International Journal of Nursing Terminologies and Classifications Volume 20, No. 1, January-March, 2009 25 doi: 10.1111/j.1744-618X.2008.01110.x Blackwell Publishing Inc Malden, USA IJNT International Journal of Nursing Terminologies and Classifications 1541-5147 1744-618X XXX ORIGINAL ARTICLE Concept Analysis of Loneliness With Implications for Nursing Diagnosis Concept Analysis of Loneliness With Implications for Nursing Diagnosis Cheryl Bombassei ElSadr, RN, MSN, ACNS-BC, Samar Noureddine, PhD, RN, and Jane Kelley, RN, PhD PURPOSE. This study aims to explore the concept of loneliness using Walker and Avant’s concept analysis framework. In addition, the overlap and potential confusion of the factors related to the nursing diagnoses Social Isolation and Risk for Loneliness were noted and discussed. DATA SOURCES. A literature review was conducted by searching Google, CINAHL, PsychINFO, and MEDLINE databases using the keywords “loneliness,” “concept analysis,” and “loneliness concept analysis” in the title. Only those sources that directly addressed loneliness were used (27). DATA SYNTHESIS. Dictionary definitions, various uses, and critical attributes were identified; model, borderline, related, and contrary cases were developed; and antecedents, consequences, and empirical referents were determined. Data were evaluated and summarized to reach conclusions and recommendations. CONCLUSIONS. The authors concluded with a recommendation that Loneliness replace Social Isolation as the primary nursing diagnosis in the NANDA International taxonomy. Search terms: Concept analysis, loneliness, social isolation Cheryl Bombassei ElSadr, RN, MSN, ACNS-BC, is Nurse Educator, Karmanos Cancer Center, Detroit, MI; Samar Noureddine, PhD, RN, is Associate Professor, MSN Program Coordinator, School of Nursing, American University of Beirut, Beirut, Lebanon; and Jane Kelley, RN, PhD, is Adjunct Professor of Nursing, University of Mississippi Medical Center, Jackson, MS. Walker and Avant (1995) explain that a concept analysis is an attempt to describe a category of infor- mation, a concept, and clarify its meaning. They relate that the goal is to analyze the concept well enough to determine what the defining characteristics of the concept are. In addition, since concepts are used in nursing diagnoses and to build theories, it is important to strive to gain a good understanding of concepts in general. Lastly, Walker and Avant relate that definitions of concepts can change over time with changes in knowledge; therefore, concept analyses are tentative. Method The concept of loneliness was analyzed using the Walker and Avant (1995) methodology, the aim of the analysis is presented, followed by the uses of the term loneliness. After determining the use of loneliness in nursing, the critical attributes and relevant case studies are discussed, followed by the antecedents and con- sequences of loneliness. Finally, the empirical referents and conclusion are presented to further elucidate the concept of loneliness. Each step is explained further as it was addressed. To begin this clarification process, the uses of the term loneliness were explored. In Google, CINAHL, PsychINFO, and MEDLINE databases, a search was conducted using the keywords “loneliness,” “concept analysis,” and “loneliness concept analysis” in the title. Several categories of sources emerged, including religious uses, a business use, psychological uses, nursing/medical research uses, and research involving the relationship of loneliness and people with disabilities.