literature review synthesis table

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• Write a Literature Review
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• Evaluate This link opens in a new window

Get Organized

• Lit Review Prep Use this template to help you evaluate your sources, create article summaries for an annotated bibliography, and a synthesis matrix for your lit review outline.

Synthesize your Information

Synthesize: combine separate elements to form a whole.

Synthesis Matrix

A synthesis matrix helps you record the main points of each source and document how sources relate to each other.

After summarizing and evaluating your sources, arrange them in a matrix or use a citation manager to help you see how they relate to each other and apply to each of your themes or variables.  

By arranging your sources by theme or variable, you can see how your sources relate to each other, and can start thinking about how you weave them together to create a narrative.

• Step-by-Step Approach
• Example Matrix from NSCU
• Matrix Template
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• Last Updated: Jul 30, 2024 1:42 PM
• URL: https://guides.library.jhu.edu/lit-review

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How to Write a Literature Review

• 6. Synthesize
• Literature Reviews: A Recap
• Reading Journal Articles
• Does it Describe a Literature Review?
• 1. Identify the Question
• 2. Review Discipline Styles
• Searching Article Databases
• Finding Full-Text of an Article
• Citation Chaining
• When to Stop Searching
• 4. Manage Your References
• 5. Critically Analyze and Evaluate

Synthesis Visualization

Synthesis matrix example.

• 7. Write a Literature Review

• Synthesis Worksheet

About Synthesis

Approaches to Synthesis

You can sort the literature in various ways, for example:

How to Begin?

Read your sources carefully and find the main idea(s) of each source

Look for similarities in your sources – which sources are talking about the same main ideas? (for example, sources that discuss the historical background on your topic)

Use the worksheet (above) or synthesis matrix (below) to get organized

This work can be messy. Don't worry if you have to go through a few iterations of the worksheet or matrix as you work on your lit review!

Four Examples of Student Writing

In the four examples below, only ONE shows a good example of synthesis: the fourth column, or  Student D . For a web accessible version, click the link below the image.

Long description of "Four Examples of Student Writing" for web accessibility

• Download a copy of the "Four Examples of Student Writing" chart

Click on the example to view the pdf.

From Jennifer Lim

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• Volume 24, Issue 2
• Five tips for developing useful literature summary tables for writing review articles
• Article Text
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• http://orcid.org/0000-0003-0157-5319 Ahtisham Younas 1 , 2 ,
• http://orcid.org/0000-0002-7839-8130 Parveen Ali 3 , 4
• 1 Memorial University of Newfoundland , St John's , Newfoundland , Canada
• 2 Swat College of Nursing , Pakistan
• 3 School of Nursing and Midwifery , University of Sheffield , Sheffield , South Yorkshire , UK
• 4 Sheffield University Interpersonal Violence Research Group , Sheffield University , Sheffield , UK
• Correspondence to Ahtisham Younas, Memorial University of Newfoundland, St John's, NL A1C 5C4, Canada; ay6133{at}mun.ca

https://doi.org/10.1136/ebnurs-2021-103417

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Introduction

Literature reviews offer a critical synthesis of empirical and theoretical literature to assess the strength of evidence, develop guidelines for practice and policymaking, and identify areas for future research. 1 It is often essential and usually the first task in any research endeavour, particularly in masters or doctoral level education. For effective data extraction and rigorous synthesis in reviews, the use of literature summary tables is of utmost importance. A literature summary table provides a synopsis of an included article. It succinctly presents its purpose, methods, findings and other relevant information pertinent to the review. The aim of developing these literature summary tables is to provide the reader with the information at one glance. Since there are multiple types of reviews (eg, systematic, integrative, scoping, critical and mixed methods) with distinct purposes and techniques, 2 there could be various approaches for developing literature summary tables making it a complex task specialty for the novice researchers or reviewers. Here, we offer five tips for authors of the review articles, relevant to all types of reviews, for creating useful and relevant literature summary tables. We also provide examples from our published reviews to illustrate how useful literature summary tables can be developed and what sort of information should be provided.

Tip 1: provide detailed information about frameworks and methods

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Tabular literature summaries from a scoping review. Source: Rasheed et al . 3

The provision of information about conceptual and theoretical frameworks and methods is useful for several reasons. First, in quantitative (reviews synthesising the results of quantitative studies) and mixed reviews (reviews synthesising the results of both qualitative and quantitative studies to address a mixed review question), it allows the readers to assess the congruence of the core findings and methods with the adapted framework and tested assumptions. In qualitative reviews (reviews synthesising results of qualitative studies), this information is beneficial for readers to recognise the underlying philosophical and paradigmatic stance of the authors of the included articles. For example, imagine the authors of an article, included in a review, used phenomenological inquiry for their research. In that case, the review authors and the readers of the review need to know what kind of (transcendental or hermeneutic) philosophical stance guided the inquiry. Review authors should, therefore, include the philosophical stance in their literature summary for the particular article. Second, information about frameworks and methods enables review authors and readers to judge the quality of the research, which allows for discerning the strengths and limitations of the article. For example, if authors of an included article intended to develop a new scale and test its psychometric properties. To achieve this aim, they used a convenience sample of 150 participants and performed exploratory (EFA) and confirmatory factor analysis (CFA) on the same sample. Such an approach would indicate a flawed methodology because EFA and CFA should not be conducted on the same sample. The review authors must include this information in their summary table. Omitting this information from a summary could lead to the inclusion of a flawed article in the review, thereby jeopardising the review’s rigour.

Tip 2: include strengths and limitations for each article

Critical appraisal of individual articles included in a review is crucial for increasing the rigour of the review. Despite using various templates for critical appraisal, authors often do not provide detailed information about each reviewed article’s strengths and limitations. Merely noting the quality score based on standardised critical appraisal templates is not adequate because the readers should be able to identify the reasons for assigning a weak or moderate rating. Many recent critical appraisal checklists (eg, Mixed Methods Appraisal Tool) discourage review authors from assigning a quality score and recommend noting the main strengths and limitations of included studies. It is also vital that methodological and conceptual limitations and strengths of the articles included in the review are provided because not all review articles include empirical research papers. Rather some review synthesises the theoretical aspects of articles. Providing information about conceptual limitations is also important for readers to judge the quality of foundations of the research. For example, if you included a mixed-methods study in the review, reporting the methodological and conceptual limitations about ‘integration’ is critical for evaluating the study’s strength. Suppose the authors only collected qualitative and quantitative data and did not state the intent and timing of integration. In that case, the strength of the study is weak. Integration only occurred at the levels of data collection. However, integration may not have occurred at the analysis, interpretation and reporting levels.

