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Loneliness and the COVID-19 pandemic: implications for practice

08 February 2024
Volume 33 · Issue 3


Loneliness is a complex universal human experience. A variety of evidence indicates that prolonged loneliness can have a negative effect on an individual's long-term physical and psychological outcomes. Empirical evidence and systematic reviews show strong links between loneliness and ill health, particularly cardiovascular disease and mental health. Loneliness is increasing in frequency and severity. The issue of loneliness has been part of UK Government mandates since 2018; however, evidence suggests that, due to the pandemic, the need to focus on the issue may be even more significant. Assessing for loneliness can be challenging and many people do not want to report their feelings of loneliness. Interventions should aim to be preventive and help people create meaningful interactions. Useful interventions include person-centred interventions, cognitive therapy and group intervention therapy. There is a need for more evidence-based loneliness interventions. A knowledge of local and voluntary sectors is vital so health professionals can effectively support their patients.

During the first wave of the COVID-19 pandemic the Office for National Statistics reported that 2.6 million adults said they felt lonely and that it had affected their sense of wellbeing (Rees and Large, 2020). The pandemic affected many people's welfare and this issue was termed ‘lockdown loneliness’ (those people whose welfare was affected in the last 7 days due to feelings of loneliness). These were mostly adults of working age who lived alone and those living with long-term health conditions (Rees and Large, 2020).

Loneliness is a subjective, unwelcome feeling of a lack or loss of companionship that is unique to each person (Perlman and Peplau, 1981). For example, a person can live alone and may never feel lonely and someone who lives with many people may frequently feel lonely. A person can be situationally lonely, which means they are lonely due to a change in life circumstances such as a recent bereavement or health issues (Young et al, 1982). Periods of loneliness can be short or long. Some people may have persistent feelings of loneliness that can be pervasive and chronic for two or more years. Older lonely people are more likely to attend emergency departments and frequent GP surgeries (The Health Foundation, 2018; Sirois and Owens, 2023). In addition, individuals may not want to disclose their feelings of loneliness due to self-dislike and the perceived stigma associated with loneliness (Ypsilanti et al, 2020). Assessing and managing loneliness can be challenging for health professionals. This article explores the fundamental issues and seeks to help nurses identify who may be at risk and how to manage this complex issue.

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