I Live Alone but Don't Feel Alone: Social Isolation and Loneliness From the Patient Perspective

Abstract

A growing homebound population may be at risk for social isolation and loneliness. Health-related social needs play a contributing role in these conditions. Research shows social isolation and loneliness are drivers of health outcomes. This pilot feasibility study seeks to explore patient-centered insight into perceptions of social isolation and loneliness in a homebound population. Eight participants were recruited from a home-based primary care practice within a family medicine residency program. One 30-minute semi-structured interview was completed in participants' homes. The interview focused on loneliness and social isolation, using the 6-item De Jong Gerveld loneliness scale. Three qualitative analysts open-coded transcriptions independently. Themes were defined using thematic analysis, then triangulated around a consensus of themes. Patients denied loneliness, but most described social isolation, highlighting the potential need for more targeted documentation and intervention in this arena. The most reported barrier affecting social isolation in our study population was mobility issues. The patient perspective is useful to focus the target of approach. Based on this pilot, additional research with a larger sample size across multiple sites is warranted to further explore homebound patients' experience of loneliness and social isolation in order to better guide assessment and interventions for these common problems.

Keywords: homebound persons; loneliness; patient-centered care; qualitative research; social isolation.

Figure 1

De Jong Gierveld loneliness scale breakdown for patient responses (n=8).

Figure 2

Distribution of patient scores (n=8) on De Jong Gierveld loneliness scale.

Figure 3

Semi-structured interview questions.