{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:05:35Z","timestamp":1790618735958,"version":"4.1.0"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Finnish Association for the Welfare of Older Adults"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Loneliness is recognized worldwide as a risk to well-being and health. It emerges from the discrepancy between our expectations of social relationships and the reality. However, very little is known about the experiences of loneliness among older deaf adults. The aim of the study was to describe the experiences and expressions of loneliness among 12 older deaf adults who use sign language. We interviewed them, and the interview transcripts were analyzed inductively. Loneliness manifested itself in a variety of ways in the narratives, facial expressions, postures, movements, gestures, and the very individual-specific signing of the respondents. The narratives illustrated the loneliness they experienced and how they coped with it. To our knowledge, this is one of the first studies on loneliness among older deaf adults who use sign language. It should be acknowledged: Discovering and understanding this hidden phenomenon is the key to alleviating it. Future studies should explore tailored interventions and inclusive communication strategies to alleviate loneliness. Involving older deaf adults who use sign language in cocreating solutions will be essential.<\/jats:p>","DOI":"10.1093\/jdsade\/enaf070","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T14:05:43Z","timestamp":1763474743000},"page":"335-344","source":"Crossref","is-referenced-by-count":1,"title":["Experiences of loneliness among older deaf adults who use sign language"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6531-2054","authenticated-orcid":false,"given":"Anu H","family":"Jansson","sequence":"first","affiliation":[{"name":"Department of General Practice and Helsinki University Hospital, Unit of Primary Health Care, University of Helsinki , Helsinki ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Kursi","sequence":"additional","affiliation":[{"name":"Finnish Folk High School for the Deaf , Helsinki ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9659-6985","authenticated-orcid":false,"given":"Kaisu H","family":"Pitk\u00e4l\u00e4","sequence":"additional","affiliation":[{"name":"Department of General Practice and Helsinki University Hospital, Unit of Primary Health Care, University of Helsinki , Helsinki ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Strandberg","sequence":"additional","affiliation":[{"name":"Helsinki University Hospital, University of Helsinki , Helsinki ,","place":["Finland"]},{"name":"Center for Life Course Health Research, University of Oulu , Oulu ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0709-3843","authenticated-orcid":false,"given":"Laura","family":"Rautiainen","sequence":"additional","affiliation":[{"name":"Department of General Practice and Helsinki University Hospital, Unit of Primary Health Care, University of Helsinki , Helsinki ,","place":["Finland"]},{"name":"The Finnish Association for the Welfare of Older Adults , Helsinki ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarja","family":"Ylimaa","sequence":"additional","affiliation":[{"name":"The Finnish Association for the Welfare of Older Adults , Helsinki ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"2026070901164688500_ref1","doi-asserted-by":"publisher","first-page":"igx029","DOI":"10.1093\/geroni\/igx029","article-title":"Social relations and technology: Continuity, context, and change","volume":"1","author":"Antonucci","year":"2017","journal-title":"Innovation in Aging"},{"key":"2026070901164688500_ref2","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1093\/qjmed\/hcw183","article-title":"Social death","volume":"110","author":"Borgstrom","year":"2017","journal-title":"QJM: An International Journal of Medicine"},{"key":"2026070901164688500_ref3","doi-asserted-by":"publisher","DOI":"10.1007\/978-981-10-5251-4_103","volume-title":"Handbook of research methods in health social sciences","author":"Braun","year":"2019"},{"key":"2026070901164688500_ref4","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1016\/j.gerinurse.2011.05.003","article-title":"The management of loneliness in aged care residents: An imp: An important therapeutic target for gerontological nursing","volume":"32","author":"Brownie","year":"2011","journal-title":"Geriatric Nursing"},{"key":"2026070901164688500_ref5","doi-asserted-by":"publisher","first-page":"1464","DOI":"10.1037\/a0037618","article-title":"Toward a neurology of loneliness","volume":"140","author":"Cacioppo","year":"2014","journal-title":"Psychological