Tip 3: write conceptual contribution of each reviewed article

While reading and evaluating review papers, we have observed that many review authors only provide core results of the article included in a review and do not explain the conceptual contribution offered by the included article. We refer to conceptual contribution as a description of how the article’s key results contribute towards the development of potential codes, themes or subthemes, or emerging patterns that are reported as the review findings. For example, the authors of a review article noted that one of the research articles included in their review demonstrated the usefulness of case studies and reflective logs as strategies for fostering compassion in nursing students. The conceptual contribution of this research article could be that experiential learning is one way to teach compassion to nursing students, as supported by case studies and reflective logs. This conceptual contribution of the article should be mentioned in the literature summary table. Delineating each reviewed article’s conceptual contribution is particularly beneficial in qualitative reviews, mixed-methods reviews, and critical reviews that often focus on developing models and describing or explaining various phenomena. Figure 2 offers an example of a literature summary table. 4

Tabular literature summaries from a critical review. Source: Younas and Maddigan. 4

Tip 4: compose potential themes from each article during summary writing

While developing literature summary tables, many authors use themes or subthemes reported in the given articles as the key results of their own review. Such an approach prevents the review authors from understanding the article’s conceptual contribution, developing rigorous synthesis and drawing reasonable interpretations of results from an individual article. Ultimately, it affects the generation of novel review findings. For example, one of the articles about women’s healthcare-seeking behaviours in developing countries reported a theme ‘social-cultural determinants of health as precursors of delays’. Instead of using this theme as one of the review findings, the reviewers should read and interpret beyond the given description in an article, compare and contrast themes, findings from one article with findings and themes from another article to find similarities and differences and to understand and explain bigger picture for their readers. Therefore, while developing literature summary tables, think twice before using the predeveloped themes. Including your themes in the summary tables (see figure 1 ) demonstrates to the readers that a robust method of data extraction and synthesis has been followed.

Tip 5: create your personalised template for literature summaries

Often templates are available for data extraction and development of literature summary tables. The available templates may be in the form of a table, chart or a structured framework that extracts some essential information about every article. The commonly used information may include authors, purpose, methods, key results and quality scores. While extracting all relevant information is important, such templates should be tailored to meet the needs of the individuals’ review. For example, for a review about the effectiveness of healthcare interventions, a literature summary table must include information about the intervention, its type, content timing, duration, setting, effectiveness, negative consequences, and receivers and implementers’ experiences of its usage. Similarly, literature summary tables for articles included in a meta-synthesis must include information about the participants’ characteristics, research context and conceptual contribution of each reviewed article so as to help the reader make an informed decision about the usefulness or lack of usefulness of the individual article in the review and the whole review.

In conclusion, narrative or systematic reviews are almost always conducted as a part of any educational project (thesis or dissertation) or academic or clinical research. Literature reviews are the foundation of research on a given topic. Robust and high-quality reviews play an instrumental role in guiding research, practice and policymaking. However, the quality of reviews is also contingent on rigorous data extraction and synthesis, which require developing literature summaries. We have outlined five tips that could enhance the quality of the data extraction and synthesis process by developing useful literature summaries.

• Aromataris E ,
• Rasheed SP ,

Twitter @Ahtisham04, @parveenazamali

Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Competing interests None declared.

Patient consent for publication Not required.

Provenance and peer review Not commissioned; externally peer reviewed.

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Literature Syntheis 101

How To Synthesise The Existing Research (With Examples)

By: Derek Jansen (MBA) | Expert Reviewer: Eunice Rautenbach (DTech) | August 2023

One of the most common mistakes that students make when writing a literature review is that they err on the side of describing the existing literature rather than providing a critical synthesis of it. In this post, we’ll unpack what exactly synthesis means and show you how to craft a strong literature synthesis using practical examples.

This post is based on our popular online course, Literature Review Bootcamp . In the course, we walk you through the full process of developing a literature review, step by step. If it’s your first time writing a literature review, you definitely want to use this link to get 50% off the course (limited-time offer).

Overview: Literature Synthesis

• What exactly does “synthesis” mean?
• Aspect 1: Agreement
• Aspect 2: Disagreement
• Aspect 3: Key theories
• Aspect 4: Contexts
• Aspect 5: Methodologies
• Bringing it all together

What does “synthesis” actually mean?

As a starting point, let’s quickly define what exactly we mean when we use the term “synthesis” within the context of a literature review.

Simply put, literature synthesis means going beyond just describing what everyone has said and found. Instead, synthesis is about bringing together all the information from various sources to present a cohesive assessment of the current state of knowledge in relation to your study’s research aims and questions .

Put another way, a good synthesis tells the reader exactly where the current research is “at” in terms of the topic you’re interested in – specifically, what’s known , what’s not , and where there’s a need for more research .

So, how do you go about doing this?

Well, there’s no “one right way” when it comes to literature synthesis, but we’ve found that it’s particularly useful to ask yourself five key questions when you’re working on your literature review. Having done so,  you can then address them more articulately within your actual write up. So, let’s take a look at each of these questions.

1. Points Of Agreement

The first question that you need to ask yourself is: “Overall, what things seem to be agreed upon by the vast majority of the literature?”

For example, if your research aim is to identify which factors contribute toward job satisfaction, you’ll need to identify which factors are broadly agreed upon and “settled” within the literature. Naturally, there may at times be some lone contrarian that has a radical viewpoint , but, provided that the vast majority of researchers are in agreement, you can put these random outliers to the side. That is, of course, unless your research aims to explore a contrarian viewpoint and there’s a clear justification for doing so. 

Identifying what’s broadly agreed upon is an essential starting point for synthesising the literature, because you generally don’t want (or need) to reinvent the wheel or run down a road investigating something that is already well established . So, addressing this question first lays a foundation of “settled” knowledge.

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2. Points Of Disagreement

Related to the previous point, but on the other end of the spectrum, is the equally important question: “Where do the disagreements lie?” .

In other words, which things are not well agreed upon by current researchers? It’s important to clarify here that by disagreement, we don’t mean that researchers are (necessarily) fighting over it – just that there are relatively mixed findings within the empirical research , with no firm consensus amongst researchers.

This is a really important question to address as these “disagreements” will often set the stage for the research gap(s). In other words, they provide clues regarding potential opportunities for further research, which your study can then (hopefully) contribute toward filling. If you’re not familiar with the concept of a research gap, be sure to check out our explainer video covering exactly that .

3. Key Theories

The next question you need to ask yourself is: “Which key theories seem to be coming up repeatedly?” .

Within most research spaces, you’ll find that you keep running into a handful of key theories that are referred to over and over again. Apart from identifying these theories, you’ll also need to think about how they’re connected to each other. Specifically, you need to ask yourself:

• Are they all covering the same ground or do they have different focal points  or underlying assumptions ?
• Do some of them feed into each other and if so, is there an opportunity to integrate them into a more cohesive theory?
• Do some of them pull in different directions ? If so, why might this be?
• Do all of the theories define the key concepts and variables in the same way, or is there some disconnect? If so, what’s the impact of this ?

Simply put, you’ll need to pay careful attention to the key theories in your research area, as they will need to feature within your theoretical framework , which will form a critical component within your final literature review. This will set the foundation for your entire study, so it’s essential that you be critical in this area of your literature synthesis.

If this sounds a bit fluffy, don’t worry. We deep dive into the theoretical framework (as well as the conceptual framework) and look at practical examples in Literature Review Bootcamp . If you’d like to learn more, take advantage of our limited-time offer to get 60% off the standard price.

4. Contexts

The next question that you need to address in your literature synthesis is an important one, and that is: “Which contexts have (and have not) been covered by the existing research?” .

For example, sticking with our earlier hypothetical topic (factors that impact job satisfaction), you may find that most of the research has focused on white-collar , management-level staff within a primarily Western context, but little has been done on blue-collar workers in an Eastern context. Given the significant socio-cultural differences between these two groups, this is an important observation, as it could present a contextual research gap .

