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"Living Inside the Walls": Systematic Review and Qualitative Meta-Synthesis.

Weitong Li1, Ziqi Mei2, WenJing Tu1

  • 1School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.

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|April 17, 2026
PubMed
Summary
This summary is machine-generated.

Social isolation in long-term care facilities stems from a person-environment mismatch. Interventions should focus on aligning individuals with their surroundings to improve well-being and social engagement.

Keywords:
LTCFlong-term care facilitymeta-synthesisolder peoplequalitative researchsocial isolationsystematic review

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Area of Science:

  • Gerontology
  • Nursing Science
  • Qualitative Research

Background:

  • Social isolation significantly impacts older adults in long-term care facilities (LTCFs), affecting quality of life and mental health.
  • Understanding the lived experiences and mechanisms of social isolation in LTCFs is crucial for effective nursing interventions.

Purpose of the Study:

  • To systematically review and synthesize qualitative evidence on the experiences of social isolation among older adults in LTCFs.
  • To analyze the causes, mechanisms, outcomes, and coping strategies related to social isolation in this population.

Main Methods:

  • A systematic review and qualitative meta-synthesis of 14 studies.
  • Searches conducted across multiple databases (PubMed, Web of Science, Embase, etc.) up to February 2025.
  • Thematic and content analysis following Thomas and Harden's method for data synthesis.

Main Results:

  • Identified four themes: person-environment mismatch (root cause), overt behavioral patterns (proactive, defensive, adaptive isolation), inner emotional experiences (confinement, sorrow, weariness), and strategies for restoring balance.
  • Person-environment mismatch was confirmed as the core mechanism driving social isolation in older adults in LTCFs.

Conclusions:

  • Person-environment mismatch is the fundamental driver of social isolation in LTCFs.
  • Interventions should aim to restore person-environment alignment by optimizing physical and social environments and enhancing psychological empowerment.
  • Future research should develop tools to quantify person-environment matching and conduct longitudinal studies of interventions.