Bulletin"},{"key":"2026070901164688500_ref6","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1017\/S0144686X04002594","article-title":"Preventing social isolation and loneliness among older people: A systematic review of health promotion interventions","volume":"25","author":"Cattan","year":"2005","journal-title":"Ageing and Society"},{"key":"2026070901164688500_ref7","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1093\/deafed\/enac046","article-title":"Associations between deaf\/hard of hearing and social participation among older Americans","volume":"28","author":"Cheung","year":"2023","journal-title":"Journal of Deaf Studies and Deaf Education"},{"key":"2026070901164688500_ref8","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1097\/AUD.0000000000001398","article-title":"The self-stigma of hearing loss in adults and older adults: A systematic review","volume":"44","author":"Silva","year":"2023","journal-title":"Ear and Hearing"},{"key":"2026070901164688500_ref9","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/978-3-031-66582-0","volume-title":"Loneliness in Europe","author":"d\u2019Hombres","year":"2024"},{"key":"2026070901164688500_ref10","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1037\/sah0000022","article-title":"Stigma regarding hearing loss and hearing aids: A scoping review","volume":"1","author":"David","year":"2016","journal-title":"Stigma and Health"},{"key":"2026070901164688500_ref11","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1044\/2017_AJA-17-0050","article-title":"Self-stigma and age-related hearing loss: A qualitative study of stigma formation and dimensions","volume":"27","author":"David","year":"2018","journal-title":"American Journal of Audiology"},{"key":"2026070901164688500_ref12","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1007\/s11017-010-9141-1","article-title":"Existential loneliness and end-of-life care: A systematic review","volume":"31","author":"Ettema","year":"2010","journal-title":"Theoretical Medicine and Bioethics"},{"key":"2026070901164688500_ref13","author":"European Commission","year":"2024"},{"key":"2026070901164688500_ref14","volume-title":"The ethical principles of research with human participants and ethical review in the human sciences in Finland (TENK guidelines 3\/2019, 2nd revised edition)","author":"Finnish National Board on Research Integrity TENK","year":"2019"},{"key":"2026070901164688500_ref15","doi-asserted-by":"crossref","first-page":"369","DOI":"10.4135\/9781848608337.n25","volume-title":"Handbook of ethnography","author":"Heyl","year":"2001"},{"key":"2026070901164688500_ref16","doi-asserted-by":"publisher","first-page":"e1000316","DOI":"10.1371\/journal.pmed.1000316","article-title":"Social relationships and mortality risk: A meta-analytic review","volume":"7","author":"Holt-Lunstad","year":"2010","journal-title":"PLoS Medicine"},{"key":"2026070901164688500_ref17","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1177\/1745691614568352","article-title":"Loneliness and social isolation as risk factors for mortality: A meta-analytic review","volume":"10","author":"Holt-Lunstad","year":"2015","journal-title":"Perspectives on Psychological Science"},{"issue":"43","key":"2026070901164688500_ref18","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1146\/annurev-publhealth-052020-110732","article-title":"Social connection as a public health issue: The evidence and a systemic framework for prioritizing the \"social\" in social determinants of health","volume":"5","author":"Holt-Lunstad","year":"2022","journal-title":"Annual Review of Public Health"},{"key":"2026070901164688500_ref19","first-page":"43","article-title":"Loneliness in nursing homes and assisted living facilities: Prevalence, associated factors and prognosis","volume":"3","author":"Jansson","year":"2017","journal-title":"Journal of Nursing Home Research"},{"key":"2026070901164688500_ref20","volume-title":"Loneliness of older people in long-term care facilities","author":"Jansson","year":"2020"},{"key":"2026070901164688500_ref21","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1007\/s12603-021-1615-5","article-title":"Editorial: Circle of friends, an encouraging intervention for alleviating loneliness","volume":"25","author":"Jansson","year":"2021","journal-title":"Journal of Nutrition, Health & Aging"},{"key":"2026070901164688500_ref22","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1080\/03601277.2017.1420005","article-title":"Training professionals to implement a group model for alleviating loneliness among older people \u2013 10-year follow-up study","volume":"44","author":"Jansson","year":"2018","journal-title":"Educational