In practical terms, this means that you’ll need to carefully assess the context of each piece of literature that you’re engaging with, especially the empirical research (i.e., studies that have collected and analysed real-world data). Ideally, you should keep notes regarding the context of each study in some sort of catalogue or sheet, so that you can easily make sense of this before you start the writing phase. If you’d like, our free literature catalogue worksheet is a great tool for this task.

5. Methodological Approaches

Last but certainly not least, you need to ask yourself the question: “What types of research methodologies have (and haven’t) been used?”

For example, you might find that most studies have approached the topic using qualitative methods such as interviews and thematic analysis. Alternatively, you might find that most studies have used quantitative methods such as online surveys and statistical analysis.

But why does this matter?

Well, it can run in one of two potential directions . If you find that the vast majority of studies use a specific methodological approach, this could provide you with a firm foundation on which to base your own study’s methodology . In other words, you can use the methodologies of similar studies to inform (and justify) your own study’s research design .

On the other hand, you might argue that the lack of diverse methodological approaches presents a research gap , and therefore your study could contribute toward filling that gap by taking a different approach. For example, taking a qualitative approach to a research area that is typically approached quantitatively. Of course, if you’re going to go against the methodological grain, you’ll need to provide a strong justification for why your proposed approach makes sense. Nevertheless, it is something worth at least considering.

Regardless of which route you opt for, you need to pay careful attention to the methodologies used in the relevant studies and provide at least some discussion about this in your write-up. Again, it’s useful to keep track of this on some sort of spreadsheet or catalogue as you digest each article, so consider grabbing a copy of our free literature catalogue if you don’t have anything in place.

Bringing It All Together

Alright, so we’ve looked at five important questions that you need to ask (and answer) to help you develop a strong synthesis within your literature review.  To recap, these are:

• Which things are broadly agreed upon within the current research?
• Which things are the subject of disagreement (or at least, present mixed findings)?
• Which theories seem to be central to your research topic and how do they relate or compare to each other?
• Which contexts have (and haven’t) been covered?
• Which methodological approaches are most common?

Importantly, you’re not just asking yourself these questions for the sake of asking them – they’re not just a reflection exercise. You need to weave your answers to them into your actual literature review when you write it up. How exactly you do this will vary from project to project depending on the structure you opt for, but you’ll still need to address them within your literature review, whichever route you go.

The best approach is to spend some time actually writing out your answers to these questions, as opposed to just thinking about them in your head. Putting your thoughts onto paper really helps you flesh out your thinking . As you do this, don’t just write down the answers – instead, think about what they mean in terms of the research gap you’ll present , as well as the methodological approach you’ll take . Your literature synthesis needs to lay the groundwork for these two things, so it’s essential that you link all of it together in your mind, and of course, on paper.

Psst… there’s more!

This post is an extract from our bestselling short course, Literature Review Bootcamp . If you want to work smart, you don't want to miss this .

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Literature Review Basics

• What is a Literature Review?
• Synthesizing Research
• Using Research & Synthesis Tables
• Additional Resources

Synthesis: What is it?

First, let's be perfectly clear about what synthesizing your research isn't :

• - It isn't  just summarizing the material you read
• - It isn't  generating a collection of annotations or comments (like an annotated bibliography)
• - It isn't  compiling a report on every single thing ever written in relation to your topic

When you  synthesize  your research, your job is to help your reader understand the current state of the conversation on your topic, relative to your research question.  That may include doing the following:

• - Selecting and using representative work on the topic
• - Identifying and discussing trends in published data or results
• - Identifying and explaining the impact of common features (study populations, interventions, etc.) that appear frequently in the literature
• - Explaining controversies, disputes, or central issues in the literature that are relevant to your research question
• - Identifying gaps in the literature, where more research is needed
• - Establishing the discussion to which your own research contributes and demonstrating the value of your contribution

Essentially, you're telling your reader where they are (and where you are) in the scholarly conversation about your project.

Synthesis: How do I do it?

Synthesis, step by step.

This is what you need to do  before  you write your review.

• Identify and clearly describe your research question (you may find the Formulating PICOT Questions table at  the Additional Resources tab helpful).
• Collect sources relevant to your research question.
• Organize and describe the sources you've found -- your job is to identify what  types  of sources you've collected (reviews, clinical trials, etc.), identify their  purpose  (what are they measuring, testing, or trying to discover?), determine the  level of evidence  they represent (see the Levels of Evidence table at the Additional Resources tab ), and briefly explain their  major findings . Use a Research Table to document this step.
• Study the information you've put in your Research Table and examine your collected sources, looking for  similarities  and  differences . Pay particular attention to  populations ,   methods  (especially relative to levels of evidence), and  findings .
• Analyze what you learn in (4) using a tool like a Synthesis Table. Your goal is to identify relevant themes, trends, gaps, and issues in the research.  Your literature review will collect the results of this analysis and explain them in relation to your research question.

Analysis tips

• - Sometimes, what you  don't  find in the literature is as important as what you do find -- look for questions that the existing research hasn't answered yet.
• - If any of the sources you've collected refer to or respond to each other, keep an eye on how they're related -- it may provide a clue as to whether or not study results have been successfully replicated.
• - Sorting your collected sources by level of evidence can provide valuable insight into how a particular topic has been covered, and it may help you to identify gaps worth addressing in your own work.
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• Next: Using Research & Synthesis Tables >>
• Last Updated: Sep 26, 2023 12:06 PM
• URL: https://usi.libguides.com/literature-review-basics

• Research Guides

Literature Review: A Self-Guided Tutorial

Using a synthesis matrix.

• Literature Reviews: A Recap
• Peer Review
• Reading the Literature
• Using Concept Maps
• Developing Research Questions
• Considering Strong Opinions
• 2. Review discipline styles
• Super Searching
• Finding the Full Text
• Citation Searching This link opens in a new window
• When to stop searching
• Citation Management
• Annotating Articles Tip
• 5. Critically analyze and evaluate
• How to Review the Literature
• 7. Write literature review

A synthesis matrix visually represents your research by organizing your sources by themes:

• Sample Synthesis Matrix Example provided by Ashford University Writing Center .
• << Previous: How to Review the Literature
• Next: 7. Write literature review >>
• Last Updated: Jul 30, 2024 4:12 PM
• URL: https://libguides.williams.edu/literature-review

Literature Review: A Self-Guided Tutorial for NUR 288

• Literature Reviews: A Recap
• Peer-Review
• Reading the Literature
• Developing Research Questions
• 2. Review discipline styles
• Super Searching
• Finding the Full Text
• Citation Searching
• Evaluating online information
• When to stop searching
• How to cite your sources following APA
• In-Text Citations
• Keeping track of your references
• Annotating Articles Tip
• 5. Critically analyze and evaluate
• How to review the literature

Using a synthesis matrix

• 7. Write literature review

Synthesize : combine separate elements to form a whole.

Why use a synthesis matrix? 

• A synthesis matrix helps you record the main points of each source and document how sources relate to each other.
• After summarizing and evaluating your sources, arrange them in a matrix or use a citation manager to help you see how they relate to each other and apply to each of your themes or variables.  
• By arranging your sources by theme or variable, you can see how your sources relate to each other, and can start thinking about how you weave them together to create a narrative.

A synthesis matrix visually represents your research by organizing your sources by themes:

Add each article citation to the Source column and begin to identify the theme(s) from the article. 

