{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T20:51:16Z","timestamp":1781988676827,"version":"3.54.5"},"reference-count":34,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T00:00:00Z","timestamp":1611878400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Royal Society Te Ap\u00e3rangi Marsden Fund","award":["MAU1723"],"award-info":[{"award-number":["MAU1723"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Nurs Ethics"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There is an international trend for frail older adults to move to residential care homes, rather than ageing at home. Residential facilities typically espouse a person-centred philosophy, yet evidence points to restrictive policies and surveillance resulting in increased loneliness and diminished opportunities for intimacy and sexual expression. Residents may experience what has been termed social death, rather than perceive they are related to by others as socially alive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To consider how the loss of intimacy and sexuality in residents\u2019 lives contributes to iatrogenic loneliness experienced in residential care, and the importance of considering these issues together.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research design:<\/jats:title>\n                    <jats:p>The study utilised a constructionist methodology, investigating the meanings associated with intimacy, loneliness, and ageing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants and research context:<\/jats:title>\n                    <jats:p>Qualitative data used in this study are drawn from a larger dataset of a mixed-methods study. Interviews were completed as follows: staff, 21 individual interviews, and two groups with a total of 13 additional people; residents, 26 interviews with 28 people; and family members, 12 interviews with 13 people.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings:<\/jats:title>\n                    <jats:p>Five key themes were identified in the data analysis: loneliness and relational identity, loneliness and functional relationships, loneliness and disrupted intimacy, loneliness and liminality, and loneliness and the built environment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethical considerations:<\/jats:title>\n                    <jats:p>The study was approved by a University Human Ethics Committee. Participation was voluntary. Consent was gained and confidentiality upheld.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Residents\u2019 expression of intimacy and sexuality can be compromised through paternalism, ageism, restrictive policies, care-rationing and functional care, alienating residents from sustaining and developing significant relationships. Attitudes and cultural beliefs of staff and family members about ageing and intimacy, compounded by architectural design, may intensify loneliness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Nurses have a pivotal role in ensuring policies and practice enhance social citizenship.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0969733020983394","type":"journal-article","created":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T04:42:00Z","timestamp":1611895320000},"page":"911-923","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Iatrogenic loneliness and loss of intimacy in residential care"],"prefix":"10.1177","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3976-6858","authenticated-orcid":false,"given":"Catherine","family":"Cook","sequence":"first","affiliation":[{"name":"Auckland University of Technology, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Henrickson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilo","family":"Atefi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Schouten","sequence":"additional","affiliation":[{"name":"Massey University Albany, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Mcdonald","sequence":"additional","affiliation":[{"name":"Manukau Institute of Technology Otara, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,1,29]]},"reference":[{"key":"bibr1-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610212000257"},{"key":"bibr2-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1080\/13691058.2018.1465203"},{"issue":"1","key":"bibr3-0969733020983394","first-page":"36","volume":"23","author":"Miles SH","year":"1999","journal-title":"Generations"},{"key":"bibr4-0969733020983394","unstructured":"World Health Organization. Defining sexual health. Report of a technical consultation on sexual health 28\u201331 January 2002, Geneva, https:\/\/www.who.int\/reproductivehealth\/publications\/sexual_health\/defining_sexual_health.pdf?ua=1 (accessed 6 October 2020)."},{"key":"bibr5-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1111\/opn.12213"},{"key":"bibr6-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2010.09.008"},{"key":"bibr7-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1177\/1049732317735079"},{"key":"bibr8-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1177\/1054137317742235"},{"key":"bibr9-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1111\/jonm.12743"},{"key":"bibr10-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1080\/17496535.2018.1512642"},{"issue":"2","key":"bibr11-0969733020983394","first-page":"165","volume":"3","author":"Kuhn D","year":"2002","journal-title":"Alzheimer\u2019s Care Q"},{"key":"bibr12-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1111\/jnu.12315"},{"key":"bibr13-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1177\/0969733018780527"},{"key":"bibr14-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2006.08.039"},{"key":"bibr15-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaging.2015.05.004"},{"key":"bibr16-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaging.2015.08.011"},{"key":"bibr17-0969733020983394","doi-asserted-by":"publisher","DOI":"10.4324\/9781315547855-3"},{"key":"bibr18-0969733020983394","unstructured":"Retirement Villages Association of New Zealand, https:\/\/www.retirementvillages.org.nz\/ (accessed 1 August 2020)."},{"key":"bibr19-0969733020983394","unstructured":"Ministry of Social Development\/Te Manatu Whakahiato Ora an ageing population, https:\/\/www.msd.govt.nz\/documents\/about-msd-and-our-work\/publications-resources\/corporate\/bims\/office-for-senior-citizens-2012.pdf (2012, accessed 1 August 2020)."},{"key":"bibr20-0969733020983394","unstructured":"Thorne S. Interpretive description: qualitative research for applied practice. 2nd ed. Taylor & Francis Group, p. 12, https:\/\/ebookcentral.proquest.com\/lib\/aut\/detail.action?docID=4511832 (2016, accessed 8 November 2020)."},{"key":"bibr21-0969733020983394","doi-asserted-by":"publisher","DOI":"10.4324\/9781315715421"},{"key":"bibr22-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1177\/0969733011408049"},{"key":"bibr23-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"bibr24-0969733020983394","unstructured":"Liamputtong P. Qualitative research methods. Oxford University Press Australia and New Zealand, https:\/\/ebookcentral.proquest.com\/lib\/AUT\/detail.action?docID=4882799 (2012, accessed 1 August 2020)."},{"key":"bibr25-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1080\/13607863.2016.1244804"},{"key":"bibr26-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaging.2015.07.003"},{"key":"bibr27-0969733020983394","unstructured":"World Health Organization. Gender and human rights, https:\/\/www.who.int\/reproductivehealth\/topics\/gender_rights\/sexual_health\/en\/ (accessed 1 August 2020)."},{"key":"bibr28-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1111\/opn.12058"},{"key":"bibr29-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1111\/jan.13361"},{"key":"bibr30-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1111\/jan.12398"},{"key":"bibr31-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610213002342"},{"key":"bibr32-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1606\/1044-3894.3434"},{"key":"bibr33-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-019-0968-x"},{"key":"bibr34-0969733020983394","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9566.12284"}],"container-title":["Nursing Ethics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0969733020983394","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0969733020983394","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0969733020983394","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:43:16Z","timestamp":1777678996000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0969733020983394"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,29]]},"references-count":34,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1177\/0969733020983394"],"URL":"https:\/\/doi.org\/10.1177\/0969733020983394","relation":{},"ISSN":["0969-7330","1477-0989"],"issn-type":[{"value":"0969-7330","type":"print"},{"value":"1477-0989","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,29]]}}}