Loneliness, Protective/Risk Factors, and Coping Strategies Among Older Adults: A Transnational Qualitative Approach

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Many thanks for submitting this paper that explores older Chilean and Spanish adults’ perceptions of loneliness, focusing on associated risk and protective factors and the coping strategies they employ. Its strength lies in its transnational approach, which amplifies the narratives of older Chilean and Spanish adults’, highlighting some cultural influences and the value of individual resilience. Please see below for a list of suggested changes:

• The abstract and article would benefit from revision to improve clarity and accuracy. The framing of loneliness as a 'lack of intimacy, abandonment, and emptiness in relationships' rather than as an absence of desired social connections requires further justification. Additionally, references are needed to support the discussion of social and emotional loneliness. It is unclear why these aspects are particularly relevant to understanding loneliness in old age, and the omission of existential loneliness - potentially more pertinent to older adults - should be addressed. It is also not clear what the significance of the study is. A more explicit focus on the transnational approach could help address this challenge.  
• The discussion on the value of meaningful social relationships for older people requires additional detail. Does the presence of relationships necessarily reduce experiences of social loneliness? What are the potential limitations of this assumption? Clarifying these aspects would strengthen the argument and provide a more nuanced understanding of loneliness in later life.
• The manuscript is logically structured and relevant to the field, but the writing would benefit from further proofreading to enhance clarity and flow. For example, consider rewording ‘avoiding loneliness’ on line 311 to ‘managing loneliness’ or ‘reducing its risk’. Phrasing such as this impacts the positioning of the article overall.
• The manuscript would benefit from additional detail on the study design and sampling strategy to better contextualise the recruitment process.
• There is a repeated sentence on lines 109 - 110 that should be addressed.
• While the chosen methods appear appropriate, more clarity is needed regarding the practicalities of conducting interviews. Were interviews conducted by community leaders or the lead researcher? Given that the Chilean sample was collected entirely online, did this exclude older adults who were unwilling or unable to participate virtually, or were measures taken to mitigate this? Additionally, were there notable differences between the online and in-person samples that may have influenced the findings?
• Further detail is needed on the transcription process - was translation required, and at what stage was it conducted? Clarification on who carried out the analysis, the timeframe for this process, and whether research tasks were distributed according to team members’ expertise would strengthen transparency. Additionally, how were disagreements in interpretation managed, and what steps were taken to incorporate reflexivity into the research process? Providing this information would significantly enhance the methodological rigor of the study.
• The methods section lacks sufficient detail to ensure the reproducibility of results. Providing more comprehensive information on the study design, participant selection, data collection procedures and analytical approach would improve transparency and allow for replication.
• Table 1 is helpful, but additional clarification on educational levels would improve accessibility for an international audience.
• Consider restructuring the results section by incorporating additional subheadings to better organise the included quotes. In section 3.1, multiple themes and challenges emerge, making it difficult to follow. Reducing the length of quotes and ensuring only content directly relevant to each theme is included would enhance clarity. Clustering responses more coherently and referencing relevant aspects of the participant table would also strengthen the presentation. Additionally, reflections on age could be linked more explicitly to internalised ageism and societal expectations of ageing.
• Terminology adjustments could further improve readability - consider changing ‘financial capacity’ to ‘availability of resources’ or ‘financial resources’ and ‘residential circumstances’ to ‘residential settings’ for greater clarity.
• While the findings are interesting, the broad scope covers too many themes, making it difficult to engage with the key takeaways. Consider refining the thematic structure by consolidating less prominent themes - those mentioned by only one participant could be summarised in a table for additional context. The volume of content currently makes it challenging to follow.
• Figure 1 is unclear and would benefit from a redesign incorporating colour and arrows to better illustrate relationships between components. Additionally, the discussion lacks a clear narrative - streamlining key arguments and ensuring consistency in data interpretation throughout the manuscript would strengthen its overall impact.
• The conclusion is not fully aligned with the evidence and arguments presented in the manuscript. It asserts that phenomenological and participatory methodologies are necessary to understand the subjectivity and complexity of loneliness in old age; however, neither approach was utilised in this study, making this claim unsupported by the research findings. Additionally, the suggestion that mixed-methods approaches would be beneficial lacks clear justification - there is no direct link to how this conclusion emerges from the study’s results. 
• The data availability statement is satisfactory. The statements on informed consent and institutional review are included; however, given the sensitive nature of the topic, they appear overly simplified. Providing more detail on ethical considerations, such as how informed consent was obtained, how participant confidentiality was ensured, and any measures taken to support participants discussing potentially distressing topics, would strengthen the ethical transparency of the manuscript.

