Conceptual analysis of loneliness in dying patients

Robert Brown, Hugh P. McKenna

Research output: Contribution to journalArticle

Abstract

This article presents a conceptual analysis of loneliness andhighlights the importance of loneliness for dying patients. It issuggested that patient and professional avoidance of, andreluctance to address, this subject may result in part because of alack of understanding of the concept. In analysing the conceptand providing a theoretical definition, this article incorporates themethods adopted by Walker and Avant (1983) and Rodgers(1989a). The defining attributes, related concepts, antecedentsand consequences of loneliness are examined and a model caseis presented. The analysis concludes that loneliness is: asubjective experience which involves the social meaning of death;based on a person’s relationship with those around him/her; andis an individualized process which is characterized by loss. It issuggested that future research should concentrate on exploringthe ‘living’ reality of dying people which in conjunction withnursing knowledge could improve the quality of life for dyingpatients.
LanguageEnglish
Pages90-97
JournalInternational Journal of Palliative Nursing
Volume5
Issue number2
Publication statusPublished - 17 Feb 1999

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dying
quality of life
death
human being
experience

Keywords

  • Loneliness
  • Concept analysis
  • Stigmatization
  • Isolation
  • Loss
  • Quality of life

Cite this

Brown, Robert ; McKenna, Hugh P. / Conceptual analysis of loneliness in dying patients. In: International Journal of Palliative Nursing. 1999 ; Vol. 5, No. 2. pp. 90-97.
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abstract = "This article presents a conceptual analysis of loneliness andhighlights the importance of loneliness for dying patients. It issuggested that patient and professional avoidance of, andreluctance to address, this subject may result in part because of alack of understanding of the concept. In analysing the conceptand providing a theoretical definition, this article incorporates themethods adopted by Walker and Avant (1983) and Rodgers(1989a). The defining attributes, related concepts, antecedentsand consequences of loneliness are examined and a model caseis presented. The analysis concludes that loneliness is: asubjective experience which involves the social meaning of death;based on a person’s relationship with those around him/her; andis an individualized process which is characterized by loss. It issuggested that future research should concentrate on exploringthe ‘living’ reality of dying people which in conjunction withnursing knowledge could improve the quality of life for dyingpatients.",
keywords = "Loneliness, Concept analysis, Stigmatization, Isolation, Loss, Quality of life",
author = "Robert Brown and McKenna, {Hugh P.}",
note = "Reference text: Alonzo AA, Reynolds NR (1995) Stigma, HIV and Aids: an exploration and elaboration of a stigma trajectory. Soc Sci Med 41(3): 301–15 Berblinger KW (1968) A psychiatrist looks at loneliness. Psychsomatics 9(2): 96–102 Beyea SC (1990) Concept analysis of feeling: a human response pattern. Nurs Diagn 1(3): 97–101 Charmaz K (1980) The Social Reality of Death. Addison Wesley, Reading, Massachusetts Chinn P, Kramer MK (1995) Theory and Nursing: A Systematic Approach. 4th edn. CV Mosby, St Louis, Missouri Clark D (1993) The Sociology of Death. Blackwell Publishers, Oxford Cocker KL, Bell DR, Kidman A (1994) Cognitive behaviour therapy with advanced breast care patient. Psycho-oncology 3(2): 233–7 Cody WK (1997) What is nursing science? Nurs Sci Q 10(1): 12–3 Corner J, Dunlop R (1997) New approaches to care. In: Clark D, Hockley J, Ahmedzai S, eds. New Themers in Palliative Care. Open University Press, Buckingham: 288–94 Davis C, Sheldon F (1997) Therapeutic innovations. In: Clark D, Hockley J, Ahmedzai S, eds. New Themes in Palliative Care. Open University Press, Buckingham: 223–38 Davis G (1992) The meaning of pain management: A concept analysis. Adv Nurs Sci 15(1): 77–86 Donaldson J, Watson R (1996) Loneliness in elderly people: an important area for nursing research. J Adv Nurs 24: 952–9 Elias N (1985) The Loneliness of the Dying. Basil Blackwell, Oxford Faulkner A, Maguire P (1994) Talking to Cancer Patients and their Families. Oxford University Press, Oxford Field D, Hockey J, Small N (1997) Death, Gender and Ethnicity. Routledge, London Fromm-Reichmann F (1959) On loneliness. In: Bullard DM, ed. Psychoanylasis and Psychotherapy. University of Chicago Press, Chicago: 326–36 Good BJ, Delvicchio Good MJ (1980) The meaning of symptoms as a cultural hermeneutic model for clinical practice. In: Eisenberg I, Kleinman A, eds. The