Use the Excel template below to help you evaluate your sources, create article summaries for an annotated bibliography, and a synthesis matrix for your lit review outline. From John Hopkins Sheridan Libraries.  

NOTE : There are several tabs at the bottom of the Excel spreadsheet to help guide you with this method.

• Literature Review Prep - with Synthesis Matrix
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• Last Updated: Aug 24, 2024 2:45 PM
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Nursing and Allied Health: Building a Summary Table or Synthesis Matrix

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Building a Summary Table or Synthesis Matrix

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What a Summary Table or Synthesis Matrix looks like

Use the "Literature Review Matrix Template" as a guideline to help you sort through your thoughts, note important points and think through the similarities and differences: 

You are organizing the review by ideas and not by sources .  The literature review is not just a summary of the already published works.  Your synthesis should show how various articles are linked. 

A summary table is also called a synthesis matrix.  The table helps you organize and compare information for your systematic review, scholarly report, dissertation or thesis

Synthesis Matrix.

A summary table is also called a synthesis matrix . A summary table helps you record the main points of each source and document how sources relate to each other. After summarizing and evaluating your sources, arrange them in a matrix to help you see how they relate to each other, and apply to each of your themes or variables.

Faculty who typically guide students find it challenging to help students learn how to synthesize material (Blondy, Blakesless, Scheffer, Rubenfeld, Cronin, & Luster-Turner, 2016; Kearney, 2015) .  Writers  can easily summarize material but seem to struggle to adequately synthesize knowledge about their topic and express that in their writing. So, whether you are writing a student papers, dissertations, or scholarly report it is necessary to learn a few tips and tricks to organize your ideas.

Building a summary table and developing solid synthesis skills is important for nurses, nurse practitioners, and allied health researchers.  Quality evidence-based practice initiatives and nursing care and medicine are based on understanding and evaluating the resources and research available, identifying gaps, and building a strong foundation for future work.

Good synthesis is about putting the data gathered, references read, and literature analyzed together in a new way that shows connections and relationships. ( Shellenbarger, 2016 ). The Merriam-Webster dictionary defines synthesis as something that is made by combining different things or the composition or combination of parts or elements so as to form a whole (Synthesis, n.d.).  

In other words, building a summary table or synthesis matrix  involves taking information from a variety of sources, evaluating that information and forming new ideas or insights in an original way.  This can be a new and potentially challenging experience for students and researchers who are used to just repeating what is already in the literature.

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Literature Reviews

• 5. Synthesize your findings
• Getting started
• Types of reviews
• 1. Define your research question
• 2. Plan your search
• 3. Search the literature
• 4. Organize your results

How to synthesize

Approaches to synthesis.

• 6. Write the review
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In the synthesis step of a literature review, researchers analyze and integrate information from selected sources to identify patterns and themes. This involves critically evaluating findings, recognizing commonalities, and constructing a cohesive narrative that contributes to the understanding of the research topic.

Here are some examples of how to approach synthesizing the literature:

💡 By themes or concepts

🕘 Historically or chronologically

📊 By methodology

These organizational approaches can also be used when writing your review. It can be beneficial to begin organizing your references by these approaches in your citation manager by using folders, groups, or collections.

Create a synthesis matrix

A synthesis matrix allows you to visually organize your literature.

Topic: ______________________________________________

Topic: Chemical exposure to workers in nail salons

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Literature Reviews

• Introduction
• Tutorials and resources
• Step 1: Literature search
• Step 2: Analysis, synthesis, critique
• Step 3: Writing the review

If you need any assistance, please contact the library staff at the Georgia Tech Library Help website . 

Analysis, synthesis, critique

Literature reviews build a story. You are telling the story about what you are researching. Therefore, a literature review is a handy way to show that you know what you are talking about. To do this, here are a few important skills you will need.

Skill #1: Analysis

Analysis means that you have carefully read a wide range of the literature on your topic and have understood the main themes, and identified how the literature relates to your own topic. Carefully read and analyze the articles you find in your search, and take notes. Notice the main point of the article, the methodologies used, what conclusions are reached, and what the main themes are. Most bibliographic management tools have capability to keep notes on each article you find, tag them with keywords, and organize into groups.

Skill #2: Synthesis

After you’ve read the literature, you will start to see some themes and categories emerge, some research trends to emerge, to see where scholars agree or disagree, and how works in your chosen field or discipline are related. One way to keep track of this is by using a Synthesis Matrix .

Skill #3: Critique

As you are writing your literature review, you will want to apply a critical eye to the literature you have evaluated and synthesized. Consider the strong arguments you will make contrasted with the potential gaps in previous research. The words that you choose to report your critiques of the literature will be non-neutral. For instance, using a word like “attempted” suggests that a researcher tried something but was not successful. For example: 

There were some attempts by Smith (2012) and Jones (2013) to integrate a new methodology in this process.

On the other hand, using a word like “proved” or a phrase like “produced results” evokes a more positive argument. For example:

The new methodologies employed by Blake (2014) produced results that provided further evidence of X.

In your critique, you can point out where you believe there is room for more coverage in a topic, or further exploration in in a sub-topic.

Need more help?

If you are looking for more detailed guidance about writing your dissertation, please contact the folks in the Georgia Tech Communication Center .

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Systematic Literature Reviews: Steps & Resources

Literature review & systematic review steps.

• What are Literature Reviews?
• Conducting & Reporting Systematic Reviews
• Finding Systematic Reviews
• Tutorials & Tools for Literature Reviews

What are Systematic Reviews? (3 minutes, 24 second YouTube Video)

These steps for conducting a systematic literature review are listed below . 

Also see subpages for more information about:

• The different types of literature reviews, including systematic reviews and other evidence synthesis methods
• Tools & Tutorials
• Develop a Focused Question
• Scope the Literature  (Initial Search)
• Refine & Expand the Search
• Limit the Results
• Download Citations
• Abstract & Analyze
• Create Flow Diagram
• Synthesize & Report Results

1. Develop a Focused   Question 

Consider the PICO Format: Population/Problem, Intervention, Comparison, Outcome

Focus on defining the Population or Problem and Intervention (don't narrow by Comparison or Outcome just yet!)

"What are the effects of the Pilates method for patients with low back pain?"

Tools & Additional Resources:

• PICO Question Help
• Stillwell, Susan B., DNP, RN, CNE; Fineout-Overholt, Ellen, PhD, RN, FNAP, FAAN; Melnyk, Bernadette Mazurek, PhD, RN, CPNP/PMHNP, FNAP, FAAN; Williamson, Kathleen M., PhD, RN Evidence-Based Practice, Step by Step: Asking the Clinical Question, AJN The American Journal of Nursing : March 2010 - Volume 110 - Issue 3 - p 58-61 doi: 10.1097/01.NAJ.0000368959.11129.79

2. Scope the Literature

A "scoping search" investigates the breadth and/or depth of the initial question or may identify a gap in the literature. 

Eligible studies may be located by searching in:

• Background sources (books, point-of-care tools)
• Article databases
• Trial registries
• Grey literature
• Cited references
• Reference lists

When searching, if possible, translate terms to controlled vocabulary of the database. Use text word searching when necessary.

