Abstract：
OBJECTIVE: To map and synthesise the literature on loneliness at end-of-life and identify key knowledge gaps in loneliness research.
BACKGROUND: Declined health conditions, reduced social engagement, loss of social roles, and fear of death may lead to loneliness at end-of-life. However, systematic information about loneliness at end-of-life is scant.
METHODS: This scoping review followed the methodology proposed by Arksey and O\'Malley. Nine electronic databases were searched from January 2001 to July 2022. Studies about loneliness at end-of-life were included. Two review authors independently screened and selected relevant studies and performed the data charting. The PAGER framework was employed to collate, summarise and report the results. The PRISMA-ScR checklist was included.
RESULTS: A total of 23 studies were included in this review (12 qualitative, 10 quantitative, and one mixed-methods design). There was not reliable data about the prevalence of loneliness among adults at end-of-life internationally. Three or 20-item UCLA loneliness scale was frequently used to measure loneliness. Factors predisposed adults at end-of-life to loneliness included passive and active withdrawal from social networks, inability to share emotions and to be understood, and inadequate support on spirituality. Four strategies were identified to alleviate loneliness, yet none have been substantiated in clinical trials. Interventions facilitating spirituality, social interactions and connectedness seem effective in alleviating loneliness.
CONCLUSIONS: This is the first scoping review on loneliness at end-of-life, synthesising evidence from qualitative, quantitative, and mixed-methods studies. Loneliness among adults at end-of-life is under-investigated and there is a prominent need to address existential loneliness at end-of-life.
CONCLUSIONS: All nurses should proactively assess loneliness or perceived social isolation for clients with life-limiting conditions, regardless of social networks. Collaborative efforts (e.g., medical-social collaborations) to promote self-worthiness, social engagement and connectedness with significant others and social networks are needed.
UNASSIGNED: No patient or public involvement.
BACKGROUND: Declined health conditions, reduced social engagement, loss of social roles, and fear of death may lead to loneliness at end-of-life. However, systematic information about loneliness at end-of-life is scant.
METHODS: This scoping review followed the methodology proposed by Arksey and O\'Malley. Nine electronic databases were searched from January 2001 to July 2022. Studies about loneliness at end-of-life were included. Two review authors independently screened and selected relevant studies and performed the data charting. The PAGER framework was employed to collate, summarise and report the results. The PRISMA-ScR checklist was included.
RESULTS: A total of 23 studies were included in this review (12 qualitative, 10 quantitative, and one mixed-methods design). There was not reliable data about the prevalence of loneliness among adults at end-of-life internationally. Three or 20-item UCLA loneliness scale was frequently used to measure loneliness. Factors predisposed adults at end-of-life to loneliness included passive and active withdrawal from social networks, inability to share emotions and to be understood, and inadequate support on spirituality. Four strategies were identified to alleviate loneliness, yet none have been substantiated in clinical trials. Interventions facilitating spirituality, social interactions and connectedness seem effective in alleviating loneliness.
CONCLUSIONS: This is the first scoping review on loneliness at end-of-life, synthesising evidence from qualitative, quantitative, and mixed-methods studies. Loneliness among adults at end-of-life is under-investigated and there is a prominent need to address existential loneliness at end-of-life.
CONCLUSIONS: All nurses should proactively assess loneliness or perceived social isolation for clients with life-limiting conditions, regardless of social networks. Collaborative efforts (e.g., medical-social collaborations) to promote self-worthiness, social engagement and connectedness with significant others and social networks are needed.
UNASSIGNED: No patient or public involvement.
摘要：
目标：绘制和综合有关临终孤独感的文献，并确定孤独感研究中的关键知识差距。
背景：健康状况下降，减少社会参与，失去社会角色，对死亡的恐惧可能会导致生命终结时的孤独。然而,关于生命终结时孤独的系统信息很少。
方法：本范围审查遵循Arksey和O\'Malley提出的方法。从2001年1月至2022年7月，共检索了9个电子数据库。包括关于生命终结时孤独的研究。两位综述作者独立筛选并选择了相关研究，并进行了数据图表。PAGER框架被用来整理，总结并报告结果。包括PRISMA-ScR清单。
结果：本综述共纳入23项研究（12项定性，10定量，和一种混合方法设计)。国际上没有关于成年后孤独患病率的可靠数据。经常使用3或20项UCLA孤独感量表来衡量孤独感。成年后倾向于孤独的因素包括被动和主动退出社交网络，无法分享情感和被理解，对灵性的支持不足。确定了四种缓解孤独的策略，然而在临床试验中没有得到证实。促进灵性的干预，社交互动和联系似乎可以有效缓解孤独。
结论：这是对生命终结时的孤独感的第一次范围审查，从定性中综合证据，定量,和混合方法研究。对生命终结时成年人的孤独感研究不足，迫切需要解决生命终结时的存在孤独感。
结论：所有护士都应主动评估生活受限患者的孤独感或感知的社会隔离感，不管社交网络。协作努力(例如，医疗-社会合作)以促进自我价值，需要与重要的他人和社交网络的社会参与和联系。
■没有患者或公众参与。
背景：健康状况下降，减少社会参与，失去社会角色，对死亡的恐惧可能会导致生命终结时的孤独。然而,关于生命终结时孤独的系统信息很少。
方法：本范围审查遵循Arksey和O\'Malley提出的方法。从2001年1月至2022年7月，共检索了9个电子数据库。包括关于生命终结时孤独的研究。两位综述作者独立筛选并选择了相关研究，并进行了数据图表。PAGER框架被用来整理，总结并报告结果。包括PRISMA-ScR清单。
结果：本综述共纳入23项研究（12项定性，10定量，和一种混合方法设计)。国际上没有关于成年后孤独患病率的可靠数据。经常使用3或20项UCLA孤独感量表来衡量孤独感。成年后倾向于孤独的因素包括被动和主动退出社交网络，无法分享情感和被理解，对灵性的支持不足。确定了四种缓解孤独的策略，然而在临床试验中没有得到证实。促进灵性的干预，社交互动和联系似乎可以有效缓解孤独。
结论：这是对生命终结时的孤独感的第一次范围审查，从定性中综合证据，定量,和混合方法研究。对生命终结时成年人的孤独感研究不足，迫切需要解决生命终结时的存在孤独感。
结论：所有护士都应主动评估生活受限患者的孤独感或感知的社会隔离感，不管社交网络。协作努力(例如，医疗-社会合作)以促进自我价值，需要与重要的他人和社交网络的社会参与和联系。
■没有患者或公众参与。