Gerontology"},{"key":"2026070901164688500_ref23","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1007\/s12603-022-1795-7","article-title":"Editorial: Screening - an important starting point for effective loneliness interventions among older adults","volume":"26","author":"Jansson","year":"2022","journal-title":"The Journal of Nutrition, Health & Aging"},{"key":"2026070901164688500_ref24","doi-asserted-by":"publisher","first-page":"2894","DOI":"10.1017\/S0144686X21001975","article-title":"Listening to the voice of older people: Dimensions of loneliness in long-term care facilities","volume":"43","author":"Jansson","year":"2023","journal-title":"Ageing and Society"},{"key":"2026070901164688500_ref25","first-page":"527","article-title":"Yksin\u00e4isyys ja aika","volume":"82","author":"Karisto","year":"2017","journal-title":"Yhteiskuntapolitiikka"},{"key":"2026070901164688500_ref26","doi-asserted-by":"publisher","DOI":"10.4324\/9781003528609","volume-title":"Deaf people, injustice and reconciliation: Signed memories","author":"Katsui","year":"2024","edition":"1st"},{"key":"2026070901164688500_ref27","volume-title":"Persons entitled to interpretation services 2022. Search criteria: Deaf, whole of Finland","author":"Kelasto","year":"2022"},{"key":"2026070901164688500_ref28","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1111\/j.1365-2648.2012.06018.x","article-title":"Facing the challenge of adapting to a life 'alone' in old age: The influence of losses","volume":"69","author":"Kirkevold","year":"2013","journal-title":"Journal of Advanced Nursing"},{"key":"2026070901164688500_ref29","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1007\/s12603-023-1949-2","article-title":"Impact of the COVID-19 pandemic on older people\u2019s loneliness: Findings from a longitudinal study between 2019 and 2021 among older home-dwellers in Finland","volume":"27","author":"Knuutila","year":"2023","journal-title":"The Journal of Nutrition, Health & Aging"},{"key":"2026070901164688500_ref30","doi-asserted-by":"publisher","first-page":"215","DOI":"10.4324\/9781032685519-12","volume-title":"Disability, happiness and the welfare state: Finland and the Nordic model","author":"Koivisto","year":"2024"},{"key":"2026070901164688500_ref31","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1016\/j.gerinurse.2025.03.061","article-title":"The importance of nature and wishes for nature-based experiences among older adults in assisted living facilities","volume":"63","author":"Kolster","year":"2025","journal-title":"Geriatric Nursing"},{"key":"2026070901164688500_ref32","doi-asserted-by":"publisher","first-page":"227","DOI":"10.23989\/gerontologia.116652","article-title":"Viitottu yksin\u00e4isyys: Selvitys viittomakielisten i\u00e4kk\u00e4iden ihmisten yksin\u00e4isyydest\u00e4 Yst\u00e4v\u00e4piiri-toiminnan kehitt\u00e4miseksi","volume":"36","author":"Kursi","year":"2022","journal-title":"Gerontologia"},{"key":"2026070901164688500_ref33","volume-title":"Interpretation service is a prerequisite for participation in society \u2013 \"tomorrow you will understand for four hours, the day after tomorrow for three\"","author":"Laakkonen","year":"2019"},{"key":"2026070901164688500_ref34","doi-asserted-by":"publisher","first-page":"4454","DOI":"10.1111\/jocn.16572","article-title":"Individuals with hearing impairment\/deafness during the COVID-19 pandemic: A rapid review on communication challenges and strategies","volume":"32","author":"Mansutti","year":"2023","journal-title":"Journal of Clinical Nursing"},{"key":"2026070901164688500_ref35","doi-asserted-by":"publisher","DOI":"10.1177\/16094069231205789","article-title":"A step-by-step process of thematic analysis to develop a conceptual model in qualitative research","volume":"22","author":"Naeem","year":"2023","journal-title":"International Journal of Qualitative Methods"},{"key":"2026070901164688500_ref36","doi-asserted-by":"publisher","first-page":"1442","DOI":"10.1097\/AUD.0000000000000948","article-title":"COVID-19 lockdown affects hearing disability and handicap in diverse ways: A rapid online survey study","volume":"41","author":"Naylor","year":"2020","journal-title":"Ear and Hearing"},{"key":"2026070901164688500_ref37","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1177\/0265407517749045","article-title":"Loneliness and social isolation of older adults: Why it is important to examine these social aspects together","volume":"36","author":"Newall","year":"2019","journal-title":"The Journal of Social and Personal Relationships"},{"key":"2026070901164688500_ref38","first-page":"123","volume-title":"Loneliness: A sourcebook of current theory, research, and