Loneliness is associated with negative outcomes, including increased mortality and is common among people with mental health problems. This qualitative study, which was carried out as part of a feasibility trial, aimed to understand what enables and hinders people with severe depression and/or anxiety under the care of secondary mental health services in the United Kingdom to participate in the Community Navigator programme, and make progress with feelings of depression, anxiety and loneliness. The programme consisted of up to ten meetings with a Community Navigator and three optional group sessions. Semi-structured interviews were carried out with participants (n = 19) shortly after programme completion. A co-produced two-stage qualitative approach, involving narrative and reflexive thematic analysis, was undertaken by members of the study’s working group, which included experts by experience, clinicians and researchers. The narrative analysis showed that individuals have varied goals, hold mixed feelings about meeting other people and define progress differently. From the thematic analysis, six themes were identified that explained facilitators and challenges to participating in the programme: desire to connect with others; individual social confidence; finding something meaningful to do; the accessibility of resources locally; the timing of the programme; and the participant’s relationship with the Community Navigator. We found that people with severe depression and/or anxiety supported by secondary mental health services may want to address feelings of loneliness but find it emotionally effortful to do so and a major personal challenge. This emotional effort, which manifests in individuals differently, can make it hard for participants to engage with a loneliness programme, though it was through facing personal challenges that a significant sense of achievement was felt. Factors at the individual, interpersonal and structural level, that enable or hinder an individual’s participation should be identified early, so that people are able to make the best use out of the Community Navigator or other similar programmes.

中文翻译：

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对参与解决抑郁症和焦虑症患者孤独感的计划的影响：“社区导航者”研究的发现

孤独与负面结果相关，包括死亡率增加，在精神健康问题患者中很常见。这项定性研究是一项可行性试验的一部分，旨在了解在英国二级精神卫生服务机构的照护下，是什么使那些患有严重抑郁症和/或焦虑症的人能够并受其阻碍，并在沮丧，焦虑和孤独感方面取得进步。该计划包括与社区导航员的多达十次会议和三个可选的小组会议。课程结束后不久，与参与者（n = 19）进行了半结构化访谈。联合制作的两阶段定性方法，涉及叙述性和反思性主题分析，由研究工作组的成员进行，其中包括经验丰富的专家，临床医生和研究人员。叙事分析表明，个人有不同的目标，对结识其他人有不同的感觉，并且对进步有不同的定义。从主题分析中，确定了六个主题，这些主题解释了促进者和参与该计划所面临的挑战：渴望与他人联系；个人的社会信心；寻找有意义的事情；当地资源的可及性；计划的时间；以及参与者与社区导航器的关系。我们发现，在二级心理健康服务的支持下，患有严重抑郁和/或焦虑的人可能想解决孤独感，但发现这样做会在情感上很费力，也是个人面临的主要挑战。这种情感上的努力以不同的方式体现在个人身上，尽管参与者通过面对个人挑战才感受到了巨大的成就感，但它使参与者难以参与孤独项目。应该及早发现在个人，人际和结构层面上导致或阻碍个人参与的因素，以便人们能够从Community Navigator或其他类似程序中充分利用。