JMIR Publications

ABSTRACT

Background:

Better understanding of older people’s experiences of social isolation in long-term care facilities is required to develop targeted nursing measures to improve quality of life and mental health.

Objective:

This study aimed to examine and synthesize qualitative data on older people’s experiences of social isolation in long-term care facilities. The meta-synthesis results could provide reference for medical clinical and nursing staff to implement personalized care services for older people.

Methods:

We conducted a systematic review and qualitative meta-synthesis. Eligible studies contained older people in long-term care facilities quotes about social isolation, conducted with a search time frame of February 2025. Data sources included PubMed, Web of Science, Embase, PsycINFO, Cochrane Library, CINAHL, Scopus, Chinese Biomedical Literature Database, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Weipu (VIP). Systematic searches yielded 4,856 identified articles, of which 14 reporting 47 studies were included. Two reviewers independently extracted data into a Microsoft Excel spreadsheet. Qualitative meta-synthesis was performed through line-by-line coding of relevant quotes, organisation of codes into descriptive themes, and development of analytical themes. Evaluation of the quality of the literature using the Joanna Briggs Institute’ s Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research, And the data were synthesised using Thomas and Harden’ s method of thematic and content analysis.

Results:

Qualitative meta-synthesis resulted in four main themes: causes of social isolation, manifestations of social isolation, feelings of social isolation, and coping strategies of social isolation, and thirteen sub-theme: the persistent threat of aging, the accumulation of negative self-cognitive and psychological states, choices based on individual biases and values, abrupt changes in social function and life structure, quiet social isolation, anxious social isolation, active social isolation, imprisonment, loss, boredom, active engagement in interaction, rational acceptance of coexistence, and passive avoidance and withdrawal.

Conclusions:

Caregivers and family members should highly value the personal feelings of older people, future studies should further explore and address the many facets of social isolation using these insights and include ongoing assessment of the social isolation risk, comprehensive preventive measures, to reduce the incidence of social isolation and promote active engagement. Clinical Trial: PROSPERO CRD42024591240