 

Comments on the Quality of English Language

The article would generally benefit from redrafting with a focus on accuracy and phrasing of writing. While most sections are clear, others would benefit from additional detail and/or improved phrasing. 

Author Response

Dear Reviewers,

We would like to thank you for the opportunity to revise our manuscript entitled:

“Loneliness, Protective-Risk Factors and Coping Strategies among Older Adults: A Transnational Qualitative Approach”
(Manuscript ID: socsci-3522755)

We would like to thank the reviewers for their comments and suggestions. We have tried to include all of them and we think that the new version of the manuscript has gained in coherence, richness of analysis and scientific scope. The changes to the document have been marked with red lettering.

REVIEWER 1

Many thanks for submitting this paper that explores older Chilean and Spanish adults’ perceptions of loneliness, focusing on associated risk and protective factors and the coping strategies they employ. Its strength lies in its transnational approach, which amplifies the narratives of older Chilean and Spanish adults’, highlighting some cultural influences and the value of individual resilience. Please see below for a list of suggested changes:

We thank the reviewer 1 for this generous summary and for acknowledging the value of our transnational approach. Below, we respond point by point to the suggestions provided.

The abstract and article would benefit from revision to improve clarity and accuracy.

We have revised the abstract to improve clarity and accuracy by restructuring the content, specifying the study design and objective, and refining the description of results and implications.

The framing of loneliness as a 'lack of intimacy, abandonment, and emptiness in relationships' rather than as an absence of desired social connections requires further justification. Additionally, references are needed to support the discussion of social and emotional loneliness. It is unclear why these aspects are particularly relevant to understanding loneliness in old age, and the omission of existential loneliness - potentially more pertinent to older adults - should be addressed. It is also not clear what the significance of the study is.

 

In the revised introduction, we have incorporated a clearer justification of the conceptualisation of loneliness.

A more explicit focus on the transnational approach could help address this challenge.  The discussion on the value of meaningful social relationships for older people requires additional detail. Does the presence of relationships necessarily reduce experiences of social loneliness? What are the potential limitations of this assumption? Clarifying these aspects would strengthen the argument and provide a more nuanced understanding of loneliness in later life.

We have incorporated a brief explanation of two elements in common between Chile and Spain: ageing societies and the relevance of the family (called ‘familist’ societies), which could explain why a transnational study is needed.

The manuscript is logically structured and relevant to the field, but the writing would benefit from further proofreading to enhance clarity and flow. For example, consider rewording ‘avoiding loneliness’ on line 311 to ‘managing loneliness’ or ‘reducing its risk’. Phrasing such as this impacts the positioning of the article overall.

We have carefully proofread the manuscript and implemented the suggested language changes, including modifying “avoiding loneliness” to “managing loneliness.”

The manuscript would benefit from additional detail on the study design and sampling strategy to better contextualise the recruitment process.

Done. This section of the methodology has been improved in order to make the step-by-step sampling process more coherent.

There is a repeated sentence on lines 109 - 110 that should be addressed.

Done.

While the chosen methods appear appropriate, more clarity is needed regarding the practicalities of conducting interviews. Were interviews conducted by community leaders or the lead researcher? Given that the Chilean sample was collected entirely online, did this exclude older adults who were unwilling or unable to participate virtually, or were measures taken to mitigate this? Additionally, were there notable differences between the online and in-person samples that may have influenced the findings?

Further detail is needed on the transcription process - was translation required, and at what stage was it conducted? Clarification on who carried out the analysis, the timeframe for this process, and whether research tasks were distributed according to team members’ expertise would strengthen transparency. Additionally, how were disagreements in interpretation managed, and what steps were taken to incorporate reflexivity into the research process? Providing this information would significantly enhance the methodological rigor of the study.

The methods section lacks sufficient detail to ensure the reproducibility of results. Providing more comprehensive information on the study design, participant selection, data collection procedures and analytical approach would improve transparency and allow for replication.

