Document Type


Publication Date

Fall 2-17-2015


School of Nursing


Adult Health


Purpose: The purpose of this paper is to present the development of LISTEN (Loneliness Intervention

using Story Theory to Enhance Nursing-sensitive outcomes), a new intervention for loneliness.

Methods: LISTEN was developed using the Medical Research Council (MRC) framework for intervention

development. Extensive literature review revealed that belonging, relating, place in community,

challenges, and meanings of coping were concepts significant to loneliness. Past interventions

were limited but it was determined from a recent meta-analysis that enhanced effectiveness

may result from interventions that targeted the poorly adapted cognitive processes of loneliness.

These processes include social undesirability, stigma, and negative thoughts about self in relation

to others. LISTEN is designed to be delivered in a determined logical sequence of 5 sessions, each

focusing on the concepts relevant to loneliness as derived from the literature. For each session,

intervention delivery is guided by the concepts from story theory (including intentional dialogue,

nurse as listener, examination of self in relation to others and community, synthesizing concerns

and patterns, and identifying messages) and the principles of cognitive restructuring (self-assessment

of maladaptive cognitions, emotions, and behaviors, identifying challenges of changing,

reconceptualization of self, new skill acquisition through group interaction, and identifying patterns

of meaning in loneliness). Results: LISTEN is developed and the first randomized trial is

complete with a sample of 27 lonely, chronically ill, community dwelling, and older adults. LISTEN

was evaluated as feasible to deliver by the study team and acceptable for significantly diminishing

loneliness by participants of the LISTEN groups who were compared to attention control groups (p

< 0.5). Conclusions: LISTEN has the potential to enhance health by diminishing loneliness which

could result in improving the long-term negative known sequelae of loneliness. Future longitudinal

randomized trials are needed in varied populations to assess long term health and healthcare

system benefit of using LISTEN to treat loneliness.

Source Citation

Open Journal of Nursing, 2015, 5, 136-143 Published Online February 2015 in SciRes.



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