Identifying loneliness cues in persons with spinal cord injuries and disorders: A qualitative inquiry of provider's perspectives.

Objective: Individuals with spinal cord injuries and disorders (SCI/D) may exhibit cues that tell a story about their loneliness. Health care providers must recognize loneliness cues in order to take action. This study identified and described loneliness cues exhibited by persons with SCI/D from health provider perspectives.

Methods: Descriptive qualitative design using in-depth interviews with health providers and analyzed using thematic analysis.

Results: Multidisciplinary SCI/D health providers from 10 nationwide Veterans Health Administration facilities. Ten themes described loneliness cues exhibited by persons with SCI/D: (a) direct or indirect verbal expression; (b) physical health symptoms/conditions; (c) mental health indicators; (d) withdrawal/lack of engagement; (e) "severe" voluntary seclusion, for example, not leaving house, not getting out of bed, sitting in the dark; (f) poor lifestyle behaviors, for example, substance use, poor nutrition; (g) neglecting personal self-care, for example, poor hygiene; (h) neglecting ones' internal environment, for example, dirty home, hoarding; (i) avoiding health care and health care management needs, for example, missing medical appointments, neglecting bowel care; and (j) fixating on health care to meet social health needs.

Conclusions: Health care providers identified several loneliness cues commonly exhibited by individuals with SCI/D. These cues, whether verbal or nonverbal, may represent a signal that alerts the provider of a concern around loneliness. The value of such cues depends on the health provider's ability to identify them in order to decide on next steps, which may involve formal screening or validated measurement followed by collaborative patient engagement to identify potential sources contributing to loneliness and areas patients wish to address. (PsycInfo Database Record (c) 2025 APA, all rights reserved).