Done. Thank you very much for this comment, we have indeed realised that we have not been clear enough. Now we are separating study 1 (Chile) and study 2 (Spain) and we are trying to be more detailed in the whole methodological process, from the sample, the procedure, the study technique and the data analysis.

Table 1 is helpful, but additional clarification on educational levels would improve accessibility for an international audience.

We have added an explanatory note below Table 1 to clarify the meaning of the educational levels and improve accessibility for an international audience. Specifically, we have defined what is meant by “Primary,” “Secondary,” “Incomplete Secondary,” and “Higher Education” within the Chilean and Spanish contexts.

Consider restructuring the results section by incorporating additional subheadings to better organise the included quotes. In section 3.1, multiple themes and challenges emerge, making it difficult to follow. Reducing the length of quotes and ensuring only content directly relevant to each theme is included would enhance clarity. Clustering responses more coherently and referencing relevant aspects of the participant table would also strengthen the presentation. Additionally, reflections on age could be linked more explicitly to internalised ageism and societal expectations of ageing.

We have restructured the entire Results section to improve clarity, coherence, and readability. Subsections have been clearly defined to reflect key thematic categories. We have reduced and reorganised quotes to better support each theme, improved the coherence of participant voices, and incorporated more analytical connections. We believe these changes strengthen the presentation and interpretative depth of the results.

Terminology adjustments could further improve readability - consider changing ‘financial capacity’ to ‘availability of resources’ or ‘financial resources’ and ‘residential circumstances’ to ‘residential settings’ for greater clarity.

Thank you for your helpful suggestion. We have revised the terms as recommended, changing “financial capacity” to “financial resources” and “residential circumstances” to “residential settings” for greater clarity. More broadly, we have improved the overall language throughout the manuscript to enhance readability.

While the findings are interesting, the broad scope covers too many themes, making it difficult to engage with the key takeaways. Consider refining the thematic structure by consolidating less prominent themes - those mentioned by only one participant could be summarised in a table for additional context. The volume of content currently makes it challenging to follow.

We have revised the thematic structure to improve focus and readability by consolidating less prominent themes and reducing repetition.

Figure 1 is unclear and would benefit from a redesign incorporating colour and arrows to better illustrate relationships between components. Additionally, the discussion lacks a clear narrative - streamlining key arguments and ensuring consistency in data interpretation throughout the manuscript would strengthen its overall impact.

We have redesigned Figure 1 to improve clarity and visual communication. The new version incorporates directional arrows and clearer layout to better illustrate the relationships between components, such as risk and protection factors, coping strategies, and sociocultural variables in relation to loneliness. Additionally, we have revised the Discussion section to streamline key arguments and ensure a more consistent interpretation of the data throughout the manuscript.

The conclusion is not fully aligned with the evidence and arguments presented in the manuscript. It asserts that phenomenological and participatory methodologies are necessary to understand the subjectivity and complexity of loneliness in old age; however, neither approach was utilised in this study, making this claim unsupported by the research findings. Additionally, the suggestion that mixed-methods approaches would be beneficial lacks clear justification - there is no direct link to how this conclusion emerges from the study’s results. 

We agree that the final paragraph of the conclusion included a reference to phenomenological and participatory methodologies that was not fully aligned with the design of our study. In response, we have revised the conclusion to avoid making claims that are not directly supported by our own methodological approach and empirical findings. Instead, we now emphasise the potential of qualitative approaches—such as the one used in this study—to capture the subjective meanings of loneliness in old age, particularly through in-depth narrative analysis. In addition, we have removed the mention of mixed-methods as a recommendation, since this suggestion was not sufficiently grounded in our results. The revised conclusion now focuses on the relevance of incorporating cultural and subjective perspectives in future research and policy to improve our understanding and response to loneliness in later life.

The data availability statement is satisfactory. The statements on informed consent and institutional review are included; however, given the sensitive nature of the topic, they appear overly simplified. Providing more detail on ethical considerations, such as how informed consent was obtained, how participant confidentiality was ensured, and any measures taken to support participants discussing potentially distressing topics, would strengthen the ethical transparency of the manuscript.