Use Boolean operators to connect search terms:

• Combine separate concepts with AND  (resulting in a narrower search)
• Connecting synonyms with OR  (resulting in an expanded search)

Search:  pilates AND ("low back pain"  OR  backache )

Video Tutorials - Translating PICO Questions into Search Queries

• Translate Your PICO Into a Search in PubMed (YouTube, Carrie Price, 5:11) 
• Translate Your PICO Into a Search in CINAHL (YouTube, Carrie Price, 4:56)

3. Refine & Expand Your Search

Expand your search strategy with synonymous search terms harvested from:

• database thesauri
• reference lists
• relevant studies

Example: 

(pilates OR exercise movement techniques) AND ("low back pain" OR backache* OR sciatica OR lumbago OR spondylosis)

As you develop a final, reproducible strategy for each database, save your strategies in a:

• a personal database account (e.g., MyNCBI for PubMed)
• Log in with your NYU credentials
• Open and "Make a Copy" to create your own tracker for your literature search strategies

4. Limit Your Results

Use database filters to limit your results based on your defined inclusion/exclusion criteria.  In addition to relying on the databases' categorical filters, you may also need to manually screen results.  

• Limit to Article type, e.g.,:  "randomized controlled trial" OR multicenter study
• Limit by publication years, age groups, language, etc.

NOTE: Many databases allow you to filter to "Full Text Only".  This filter is  not recommended . It excludes articles if their full text is not available in that particular database (CINAHL, PubMed, etc), but if the article is relevant, it is important that you are able to read its title and abstract, regardless of 'full text' status. The full text is likely to be accessible through another source (a different database, or Interlibrary Loan).  

• Filters in PubMed
• CINAHL Advanced Searching Tutorial

5. Download Citations

Selected citations and/or entire sets of search results can be downloaded from the database into a citation management tool. If you are conducting a systematic review that will require reporting according to PRISMA standards, a citation manager can help you keep track of the number of articles that came from each database, as well as the number of duplicate records.

In Zotero, you can create a Collection for the combined results set, and sub-collections for the results from each database you search.  You can then use Zotero's 'Duplicate Items" function to find and merge duplicate records.

• Citation Managers - General Guide

6. Abstract and Analyze

• Migrate citations to data collection/extraction tool
• Screen Title/Abstracts for inclusion/exclusion
• Screen and appraise full text for relevance, methods, 
• Resolve disagreements by consensus

Covidence is a web-based tool that enables you to work with a team to screen titles/abstracts and full text for inclusion in your review, as well as extract data from the included studies.

• Covidence Support
• Critical Appraisal Tools
• Data Extraction Tools

7. Create Flow Diagram

The PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) flow diagram is a visual representation of the flow of records through different phases of a systematic review.  It depicts the number of records identified, included and excluded.  It is best used in conjunction with the PRISMA checklist .

Example from: Stotz, S. A., McNealy, K., Begay, R. L., DeSanto, K., Manson, S. M., & Moore, K. R. (2021). Multi-level diabetes prevention and treatment interventions for Native people in the USA and Canada: A scoping review. Current Diabetes Reports, 2 (11), 46. https://doi.org/10.1007/s11892-021-01414-3

• PRISMA Flow Diagram Generator (ShinyApp.io, Haddaway et al. )
• PRISMA Diagram Templates  (Word and PDF)
• Make a copy of the file to fill out the template
• Image can be downloaded as PDF, PNG, JPG, or SVG
• Covidence generates a PRISMA diagram that is automatically updated as records move through the review phases

8. Synthesize & Report Results

There are a number of reporting guideline available to guide the synthesis and reporting of results in systematic literature reviews.

It is common to organize findings in a matrix, also known as a Table of Evidence (ToE).

• Reporting Guidelines for Systematic Reviews
• Download a sample template of a health sciences review matrix  (GoogleSheets)

Steps modified from: 

Cook, D. A., & West, C. P. (2012). Conducting systematic reviews in medical education: a stepwise approach.   Medical Education , 46 (10), 943–952.

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Nursing Literature Reviews

• Literature and Other Types of Reviews
• Starting Your Search
• Developing a Research Question and the Literature Search Process
• Conducting a Literature Search
• Levels of Evidence
• Creating a PRISMA Table
• Literature Table and Synthesis
• Other Resources

About Literature Tables and Writing a Synthesis

A literature table is a way to organize the articles you've selected for inclusion in your publication. There are many different types of literature tables-the main thing is to determine the important pieces that help draw out the comparisons and contrasts between the articles included in your review. The first few columns should include the basic info about the article (title, authors, journal), publication year, and the purpose of the paper.

While the table is a step to help you organize the articles you've selected for your research, the literature synthesis can take many forms and can have multiple parts. This largely depends on what type of review you've undertaken. Look back at the examples under Literature and Other Types of Reviews to see examples of different types of reviews.

• Example of Literature Table

Examples of Literature Tables

Camak, D.J. (2015), Addressing the burden of stroke caregivers: a literature review. J Clin Nurs, 24: 2376-2382. doi: 10.1111/jocn.12884

Balcombe, L., Miller, C., & McGuiness, W. (2017). Approaches to the application and removal of compression therapy: A literature review. British Journal of Community Nursing , 22 , S6–S14. https://doi-org.proxy1.cl.msu.edu/10.12968/bjcn.2017.22.Sup10.S6

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Chapter 7: Synthesizing Sources

Learning objectives.

At the conclusion of this chapter, you will be able to:

• synthesize key sources connecting them with the research question and topic area.

7.1 Overview of synthesizing

7.1.1 putting the pieces together.

Combining separate elements into a whole is the dictionary definition of synthesis.  It is a way to make connections among and between numerous and varied source materials.  A literature review is not an annotated bibliography, organized by title, author, or date of publication.  Rather, it is grouped by topic to create a whole view of the literature relevant to your research question.

Your synthesis must demonstrate a critical analysis of the papers you collected as well as your ability to integrate the results of your analysis into your own literature review.  Each paper collected should be critically evaluated and weighed for “adequacy, appropriateness, and thoroughness” ( Garrard, 2017 ) before inclusion in your own review.  Papers that do not meet this criteria likely should not be included in your literature review.

Begin the synthesis process by creating a grid, table, or an outline where you will summarize, using common themes you have identified and the sources you have found. The summary grid or outline will help you compare and contrast the themes so you can see the relationships among them as well as areas where you may need to do more searching. Whichever method you choose, this type of organization will help you to both understand the information you find and structure the writing of your review.  Remember, although “the means of summarizing can vary, the key at this point is to make sure you understand what you’ve found and how it relates to your topic and research question” ( Bennard et al., 2014 ).

As you read through the material you gather, look for common themes as they may provide the structure for your literature review.  And, remember, research is an iterative process: it is not unusual to go back and search information sources for more material.

At one extreme, if you are claiming, ‘There are no prior publications on this topic,’ it is more likely that you have not found them yet and may need to broaden your search.  At another extreme, writing a complete literature review can be difficult with a well-trod topic.  Do not cite it all; instead cite what is most relevant.  If that still leaves too much to include, be sure to reference influential sources…as well as high-quality work that clearly connects to the points you make. ( Klingner, Scanlon, & Pressley, 2005 ).

