Conceptual analysis of loneliness in dying patients

Robert Brown, Hugh P. McKenna

Research output: Contribution to journalArticlepeer-review


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.
Original languageEnglish
Pages (from-to)90-97
JournalInternational Journal of Palliative Nursing
Issue number2
Publication statusPublished (in print/issue) - 17 Feb 1999

Bibliographical 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):
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
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
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,
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,
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:
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):


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


Dive into the research topics of 'Conceptual analysis of loneliness in dying patients'. Together they form a unique fingerprint.

Cite this