Thank you for your comment regarding the ethical transparency of the manuscript. We have revised and expanded the relevant section to provide a more detailed description of the informed consent process and the measures taken to ensure participants’ well-being, given the emotional sensitivity of the topic. Specifically, we added information explaining that although written consent was obtained, it was also supported by clear and thorough oral explanations to ensure participants fully understood the study’s objectives, the voluntary nature of their involvement, and their right to withdraw at any point.

Comments on the Quality of English Language: The article would generally benefit from redrafting with a focus on accuracy and phrasing of writing. While most sections are clear, others would benefit from additional detail and/or improved phrasing.

We have tried to improve the writing; we have had the support of a native English speaker in revising the style. However, the translation of the verbatim (stories) has been complex as some of them have Chilean idioms and others were in Catalan. We hope that the new version will be clearer to read. 

Reviewer 2 Report

Comments and Suggestions for Authors

The paper provides a concise overview of the topic, taking into account the relevant theoretical and empirical background. The author introduces the issue and places it in the context of previous research. The paper represents a valuable contribution to the field of research, but with some room for improvement, especially in the explanation of the methodology.

The research design is clearly defined, including research questions. The methodological framework is well developed, but the justification of the chosen methods and their applicability to the hypotheses could be further clarified. I recommend defining the sample size more precisely, the method of data collection using snowball sampling, and describing the coding and data analysis strategy in more detail to ensure greater transparency of the research. 

At the same time, the work brings a certain level of originality in its approach to the topic, but it would be useful to more clearly highlight the scientific contribution of the research in relation to existing studies.

Author Response

Dear Reviewers,

We would like to thank you for the opportunity to revise our manuscript entitled:

“Loneliness, Protective-Risk Factors and Coping Strategies among Older Adults: A Transnational Qualitative Approach”
(Manuscript ID: socsci-3522755)

We would like to thank the reviewers for their comments and suggestions. We have tried to include all of them and we think that the new version of the manuscript has gained in coherence, richness of analysis and scientific scope. The changes to the document have been marked with red lettering.

The paper provides a concise overview of the topic, taking into account the relevant theoretical and empirical background. The author introduces the issue and places it in the context of previous research. The paper represents a valuable contribution to the field of research, but with some room for improvement, especially in the explanation of the methodology.

The research design is clearly defined, including research questions. The methodological framework is well developed, but the justification of the chosen methods and their applicability to the hypotheses could be further clarified. I recommend defining the sample size more precisely, the method of data collection using snowball sampling, and describing the coding and data analysis strategy in more detail to ensure greater transparency of the research. 

We sincerely thank Reviewer 2 for their thoughtful and constructive feedback. We appreciate your recognition of the relevance and value of our manuscript, as well as your helpful suggestions for improving the methodological clarity and scientific contribution.

In response to your recommendation, we have expanded the explanation of the methodological approach. Specifically, we have clarified the rationale for using qualitative descriptive research and how this design aligns with the aim of capturing the subjective and contextualised experience of loneliness among older adults in two sociocultural contexts. This approach was deemed appropriate given the study’s exploratory and interpretive goals, rather than testing predefined hypotheses.

We have elaborated on the data analysis section to increase transparency. We describe the open, axial, and selective coding procedures used, following a spiral analytical model, and how this process was supported by the use of Atlas.ti software. We also detail the triangulation process, which included researchers from both countries to ensure consistency in interpretation and thematic integration. This revision aims to clarify how analytical rigour and intercoder reliability were maintained.

At the same time, the work brings a certain level of originality in its approach to the topic, but it would be useful to more clearly highlight the scientific contribution of the research in relation to existing studies.

In response to your final point, we have revised the introduction and conclusion to more explicitly articulate the study’s scientific contribution. We now emphasise how the transnational perspective offers a comparative insight into cultural nuances surrounding loneliness in old age, which is an under-explored area in existing qualitative research. We also highlight how the identification of shared and context-specific factors may inform future interventions adapted to sociocultural contexts.

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Many thanks for addressing the suggestions raised and for the revisions made to the manuscript. The changes have significantly improved the overall quality and clarity of the paper.

Comments on the Quality of English Language

While the overall quality of the manuscript has notably improved, a few minor typographical errors remain. I recommend a thorough proofread prior to final submission. Additionally, while I understand that the term 'elderly' is used in the context of the special issue, I would strongly encourage the authors to avoid this term completely, as it may be perceived as derogatory. Alternatives such as older people, older persons or old age are more appropriate.