Relevance of Social Science for Medicine. Dordrect and Boston, Reidel, MA Goffman E (1968) Stigma: Notes on the Management of Spoiled Identity. Penguin, Harmondsworth Green G (1995) Attitudes towards people with HIV. Soc Sci Med 41(4): 557–68 Green G, Platt S (1997) Fear and loathing in health care settings reported by people with HIV. Soc Health Illn 19(1): 70–92 Havighurst R (1978) Aging in western society. In: Hobmann D, ed. The Social Challenge of Aging. Croom-Helm, London: 15–44 Hinshaw AS (1989) Nursing science: the challenge to develop knowledge. Nurs Sci Q 2(4): 162–1 Hunt A (1978) The Elderly at Home: A Study of People Aged 65 and Over Living in the Community in England in 1976. Social Survey Division, Office of Population and Census Surveys, London Jacob SR (1993) An analysis of the concept of grief. J Adv Nurs 18: 1787–94 Jones SA (1992) Personal unity in dying: alternative conceptions of the meaning of health. J Adv Nurs 18: 89–94 Kearney M (1992) Imagework in a case of intractable pain. Palliat Med 2(6): 152–7 Kellehear A (1990) Dying of Cancer: The Final Year of Life. Harwood Academic Publishers, London Kemp V (1985) Concept analysis as a strategy for promoting critical thinking. J Nurs Educ 24(9): 282–84 Kleinman A (1988) The Illness Narratives: Suffering, Healingf and the Human Condition. Basic Books, New York Kurtz I (1983) Loneliness. Basil Blackwell, Oxford Lawton J (1998) Contemporary hospice care: the sequestration of the unbounded body and ‘dirty dying’. Soc Health Illn 20(2): 121–43 Lopata H (1969) Loneliness: forms and components. Soc Probl 17: 248–62 Mason DJ, Backer BA, Georges CA (1991) Towards a feminist model for the political empowerment of nurses. Image J Nurs Sch 23(2): 72–7 McKenna H (1997) Nursing Theories and Models. Routledge, London Mellor P (1993) Death in high modernity: the contemporary presence and absence of death. In: Clark D, ed. The Sociology of Death: Theory, Culture, Practice. Blackwell Publishers, Oxford: 11–31 Moody LE (1990) Advancing nursing science through research. Volume 1. Sage Publications, Newbury Park Morse JM (1995) Exploring the theoretical basis of nursing using advanced techniques of concept analysis. Adv Nurs Sci 19(3): 31–46 Mort F (1987) Dangerous sexualities. In: Clark D, ed. The Sociology of Death (1993), Blackwell, Oxford: 90 Moustakas CE (1961) Loneliness. Prentice-Hall, New Jersey Norris CM (1970) Proceedings from the Second Annual Nursing Theory Conference. University of Kansas, Kansas Oxford English Dictionary (1989) 2nd edn. Claredon Press, Oxford Power B (1979) Old and Alone in Ireland. St Vincent de Paul, Dublin Rodgers BL (1989a) Concepts, analysis and the development of nursing knowledge: the evolutionary cycle. J Adv Nurs 23: 305–13 Rodgers BL (1989b) Lonliness. Easing the pain of the hospitalized elderly. J Gerontol Nurs 15(8): 16–21 Rodgers BL (1994) Concepts, analysis and the development of nursing knowledge. In: Smith JP, ed. Models, Theories and Concepts. Blackwell, Oxford: 21–30 Rodwell CM (1996) An analysis of the concept of empowerment. J Adv Nurs 23: 305–13. Seabrook J (1973) Loneliness. Maurice Temple Smith, London Seale C, Addington-Hall J (1995) Dying at the best time. Soc Sci Med 40(5): 589–95 Siminoff LI, Erien JA, Lidz CW (1991) Stigma, Aids and quality of nursing care: state of the science. J Adv Nurs 16: 262–9 Simpson J, Weiner E (1989) Oxford English Dictionary. Clarendon Press, London Slevin E (1995) A concept analysis of and proposed new term for, challenging behaviour. J Adv Nurs 21: 928–34 Small N (1997) Death and difference. In: Field D, Hockley J, Small N, eds. Death, Gender and Ethnicity. Routledge, London Smith EE, Medin DL (1981) Categories and Concepts. Harvard University Press, Cambridge, Massachusetts Tornstam L (1981) Daily problems in various ages. Paper presented to XIIth International Congress of Gerontology, Hamburg Townsend P, Turnstall S (1973) Sociological explanations of the lonely. In: Townsend P, ed. The Social Minority. Allen Lane, London: 257–63 Walker LO, Avant KC (1983) Strategies for Theory Construction in Nursing. 1st edn. Appleton and Lange, Norwalk, Connecticut Weiss RS (1973) Loneliness: The Experience of Emotional and Social Isolation. MIT Press, Cambridge, Massachusetts Wenger C (1983) Loneliness: a problem of measurement. In: Jerrome D, ed. Aging in Modern Society. Croom Helm, London: 145–65 Witzleben HD (1968) On loneliness. Psychiatry 21: 31–43 Younger JB (1995) The alienation of the sufferer. Adv Nurs Sci 17(4): 53–72 Zack MV (1985) Lonliness: a concept relevant to the care of dying persons. Nurs Clin North Am 20(2): 403–14",
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Conceptual analysis of loneliness in dying patients. / Brown, Robert; McKenna, Hugh P.