7.2 Creating a summary table

Literature reviews can be organized sequentially or by topic, theme, method, results, theory, or argument.  It’s important to develop categories that are meaningful and relevant to your research question.  Take detailed notes on each article and use a consistent format for capturing all the information each article provides.  These notes and the summary table can be done manually, using note cards.  However, given the amount of information you will be recording, an electronic file created in a word processing or spreadsheet is more manageable. Examples of fields you may want to capture in your notes include:

• Authors’ names
• Article title
• Publication year
• Main purpose of the article
• Methodology or research design
• Participants
• Measurement
• Conclusions

  Other fields that will be useful when you begin to synthesize the sum total of your research:

• Specific details of the article or research that are especially relevant to your study
• Key terms and definitions
• Strengths or weaknesses in research design
• Relationships to other studies
• Possible gaps in the research or literature (for example, many research articles conclude with the statement “more research is needed in this area”)
• Finally, note how closely each article relates to your topic.  You may want to rank these as high, medium, or low relevance.  For papers that you decide not to include, you may want to note your reasoning for exclusion, such as ‘small sample size’, ‘local case study,’ or ‘lacks evidence to support assertion.’

This short video demonstrates how a nursing researcher might create a summary table.

7.2.1 Creating a Summary Table

  Summary tables can be organized by author or by theme, for example:

For a summary table template, see http://blogs.monm.edu/writingatmc/files/2013/04/Synthesis-Matrix-Template.pdf

7.3 Creating a summary outline

An alternate way to organize your articles for synthesis it to create an outline. After you have collected the articles you intend to use (and have put aside the ones you won’t be using), it’s time to identify the conclusions that can be drawn from the articles as a group.

  Based on your review of the collected articles, group them by categories.  You may wish to further organize them by topic and then chronologically or alphabetically by author.  For each topic or subtopic you identified during your critical analysis of the paper, determine what those papers have in common.  Likewise, determine which ones in the group differ.  If there are contradictory findings, you may be able to identify methodological or theoretical differences that could account for the contradiction (for example, differences in population demographics).  Determine what general conclusions you can report about the topic or subtopic as the entire group of studies relate to it.  For example, you may have several studies that agree on outcome, such as ‘hands on learning is best for science in elementary school’ or that ‘continuing education is the best method for updating nursing certification.’ In that case, you may want to organize by methodology used in the studies rather than by outcome.

Organize your outline in a logical order and prepare to write the first draft of your literature review.  That order might be from broad to more specific, or it may be sequential or chronological, going from foundational literature to more current.  Remember, “an effective literature review need not denote the entire historical record, but rather establish the raison d’etre for the current study and in doing so cite that literature distinctly pertinent for theoretical, methodological, or empirical reasons.” ( Milardo, 2015, p. 22 ).

As you organize the summarized documents into a logical structure, you are also appraising and synthesizing complex information from multiple sources.  Your literature review is the result of your research that synthesizes new and old information and creates new knowledge.

7.4 Additional resources:

Literature Reviews: Using a Matrix to Organize Research / Saint Mary’s University of Minnesota

Literature Review: Synthesizing Multiple Sources / Indiana University

Writing a Literature Review and Using a Synthesis Matrix / Florida International University

 Sample Literature Reviews Grid / Complied by Lindsay Roberts

Select three or four articles on a single topic of interest to you. Then enter them into an outline or table in the categories you feel are important to a research question. Try both the grid and the outline if you can to see which suits you better. The attached grid contains the fields suggested in the video .

Literature Review Table  

Test Yourself

• Select two articles from your own summary table or outline and write a paragraph explaining how and why the sources relate to each other and your review of the literature.
• In your literature review, under what topic or subtopic will you place the paragraph you just wrote?

Image attribution

Literature Reviews for Education and Nursing Graduate Students Copyright © by Linda Frederiksen is licensed under a Creative Commons Attribution 4.0 International License , except where otherwise noted.

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Methodology

• How to Write a Literature Review | Guide, Examples, & Templates

How to Write a Literature Review | Guide, Examples, & Templates

Published on January 2, 2023 by Shona McCombes . Revised on September 11, 2023.

What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research that you can later apply to your paper, thesis, or dissertation topic .

There are five key steps to writing a literature review:

• Search for relevant literature
• Evaluate sources
• Identify themes, debates, and gaps
• Outline the structure
• Write your literature review

A good literature review doesn’t just summarize sources—it analyzes, synthesizes , and critically evaluates to give a clear picture of the state of knowledge on the subject.

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Table of contents

What is the purpose of a literature review, examples of literature reviews, step 1 – search for relevant literature, step 2 – evaluate and select sources, step 3 – identify themes, debates, and gaps, step 4 – outline your literature review’s structure, step 5 – write your literature review, free lecture slides, other interesting articles, frequently asked questions, introduction.

• Quick Run-through
• Step 1 & 2

When you write a thesis , dissertation , or research paper , you will likely have to conduct a literature review to situate your research within existing knowledge. The literature review gives you a chance to:

• Demonstrate your familiarity with the topic and its scholarly context
• Develop a theoretical framework and methodology for your research
• Position your work in relation to other researchers and theorists
• Show how your research addresses a gap or contributes to a debate
• Evaluate the current state of research and demonstrate your knowledge of the scholarly debates around your topic.

Writing literature reviews is a particularly important skill if you want to apply for graduate school or pursue a career in research. We’ve written a step-by-step guide that you can follow below.

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See an example

Writing literature reviews can be quite challenging! A good starting point could be to look at some examples, depending on what kind of literature review you’d like to write.

• Example literature review #1: “Why Do People Migrate? A Review of the Theoretical Literature” ( Theoretical literature review about the development of economic migration theory from the 1950s to today.)
• Example literature review #2: “Literature review as a research methodology: An overview and guidelines” ( Methodological literature review about interdisciplinary knowledge acquisition and production.)
• Example literature review #3: “The Use of Technology in English Language Learning: A Literature Review” ( Thematic literature review about the effects of technology on language acquisition.)
• Example literature review #4: “Learners’ Listening Comprehension Difficulties in English Language Learning: A Literature Review” ( Chronological literature review about how the concept of listening skills has changed over time.)

You can also check out our templates with literature review examples and sample outlines at the links below.

Download Word doc Download Google doc

Before you begin searching for literature, you need a clearly defined topic .

If you are writing the literature review section of a dissertation or research paper, you will search for literature related to your research problem and questions .

Make a list of keywords

Start by creating a list of keywords related to your research question. Include each of the key concepts or variables you’re interested in, and list any synonyms and related terms. You can add to this list as you discover new keywords in the process of your literature search.

• Social media, Facebook, Instagram, Twitter, Snapchat, TikTok
• Body image, self-perception, self-esteem, mental health
• Generation Z, teenagers, adolescents, youth

Search for relevant sources

Use your keywords to begin searching for sources. Some useful databases to search for journals and articles include:

• Your university’s library catalogue
• Google Scholar
• Project Muse (humanities and social sciences)
• Medline (life sciences and biomedicine)
• EconLit (economics)
• Inspec (physics, engineering and computer science)

You can also use boolean operators to help narrow down your search.

Make sure to read the abstract to find out whether an article is relevant to your question. When you find a useful book or article, you can check the bibliography to find other relevant sources.

You likely won’t be able to read absolutely everything that has been written on your topic, so it will be necessary to evaluate which sources are most relevant to your research question.

