Background:Loneliness is a subjective phenomenon. It is experienced a lack of satisfying relationship to others, whether because the subject has too few relationships or because their existing relationships do not provide the desired form of closeness (Svenderson, 2017). As defined by Peplou and Perlman (1982), the definitions of loneliness share the same concept: an unpleasant, subjective experience resulting from inadequate social relationships. Loneliness and rumination are remarkable risk factors of depression among the elderly in the both community and nursing homes (Gan at al.,2015). A Norwegian study found that 56% of nursing home residents are feeling lonely (Dragaset et al.,2011). The study from Poland found that depression was observed in 33.8% long term care facility (Horwath, Scerbinska,2017). Furthermore, another study from China shown that 14.9% residents in long term facility reported suicidal ideation (Zhang at al.,2020). Associated with one being depressed in nursing homes include pain, risk of stroke, risk of heart attack, decreased cognitive function and is also linked to increased morbidity in nursing home residents, a relationship it has been also suggested for medical inpatients (Zammit, Fiorini, 2015).
Methodology:The scoping review has been selected as the appropriate methodology for this study. The general purpose for conducting scoping reviews is to identify and map the available evidence (Arskley,O’Malley, 2005). Scoping reviews can be useful tools to investigate the design and conduct of research on a particular topic and conducted to review current research an identify knowledge gaps on the topic (Munn at al.,2018). According to Arksey and O’Malley (2005) the scoping review methodology is divided into six steps framework: identifying the research question, searching for relevant studies, selecting studies, charting the data, collecting the data, summarizing and reporting results and consulting with stakeholders to inform or validate study findings.
Results:A total of 27 studies were included in the final synthesis, mixed designed studies (n=7) including questionnaires, surveys, Geriatric depression Scales, Satisfaction with life Scale, Loneliness Scale, face to face interviews and observations. Furthermore, were included quantitative studies (n=10) included one longitudinal study with 6 years follow up. Finally, were also included qualitative studies (n=10), the studies used a mixture of approach of interviews an observation. The majority of the participants were from long-term facilities (n=24), medical students and nurses were included (n=1) study and mixture of participants such as residents, family members and staff were included in (n=1) study. The most of the studies are from Norway (n=7), China (n=3), Finland (n=2), Turkey (n=2), Poland (n=2), US (n=2), Belgium (n=1), Sri Lanka (n=1), South Korea and Japan (n=1), Hong Kong (n=1), Malta (n=1), Taiwan (n=1), Iran (n=1), New Zealand (n=1) and Sweden (n=1). In Table 1, we provide a summary of the individual studies.
Discussion:This scoping review highlights the importance to continue support residents’ well-being in the long-term care facilities, support their mental health and also to continue educate and support healthcare staff as they have the major impact on resident’s welfare. Previous studies indicated the correlation between loneliness and depression with demographics factors such as being married, unmarried or widowed for that reason it was recommended by Mahammadi et al. (2016) pay more attention on reducing feeling of loneliness and anxiety by increasing their life satisfaction. We found that only one study was focused on resident’s suicidal ideation (Zhang et al., 2020) who concluded from his cross-sectional study with 538 participants, age above 60 years old, from 37 nursing homes in China that 14.9% reported current suicidal ideation but we are worried that this number could be higher and we believe that needs to be done more research for the future to prevent any risk of suicide among elderly. One reason for the lack of information on suicide risk in long term facilities is that prior 2010, universal screening for suicidal ideation in these facilities had not been widely adopted nor recommended as an approach to prevent suicide (Mezuk et al.,2014).