In: International Journal of Palliative Nursing, Vol. 5, No. 2, 17.02.1999, p. 90-97.

Research output: Contribution to journalArticle

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In: Clark D, Hockley J, Ahmedzai S, eds. New Themes in Palliative Care. Open University Press, Buckingham: 223–38 Davis G (1992) The meaning of pain management: A concept analysis. Adv Nurs Sci 15(1): 77–86 Donaldson J, Watson R (1996) Loneliness in elderly people: an important area for nursing research. J Adv Nurs 24: 952–9 Elias N (1985) The Loneliness of the Dying. Basil Blackwell, Oxford Faulkner A, Maguire P (1994) Talking to Cancer Patients and their Families. Oxford University Press, Oxford Field D, Hockey J, Small N (1997) Death, Gender and Ethnicity. Routledge, London Fromm-Reichmann F (1959) On loneliness. In: Bullard DM, ed. Psychoanylasis and Psychotherapy. University of Chicago Press, Chicago: 326–36 Good BJ, Delvicchio Good MJ (1980) The meaning of symptoms as a cultural hermeneutic model for clinical practice. In: Eisenberg I, Kleinman A, eds. The Relevance of Social Science for Medicine. Dordrect and Boston, Reidel, MA Goffman E (1968) Stigma: Notes on the Management of Spoiled Identity. Penguin, Harmondsworth Green G (1995) Attitudes towards people with HIV. Soc Sci Med 41(4): 557–68 Green G, Platt S (1997) Fear and loathing in health care settings reported by people with HIV. Soc Health Illn 19(1): 70–92 Havighurst R (1978) Aging in western society. In: Hobmann D, ed. The Social Challenge of Aging. Croom-Helm, London: 15–44 Hinshaw AS (1989) Nursing science: the challenge to develop knowledge. Nurs Sci Q 2(4): 162–1 Hunt A (1978) The Elderly at Home: A Study of People Aged 65 and Over Living in the Community in England in 1976. Social Survey Division, Office of Population and Census Surveys, London Jacob SR (1993) An analysis of the concept of grief. J Adv Nurs 18: 1787–94 Jones SA (1992) Personal unity in dying: alternative conceptions of the meaning of health. J Adv Nurs 18: 89–94 Kearney M (1992) Imagework in a case of intractable pain. Palliat Med 2(6): 152–7 Kellehear A (1990) Dying of Cancer: The Final Year of Life. Harwood Academic Publishers, London Kemp V (1985) Concept analysis as a strategy for promoting critical thinking. J Nurs Educ 24(9): 282–84 Kleinman A (1988) The Illness Narratives: Suffering, Healingf and the Human Condition. Basic Books, New York Kurtz I (1983) Loneliness. Basil Blackwell, Oxford Lawton J (1998) Contemporary hospice care: the sequestration of the unbounded body and ‘dirty dying’. Soc Health Illn 20(2): 121–43 Lopata H (1969) Loneliness: forms and components. Soc Probl 17: 248–62 Mason DJ, Backer BA, Georges CA (1991) Towards a feminist model for the political empowerment of nurses. Image J Nurs Sch 23(2): 72–7 McKenna H (1997) Nursing Theories and Models. Routledge, London Mellor P (1993) Death in high modernity: the contemporary presence and absence of death. In: Clark D, ed. The Sociology of Death: Theory, Culture, Practice. Blackwell Publishers, Oxford: 11–31 Moody LE (1990) Advancing nursing science through research. Volume 1. Sage Publications, Newbury Park Morse JM (1995) Exploring the theoretical basis of nursing using advanced techniques of concept analysis. Adv Nurs Sci 19(3): 31–46 Mort F (1987) Dangerous sexualities. In: Clark D, ed. The Sociology of Death (1993), Blackwell, Oxford: 90 Moustakas CE (1961) Loneliness. Prentice-Hall, New Jersey Norris CM (1970) Proceedings from the Second Annual Nursing Theory Conference. University of Kansas, Kansas Oxford English Dictionary (1989) 2nd edn. Claredon Press, Oxford Power B (1979) Old and Alone in Ireland. St Vincent de Paul, Dublin Rodgers BL (1989a) Concepts, analysis and the development of nursing knowledge: the evolutionary cycle. J Adv Nurs 23: 305–13 Rodgers BL (1989b) Lonliness. Easing the pain of the hospitalized elderly. J Gerontol Nurs 15(8): 16–21 Rodgers BL (1994) Concepts, analysis and the development of nursing knowledge. In: Smith JP, ed. Models, Theories and Concepts. Blackwell, Oxford: 21–30 Rodwell CM (1996) An analysis of the concept of empowerment. J Adv Nurs 23: 305–13. Seabrook J (1973) Loneliness. Maurice Temple Smith, London Seale C, Addington-Hall J (1995) Dying at the best time. Soc Sci Med 40(5): 589–95 Siminoff LI, Erien JA, Lidz CW (1991) Stigma, Aids and quality of nursing care: state of the science. J Adv Nurs 16: 262–9 Simpson J, Weiner E (1989) Oxford English Dictionary. Clarendon Press, London Slevin E (1995) A concept analysis of and proposed new term for, challenging behaviour. J Adv Nurs 21: 928–34 Small N (1997) Death and difference. In: Field D, Hockley J, Small N, eds. Death, Gender and Ethnicity. Routledge, London Smith EE, Medin DL (1981) Categories and Concepts. Harvard University Press, Cambridge, Massachusetts Tornstam L (1981) Daily problems in various ages. Paper presented to XIIth International Congress of Gerontology, Hamburg Townsend P, Turnstall S (1973) Sociological explanations of the lonely. In: Townsend P, ed. The Social Minority. Allen Lane, London: 257–63 Walker LO, Avant KC (1983) Strategies for Theory Construction in Nursing. 1st edn. Appleton and Lange, Norwalk, Connecticut Weiss RS (1973) Loneliness: The Experience of Emotional and Social Isolation. MIT Press, Cambridge, Massachusetts Wenger C (1983) Loneliness: a problem of measurement. In: Jerrome D, ed. Aging in Modern Society. Croom Helm, London: 145–65 Witzleben HD (1968) On loneliness. Psychiatry 21: 31–43 Younger JB (1995) The alienation of the sufferer. Adv Nurs Sci 17(4): 53–72 Zack MV (1985) Lonliness: a concept relevant to the care of dying persons. Nurs Clin North Am 20(2): 403–14

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AB - This article presents a conceptual analysis of loneliness andhighlights the importance of loneliness for dying patients. It issuggested that patient and professional avoidance of, andreluctance to address, this subject may result in part because of alack of understanding of the concept. In analysing the conceptand providing a theoretical definition, this article incorporates themethods adopted by Walker and Avant (1983) and Rodgers(1989a). The defining attributes, related concepts, antecedentsand consequences of loneliness are examined and a model caseis presented. The analysis concludes that loneliness is: asubjective experience which involves the social meaning of death;based on a person’s relationship with those around him/her; andis an individualized process which is characterized by loss. It issuggested that future research should concentrate on exploringthe ‘living’ reality of dying people which in conjunction withnursing knowledge could improve the quality of life for dyingpatients.

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