For each publication, ask yourself:

• What question or problem is the author addressing?
• What are the key concepts and how are they defined?
• What are the key theories, models, and methods?
• Does the research use established frameworks or take an innovative approach?
• What are the results and conclusions of the study?
• How does the publication relate to other literature in the field? Does it confirm, add to, or challenge established knowledge?
• What are the strengths and weaknesses of the research?

Make sure the sources you use are credible , and make sure you read any landmark studies and major theories in your field of research.

You can use our template to summarize and evaluate sources you’re thinking about using. Click on either button below to download.

Take notes and cite your sources

As you read, you should also begin the writing process. Take notes that you can later incorporate into the text of your literature review.

It is important to keep track of your sources with citations to avoid plagiarism . It can be helpful to make an annotated bibliography , where you compile full citation information and write a paragraph of summary and analysis for each source. This helps you remember what you read and saves time later in the process.

To begin organizing your literature review’s argument and structure, be sure you understand the connections and relationships between the sources you’ve read. Based on your reading and notes, you can look for:

• Trends and patterns (in theory, method or results): do certain approaches become more or less popular over time?
• Themes: what questions or concepts recur across the literature?
• Debates, conflicts and contradictions: where do sources disagree?
• Pivotal publications: are there any influential theories or studies that changed the direction of the field?
• Gaps: what is missing from the literature? Are there weaknesses that need to be addressed?

This step will help you work out the structure of your literature review and (if applicable) show how your own research will contribute to existing knowledge.

• Most research has focused on young women.
• There is an increasing interest in the visual aspects of social media.
• But there is still a lack of robust research on highly visual platforms like Instagram and Snapchat—this is a gap that you could address in your own research.

There are various approaches to organizing the body of a literature review. Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).

Chronological

The simplest approach is to trace the development of the topic over time. However, if you choose this strategy, be careful to avoid simply listing and summarizing sources in order.

Try to analyze patterns, turning points and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred.

If you have found some recurring central themes, you can organize your literature review into subsections that address different aspects of the topic.

For example, if you are reviewing literature about inequalities in migrant health outcomes, key themes might include healthcare policy, language barriers, cultural attitudes, legal status, and economic access.

Methodological

If you draw your sources from different disciplines or fields that use a variety of research methods , you might want to compare the results and conclusions that emerge from different approaches. For example:

• Look at what results have emerged in qualitative versus quantitative research
• Discuss how the topic has been approached by empirical versus theoretical scholarship
• Divide the literature into sociological, historical, and cultural sources

Theoretical

A literature review is often the foundation for a theoretical framework . You can use it to discuss various theories, models, and definitions of key concepts.

You might argue for the relevance of a specific theoretical approach, or combine various theoretical concepts to create a framework for your research.

Like any other academic text , your literature review should have an introduction , a main body, and a conclusion . What you include in each depends on the objective of your literature review.

The introduction should clearly establish the focus and purpose of the literature review.

Depending on the length of your literature review, you might want to divide the body into subsections. You can use a subheading for each theme, time period, or methodological approach.

As you write, you can follow these tips:

• Summarize and synthesize: give an overview of the main points of each source and combine them into a coherent whole
• Analyze and interpret: don’t just paraphrase other researchers — add your own interpretations where possible, discussing the significance of findings in relation to the literature as a whole
• Critically evaluate: mention the strengths and weaknesses of your sources
• Write in well-structured paragraphs: use transition words and topic sentences to draw connections, comparisons and contrasts

In the conclusion, you should summarize the key findings you have taken from the literature and emphasize their significance.

When you’ve finished writing and revising your literature review, don’t forget to proofread thoroughly before submitting. Not a language expert? Check out Scribbr’s professional proofreading services !

This article has been adapted into lecture slides that you can use to teach your students about writing a literature review.

Scribbr slides are free to use, customize, and distribute for educational purposes.

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If you want to know more about the research process , methodology , research bias , or statistics , make sure to check out some of our other articles with explanations and examples.

• Sampling methods
• Simple random sampling
• Stratified sampling
• Cluster sampling
• Likert scales
• Reproducibility

 Statistics

• Null hypothesis
• Statistical power
• Probability distribution
• Effect size
• Poisson distribution

Research bias

• Optimism bias
• Cognitive bias
• Implicit bias
• Hawthorne effect
• Anchoring bias
• Explicit bias

A literature review is a survey of scholarly sources (such as books, journal articles, and theses) related to a specific topic or research question .

It is often written as part of a thesis, dissertation , or research paper , in order to situate your work in relation to existing knowledge.

There are several reasons to conduct a literature review at the beginning of a research project:

• To familiarize yourself with the current state of knowledge on your topic
• To ensure that you’re not just repeating what others have already done
• To identify gaps in knowledge and unresolved problems that your research can address
• To develop your theoretical framework and methodology
• To provide an overview of the key findings and debates on the topic

Writing the literature review shows your reader how your work relates to existing research and what new insights it will contribute.

The literature review usually comes near the beginning of your thesis or dissertation . After the introduction , it grounds your research in a scholarly field and leads directly to your theoretical framework or methodology .

A literature review is a survey of credible sources on a topic, often used in dissertations , theses, and research papers . Literature reviews give an overview of knowledge on a subject, helping you identify relevant theories and methods, as well as gaps in existing research. Literature reviews are set up similarly to other  academic texts , with an introduction , a main body, and a conclusion .

An  annotated bibliography is a list of  source references that has a short description (called an annotation ) for each of the sources. It is often assigned as part of the research process for a  paper .  

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Common Assignments: Literature Review Matrix

Literature review matrix.

As you read and evaluate your literature there are several different ways to organize your research. Courtesy of Dr. Gary Burkholder in the School of Psychology, these sample matrices are one option to help organize your articles. These documents allow you to compile details about your sources, such as the foundational theories, methodologies, and conclusions; begin to note similarities among the authors; and retrieve citation information for easy insertion within a document.

You can review the sample matrixes to see a completed form or download the blank matrix for your own use.

• Literature Review Matrix 1 This PDF file provides a sample literature review matrix.
• Literature Review Matrix 2 This PDF file provides a sample literature review matrix.
• Literature Review Matrix Template (Word)
• Literature Review Matrix Template (Excel)

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How to Synthesize Written Information from Multiple Sources

Shona McCombes

Content Manager

B.A., English Literature, University of Glasgow

Shona McCombes is the content manager at Scribbr, Netherlands.

Learn about our Editorial Process

Saul McLeod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

On This Page:

When you write a literature review or essay, you have to go beyond just summarizing the articles you’ve read – you need to synthesize the literature to show how it all fits together (and how your own research fits in).

Synthesizing simply means combining. Instead of summarizing the main points of each source in turn, you put together the ideas and findings of multiple sources in order to make an overall point.

At the most basic level, this involves looking for similarities and differences between your sources. Your synthesis should show the reader where the sources overlap and where they diverge.

Unsynthesized Example

Franz (2008) studied undergraduate online students. He looked at 17 females and 18 males and found that none of them liked APA. According to Franz, the evidence suggested that all students are reluctant to learn citations style. Perez (2010) also studies undergraduate students. She looked at 42 females and 50 males and found that males were significantly more inclined to use citation software ( p < .05). Findings suggest that females might graduate sooner. Goldstein (2012) looked at British undergraduates. Among a sample of 50, all females, all confident in their abilities to cite and were eager to write their dissertations.

