Susceptible to overwhelming feeling of sadness, dejection or discomfort associated with lack of companionship or being separated from others

• Difficulty establishing social interaction
• Impaired physical mobility
• Inadequate emotional support
• Inadequate informational support
• Inadequate instrumental support
• Inadequate positive social interaction
• Physical isolation

• Family status, including family composition, presence of a spouse, ability of family to meet patient's physical and emotional needs, conflicts between patient's needs and family's ability to meet them, and family member's feelings of self-worth
• Psychological status, including changes in appetite, behavior, energy level, mood, motivation, self-image, self-esteem, or sleep patterns; alcohol and drug consumption; recent death, job loss, loss of loved one, or relocation; and psychiatric history
• Social status, including interpersonal skills, size of social network, quality of relationships, degree of trust in others, level of self-esteem, and ability to function in social and occupational roles
• Health history, including medical illness, disabilities, and deformities
• Spiritual status, including religious or church affiliation, description of faith and religious practices, and support network (family, clergy, and friends)

• Patient will identify feelings of loneliness and will express desire to socialize more.
• Patient will identify behaviors that lead to loneliness.
• Patient will identify people whose support and acceptance are most likely.
• Patient will spend time with others.
• Patient will be comfortable in social settings, will interact with peers, and will receive support from others.
• Patient will make specific plans to continue involvement with others, such as through recreational activities or social interaction groups.

Suggested NOC Outcomes

• Spend sufficient time with patient to allow self-expression of feelings of loneliness to establish trusting relationship.
• Inform patient that you'll help with expression of feelings of loneliness and identify ways to increase social activity to bring issue into open and help patient understand that you want to be of help.
• Work with patient to identify factors and behaviors that have contributed to loneliness to begin changing behaviors that may have alienated others.
• Help patient identify feelings associated with loneliness to lessen their impact and mobilize energy to counteract them.
• Help patient curb feelings of loneliness by encouraging one-on-one interaction with others whose acceptance is likely—for example, church members or patients with similar health problems—to promote feelings of acceptance and support.
• Encourage patient to address personal needs assertively. By being assertive, patient assumes responsibility for meeting personal needs, without anger or guilt.
• As patient's comfort level improves, encourage patient to attend group activities and social functions to promote use of social skills.
• Help patient identify social activities that patient can initiate, such as becoming active in a support group or volunteer organization, to foster feelings of control and increase social contacts.
• Help patient come to terms with being viewed differently by others because of patient's illness, and explore ways of coping with their reactions to help patient learn to cope with stigma associated with the illness.
• Work with patient to establish goals for reducing feelings of loneliness after patient leaves health care setting to focus energy on specific objectives.
• Refer patient and family to social service agencies, mental health center, and appropriate support groups to ensure continued care and maintain social involvement.

Suggested NIC Interventions

• Patient expresses feelings of loneliness.
• Patient describes behaviors that lead to loneliness.
• Patient lists at least _____ (specify) people whose support and acceptance are most likely.
• Patient initiates conversations with peers.
• Patient participates in group activities.
• Patient describes plans to continue involvement with others.

• Patient's statements of loneliness
• Observations of patient's behaviors and problems associated with loneliness
• Patient's choice of activities to end isolation
• Teaching of new coping methods
• Goals established by patient
• Evidence of efforts to use new coping mechanisms
• Referral
• Evaluations for expected outcomes

• Chang, E. C., Chang, O. D., Lucas, A. G., Li, M., Beavan, C. B., Eisner, R. S., … Hirsch, J. K. (2019). Depression, loneliness, and suicide risk among Latino college students: A Test of a Psychosocial Interaction Model. Social Work, 64(1), 51-60. doi:10.1093/sw/swy052
• Cheung, J. C. S., Chan, K. H. W., Lui, Y. W., Tsui, M. S., & Chan, C. (2018). Psychological well-being and adolescents' internet addiction: A school-based cross-sectional study in Hong Kong. Child & Adolescent Social Work Journal, 35(5), 477-487. doi:10.1007/s10560-018-0543-7
• Kovaleva, M., Spangler, S., Clevenger, C., & Hepburn, K. (2018). Chronic stress, social isolation, and perceived loneliness in dementia caregivers. Journal of Psychosocial Nursing & Mental Health Services, 56(10), 36-43. doi:10.3928/02793695-20180329-04
• Nyatanga, B. (2017). Being lonely and isolated: Challenges for palliative care. British Journal of Community Nursing, 22(7), 360. doi:10.12968/bjcn.2017.22.7.360
• Paque, K., Bastiaens, H., Van Bogaert, P., & Dilles, T. (2018). Living in a nursing home: A phenomenological study exploring residents' loneliness and other feelings. Scandinavian Journal of Caring Sciences, 32(4), 1477-1484. doi:10.1111/scs.12599