Risk for Loneliness and Social Isolation: Potentially Underestimated Nursing Diagnoses in Onco-Hematology Inpatients

Background: Loneliness and social isolation are recognized as serious psychosocial issues for inpatients with onco-hematologic diseases, negatively affecting well-being, treatment adherence, and clinical outcomes. However, the prevalence of loneliness and social isolation remains understudied, particularly when assessed using standardized nursing diagnoses. Objective: To describe the prevalence and 1-week changes of the nursing diagnoses Risk for Loneliness and Social Isolation in patients hospitalized with onco-hematologic diseases, and to identify variables associated with their presence at admission. Methods: This was a prospective longitudinal study. Adult inpatients with onco-hematologic diseases admitted for at least 7 days were assessed within 48 hours of admission (T0) and reassessed 1 week later (T1). Changes in diagnostic indicators were analyzed, and multivariable analyses were used to identify variables associated with their presence at T0. Results: One hundred patients participated. At T0, the prevalence of Risk for Loneliness and Social Isolation was 73% and 15%, respectively. The incidence of both diagnoses increased over the 1-week follow-up. For Risk for Loneliness, the related factors affectional deprivation and social isolation increased at T1. For Social Isolation, most defining characteristics and several related factors increased at follow-up. Self-esteem, age, and single-room accommodation were associated with Risk for Loneliness, whereas only self-esteem was associated with Social Isolation. Conclusion: High and increasing levels of loneliness and social isolation were documented, indicating the need for systematic assessment and timely intervention. Implications for oncology nursing practice: Flexible, patient-centered visiting policies and targeted psychosocial nursing interventions may help reduce loneliness and social isolation, thereby improving patient outcomes.