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Risk for Loneliness and Social Isolation: Potentially Underestimated Nursing Diagnoses in Onco-Hematology Inpatients
Luca Bertocchi1, Giorgia Franzoi, Giulia Zamagni
1Author Affiliations: Department of Oncology, Hematology Unit, Trieste University Hospital (ASUGI), Trieste, Italy (Bertocchi and Franzoi); Emergency Department, San Polo Hospital, Monfalcone (ASUGI), Trieste, Italy (De Martino); Marjory Gordon Program for Clinical Reasoning and Knowledge Development, William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Bertocchi); Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy (Zamagni); Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy (Sanson).
Background:
Loneliness and social isolation are recognized as serious psychosocial issues for inpatients with onco-hematologic diseases, negatively affecting well-being, treatment adherence, and clinical outcomes. However, the prevalence of loneliness and social isolation remains understudied, particularly when assessed using standardized nursing diagnoses.
Objective:
To describe the prevalence and 1-week changes of the nursing diagnoses Risk for Loneliness and Social Isolation in patients hospitalized with onco-hematologic diseases, and to identify variables associated with their presence at admission.
Methods:
This was a prospective longitudinal study. Adult inpatients with onco-hematologic diseases admitted for at least 7 days were assessed within 48 hours of admission (T 0 ) and reassessed 1 week later (T 1 ). Changes in diagnostic indicators were analyzed, and multivariable analyses were used to identify variables associated with their presence at T 0 .
Results:
One hundred patients participated. At T 0 , the prevalence of Risk for Loneliness and Social Isolation was 73% and 15%, respectively. The incidence of both diagnoses increased over the 1-week follow-up. For Risk for Loneliness, the related factors affectional deprivation and social isolation increased at T 1 . For Social Isolation, most defining characteristics and several related factors increased at follow-up. Self-esteem, age, and single-room accommodation were associated with Risk for Loneliness, whereas only self-esteem was associated with Social Isolation.
Conclusion:
High and increasing levels of loneliness and social isolation were documented, indicating the need for systematic assessment and timely intervention.
Implications For Oncology Nursing Practice:
Flexible, patient-centered visiting policies and targeted psychosocial nursing interventions may help reduce loneliness and social isolation, thereby improving patient outcomes.
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