barak, A and Gal, I (2007) Promoting older adults’ well-being through Internet training and use. Aging and Mental Health 11(5), 477484. https://doi.org/10.1080/13607860601086546CrossRefGoogle ScholarPubMed
Shin, JY, Kang, TI, Noll, RB, et al. (2018) Supporting caregivers of patients with cancer: A summary of technology-mediated interventions and future directions. American Society of Clinical Oncology Educational Book 23(38), 838849. https://doi.org/doi:10.1200/EDBK_201397CrossRefGoogle Scholar
Shiovitz-Ezra, S and Leitsch, SA (2010) The role of social relationships in predicting loneliness: The National Social Life, Health, and Aging Project. Social Work Research 34(3), 157167. https://doi.org/10.1093/swr/34.3.157CrossRefGoogle Scholar
Siette, J, Cassidy, M and Priebe, S (2017) Effectiveness of befriending interventions: A systematic review and meta-analysis. BMJ Open 26(7), e014304. https://doi.org/10.1136/bmjopen-2016-014304CrossRefGoogle Scholar
Sinclair, S, Raffin-Bouchal, S, Venturato, L, et al. (2017) Compassion fatigue: A meta-narrative review of the healthcare literature. International Journal of Nursing Studies 69, 924.CrossRefGoogle ScholarPubMed
Soothill, K, Morris, SM, Harman, JC, et al. (2001) Informal carers of cancer patients: What are their unmet psychosocial needs? Health and Social Care in the Community 9(6), 464475. https://doi.org/10.1046/j.0966-0410.2001.00326.xCrossRefGoogle ScholarPubMed
Sorkin, D, Rook, KS and Lu, JL (2002) Loneliness, lack of emotional support, lack of companionship, and the likelihood of having a heart condition in an elderly sample. Annals of Behavioral Medicine 24(4), 290298. https://doi.org/10.1207/S15324796ABM2404_05CrossRefGoogle Scholar
Soylu, C, Ozaslan, E, Karaca, H, et al. (2016) Psychological distress and loneliness in caregiver of advanced oncological inpatients. Journal of Health Psychology 21(9), 18961906. https://doi.org/10.1177/1359105314567770CrossRefGoogle ScholarPubMed
Stenberg, U, Ruland, CM and Miaskowski, C (2010) Review of the literature on the effects of caring for a patient with cancer. Psycho-Oncology 19(10), 10131025. https://doi.org/10.1002/pon.1670CrossRefGoogle ScholarPubMed
Stenberg, U, Ruland, CM, Olsson, M, et al. (2012) To live close to a person with cancer-experiences of family caregivers. Social Work in Health Care 51(10), 909926. https://doi.org/10.1080/00981389.2012.714847CrossRefGoogle ScholarPubMed
Steptoe, A, Shankar, A, Demakakos, P, et al. (2013) Social isolation, loneliness, and all-cause mortality in older men and women. Proceedings of the National Academy of Sciences 110(15), 57975801. https://doi.org/10.1073/pnas.1219686110CrossRefGoogle ScholarPubMed
Stewart, M, Barnfather, A, Neufeld, A, et al. (2006) Accessible support for family caregivers of seniors with chronic conditions: From isolation to inclusion. Canadian Journal on Aging/La Revue Canadienne Du Vieillissement 25(2), 179192. https://doi.org/10.1353/cja.2006.0041CrossRefGoogle ScholarPubMed
Stickley, A and Koyanagi, A (2016) Loneliness, common mental disorders and suicidal behavior: Findings from a general population survey. Journal of Affective Disorders 197, 8187. https://doi.org/10.1016/j.jad.2016.02.054CrossRefGoogle ScholarPubMed
Theeke, LA (2010) Sociodemographic and health-related risks for loneliness and outcome differences by loneliness status in a sample of U.S. older adults. Research in Gerontological Nursing 3(2), 113125. https://doi.org/10.3928/19404921-20091103-99CrossRefGoogle Scholar
Theeke, LA, Mallow, JA, Barnes, ER, et al. (2015) The feasibility and acceptability of LISTEN for loneliness. Open Journal of Nursing 5(5), 416425. https://doi.org/10.4236/ojn.2015.55045CrossRefGoogle ScholarPubMed