therapy","author":"Perlman","year":"1982"},{"key":"2026070901164688500_ref39","first-page":"2272","volume-title":"Good human life in assisted living for older people","author":"Pirhonen","year":"2017"},{"key":"2026070901164688500_ref40","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1093\/gerona\/glp011","article-title":"Effects of psychosocial group rehabilitation on health, use of health care services, and mortality of older persons suffering from loneliness: A randomized, controlled trial","volume":"64","author":"Pitk\u00e4l\u00e4","year":"2009","journal-title":"The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences"},{"key":"2026070901164688500_ref41","first-page":"39","volume-title":"Group therapy","author":"Pitk\u00e4l\u00e4","year":"2015"},{"key":"2026070901164688500_ref42","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1159\/000540345","article-title":"Comparing loneliness, social inactivity, and social isolation: Associations with health-related quality of life and mortality among home-dwelling older adults","volume":"70","author":"Rautiainen","year":"2024","journal-title":"Gerontology"},{"key":"2026070901164688500_ref43","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1080\/10926771.2016.1145162","article-title":"Information deprivation trauma: Definition, assessment, and interventions","volume":"25","author":"Schild","year":"2016","journal-title":"Journal of Aggression, Maltreatment & Trauma"},{"key":"2026070901164688500_ref44","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1177\/0898264317703559","article-title":"Social isolation and Medicare spending: Among older adults, objective social isolation increases expenditures while loneliness does not","volume":"29","author":"Shaw","year":"2017","journal-title":"Journal of Aging and Health"},{"key":"2026070901164688500_ref45","doi-asserted-by":"publisher","first-page":"e164","DOI":"10.1212\/WNL.0000000000200583","article-title":"Associations of social isolation and loneliness with later dementia","volume":"99","author":"Shen","year":"2022","journal-title":"Neurology"},{"key":"2026070901164688500_ref46","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1177\/0194599820910377","article-title":"Hearing loss, loneliness, and social isolation: A systematic review","volume":"162","author":"Shukla","year":"2020","journal-title":"Otolaryngology\u2013Head and Neck Surgery"},{"key":"2026070901164688500_ref47","doi-asserted-by":"crossref","DOI":"10.1017\/CBO9781139167048","volume-title":"The linguistics of British sign language: An introduction","author":"Sutton-Spence","year":"1999"},{"key":"2026070901164688500_ref48","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1186\/s12877-024-04967-6","article-title":"Early-life circumstances and late life loneliness trajectories among Finnish older adults","volume":"24","author":"Tiilikainen","year":"2024","journal-title":"BMC Geriatrics"},{"key":"2026070901164688500_ref49","doi-asserted-by":"publisher","first-page":"1068","DOI":"10.1017\/S0144686X16000040","article-title":"Lost and unfulfilled relationships behind emotional loneliness in old age","volume":"37","author":"Tiilikainen","year":"2017","journal-title":"Ageing and Society"},{"key":"2026070901164688500_ref50","volume-title":"Programme to promote the well-being of older people using sign language in Finland","author":"Torboli","year":"2013"},{"key":"2026070901164688500_ref51","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1017\/S0959259805001723","article-title":"Measuring loneliness in later life: A comparison of differing measures","volume":"15","author":"Victor","year":"2005","journal-title":"Reviews in Clinical Gerontology"},{"key":"2026070901164688500_ref52","volume-title":"The social world of older people: Understanding loneliness and social isolation in later life","author":"Victor","year":"2009"}],"container-title":["Journal of Deaf Studies and Deaf Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jdsde\/article-pdf\/31\/2\/335\/65370756\/enaf070.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jdsde\/article-pdf\/31\/2\/335\/65370756\/enaf070.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:16:58Z","timestamp":1783574218000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jdsde\/article\/31\/2\/335\/8326583"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,18]]},"references-count":52,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,11,18]]},"published-print":{"date-parts":[[2026,7,2]]}},"URL":"https:\/\/doi.org\/10.1093\/jdsade\/enaf070","relation":{},"ISSN":["1081-4159","1465-7325"],"issn-type":[{"value":"1081-4159","type":"print"},{"value":"1465-7325","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4]]},"published":{"date-parts":[[2025,11,18]]}}}