Theeke, LA, Mallow, JA, Moore, J, et al. (2016a) Effectiveness of LISTEN on loneliness, neuroimmunological stress response, psychosocial functioning, quality of life, and physical health measures of chronic illness. International Journal of Nursing Sciences 3(3), 242251. https://doi.org/10.1016/j.ijnss.2016.08.004CrossRefGoogle Scholar
Theeke, LA, Mallow, JA, Moore, J, et al. (2016b) Using gene expression analysis to examine changes in loneliness, depression and systemic inflammation in lonely chronically ill older adults. Open Journal of Nursing 6(8), 620631. https://doi.org/10.4236/ojn.2016.68066CrossRefGoogle Scholar
Totman, J, Pistrang, N, Smith, S, et al. (2015) “You only have one chance to get it right”: A qualitative study of relatives’ experiences of caring at home for a family member with terminal cancer. Palliative Medicine 29(6), 496507.CrossRefGoogle ScholarPubMed
Ussher, JM, Kirsten, L, Butow, P, et al. (2008) A qualitative analysis of reasons for leaving, or not attending, a cancer support group. Social Work in Health Care 47(1), 1429.CrossRefGoogle ScholarPubMed
Valtorta, NK, Kanaan, M, Gilbody, S, et al. (2016) Loneliness and social isolation as risk factors for coronary heart disease and stroke: Systematic review and meta-analysis of longitudinal observational studies. Heart 102(13), 10091016. https://doi.org/10.1136/heartjnl-2015-308790CrossRefGoogle ScholarPubMed
Van Ryn, M, Sanders, S, Kahn, K, et al. (2011) Objective burden, resources, and other stressors among informal cancer caregivers: A hidden quality issue? Psycho-Oncology 20(1), 4452. https://doi.org/10.1002/pon.1703CrossRefGoogle ScholarPubMed
Vasileiou, K, Barnett, J, Barreto, M, et al. (2017) Experiences of loneliness associated with being an informal caregiver: A qualitative investigation. Frontiers in Psychology 8, 585. https://doi.org/10.3389/fpsyg.2017.00585CrossRefGoogle ScholarPubMed
Victor, CR, Scambler, SJ, Bowling, A, et al. (2005) The prevalence of, and risk factors for, loneliness in later life: A survey of older people in Great Britain. Ageing and Society 25(6), 357375. https://doi.org/10.1017/S0144686X04003332CrossRefGoogle Scholar
Vines, AI and Demissie, Z (2013) Racial differences in social support and coping among family caregivers of patients with prostate cancer. Journal of Psychosocial Oncology 31(3), 305318. https://doi.org/10.1080/07347332.2013.778931CrossRefGoogle ScholarPubMed
Weitzner, MA, Haley, WE and Chen, H (2000) The family caregiver of the older cancer patient. Hematology/Oncology Clinics of North America 14(1), 269281.CrossRefGoogle ScholarPubMed
Williams, AL and Bakitas, M (2012) Cancer family caregivers: A new direction for interventions. Journal of Palliative Medicine 15(7), 775783. https://doi.org/10.1089/jpm.2012.0046CrossRefGoogle ScholarPubMed
Wilson, C and Moulton, B (2010) Loneliness among older adults: A national survey of adults 45+. Washington, DC: AARP. Retrieved from: http://www.aarp.org/research/topics/life/info-2014/loneliness_2010.htmlGoogle Scholar
Wilson, BJ, Zitella, LJ, Erb, CH, et al. (2018) Prevention of infection: A systematic review of evidence-based practice interventions for management in patients with cancer. Clinical Journal of Oncology Nursing 22(2), 157168. https://doi.org/10.1188/18.CJON.157-168CrossRefGoogle ScholarPubMed
Yang, YC, Schorpp, K and Harris, KM (2014) Social support, social strain and inflammation: Evidence from a national longitudinal study of U.S. adults. Social Science & Medicine 107, 124135. https://doi.org/10.1016/j.socscimed.2014.02.013CrossRefGoogle ScholarPubMed
Yoon, H, Chatters, L, Kao, TSA, et al. (2018) Predictors of quality of life and depression among Korean-American cancer patients and their family caregivers. Psycho-Oncology, 18. https://doi.org/10.1002/pon.4864Google ScholarPubMed