Synthesized Example

Studies of undergraduate students reveal conflicting conclusions regarding relationships between advanced scholarly study and citation efficacy. Although Franz (2008) found that no participants enjoyed learning citation style, Goldstein (2012) determined in a larger study that all participants watched felt comfortable citing sources, suggesting that variables among participant and control group populations must be examined more closely. Although Perez (2010) expanded on Franz’s original study with a larger, more diverse sample…

Step 1: Organize your sources

After collecting the relevant literature, you’ve got a lot of information to work through, and no clear idea of how it all fits together.

Before you can start writing, you need to organize your notes in a way that allows you to see the relationships between sources.

One way to begin synthesizing the literature is to put your notes into a table. Depending on your topic and the type of literature you’re dealing with, there are a couple of different ways you can organize this.

Summary table

A summary table collates the key points of each source under consistent headings. This is a good approach if your sources tend to have a similar structure – for instance, if they’re all empirical papers.

Each row in the table lists one source, and each column identifies a specific part of the source. You can decide which headings to include based on what’s most relevant to the literature you’re dealing with.

For example, you might include columns for things like aims, methods, variables, population, sample size, and conclusion.

For each study, you briefly summarize each of these aspects. You can also include columns for your own evaluation and analysis.

The summary table gives you a quick overview of the key points of each source. This allows you to group sources by relevant similarities, as well as noticing important differences or contradictions in their findings.

Synthesis matrix

A synthesis matrix is useful when your sources are more varied in their purpose and structure – for example, when you’re dealing with books and essays making various different arguments about a topic.

Each column in the table lists one source. Each row is labeled with a specific concept, topic or theme that recurs across all or most of the sources.

Then, for each source, you summarize the main points or arguments related to the theme.

The purposes of the table is to identify the common points that connect the sources, as well as identifying points where they diverge or disagree.

Step 2: Outline your structure

Now you should have a clear overview of the main connections and differences between the sources you’ve read. Next, you need to decide how you’ll group them together and the order in which you’ll discuss them.

For shorter papers, your outline can just identify the focus of each paragraph; for longer papers, you might want to divide it into sections with headings.

There are a few different approaches you can take to help you structure your synthesis.

If your sources cover a broad time period, and you found patterns in how researchers approached the topic over time, you can organize your discussion chronologically .

That doesn’t mean you just summarize each paper in chronological order; instead, you should group articles into time periods and identify what they have in common, as well as signalling important turning points or developments in the literature.

If the literature covers various different topics, you can organize it thematically .

That means that each paragraph or section focuses on a specific theme and explains how that theme is approached in the literature.

Source Used with Permission: The Chicago School

If you’re drawing on literature from various different fields or they use a wide variety of research methods, you can organize your sources methodologically .

That means grouping together studies based on the type of research they did and discussing the findings that emerged from each method.

If your topic involves a debate between different schools of thought, you can organize it theoretically .

That means comparing the different theories that have been developed and grouping together papers based on the position or perspective they take on the topic, as well as evaluating which arguments are most convincing.

Step 3: Write paragraphs with topic sentences

What sets a synthesis apart from a summary is that it combines various sources. The easiest way to think about this is that each paragraph should discuss a few different sources, and you should be able to condense the overall point of the paragraph into one sentence.

This is called a topic sentence , and it usually appears at the start of the paragraph. The topic sentence signals what the whole paragraph is about; every sentence in the paragraph should be clearly related to it.

A topic sentence can be a simple summary of the paragraph’s content:

“Early research on [x] focused heavily on [y].”

For an effective synthesis, you can use topic sentences to link back to the previous paragraph, highlighting a point of debate or critique:

“Several scholars have pointed out the flaws in this approach.” “While recent research has attempted to address the problem, many of these studies have methodological flaws that limit their validity.”

By using topic sentences, you can ensure that your paragraphs are coherent and clearly show the connections between the articles you are discussing.

As you write your paragraphs, avoid quoting directly from sources: use your own words to explain the commonalities and differences that you found in the literature.

Don’t try to cover every single point from every single source – the key to synthesizing is to extract the most important and relevant information and combine it to give your reader an overall picture of the state of knowledge on your topic.

Step 4: Revise, edit and proofread

Like any other piece of academic writing, synthesizing literature doesn’t happen all in one go – it involves redrafting, revising, editing and proofreading your work.

Checklist for Synthesis

•   Do I introduce the paragraph with a clear, focused topic sentence?
•   Do I discuss more than one source in the paragraph?
•   Do I mention only the most relevant findings, rather than describing every part of the studies?
•   Do I discuss the similarities or differences between the sources, rather than summarizing each source in turn?
•   Do I put the findings or arguments of the sources in my own words?
•   Is the paragraph organized around a single idea?
•   Is the paragraph directly relevant to my research question or topic?
•   Is there a logical transition from this paragraph to the next one?

Further Information

How to Synthesise: a Step-by-Step Approach

Help…I”ve Been Asked to Synthesize!

Learn how to Synthesise (combine information from sources)

How to write a Psychology Essay

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Writing a Literature Review

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A literature review is a document or section of a document that collects key sources on a topic and discusses those sources in conversation with each other (also called synthesis ). The lit review is an important genre in many disciplines, not just literature (i.e., the study of works of literature such as novels and plays). When we say “literature review” or refer to “the literature,” we are talking about the research ( scholarship ) in a given field. You will often see the terms “the research,” “the scholarship,” and “the literature” used mostly interchangeably.

Where, when, and why would I write a lit review?

There are a number of different situations where you might write a literature review, each with slightly different expectations; different disciplines, too, have field-specific expectations for what a literature review is and does. For instance, in the humanities, authors might include more overt argumentation and interpretation of source material in their literature reviews, whereas in the sciences, authors are more likely to report study designs and results in their literature reviews; these differences reflect these disciplines’ purposes and conventions in scholarship. You should always look at examples from your own discipline and talk to professors or mentors in your field to be sure you understand your discipline’s conventions, for literature reviews as well as for any other genre.

A literature review can be a part of a research paper or scholarly article, usually falling after the introduction and before the research methods sections. In these cases, the lit review just needs to cover scholarship that is important to the issue you are writing about; sometimes it will also cover key sources that informed your research methodology.

Lit reviews can also be standalone pieces, either as assignments in a class or as publications. In a class, a lit review may be assigned to help students familiarize themselves with a topic and with scholarship in their field, get an idea of the other researchers working on the topic they’re interested in, find gaps in existing research in order to propose new projects, and/or develop a theoretical framework and methodology for later research. As a publication, a lit review usually is meant to help make other scholars’ lives easier by collecting and summarizing, synthesizing, and analyzing existing research on a topic. This can be especially helpful for students or scholars getting into a new research area, or for directing an entire community of scholars toward questions that have not yet been answered.

What are the parts of a lit review?

Most lit reviews use a basic introduction-body-conclusion structure; if your lit review is part of a larger paper, the introduction and conclusion pieces may be just a few sentences while you focus most of your attention on the body. If your lit review is a standalone piece, the introduction and conclusion take up more space and give you a place to discuss your goals, research methods, and conclusions separately from where you discuss the literature itself.

Introduction:

• An introductory paragraph that explains what your working topic and thesis is
• A forecast of key topics or texts that will appear in the review
• Potentially, a description of how you found sources and how you analyzed them for inclusion and discussion in the review (more often found in published, standalone literature reviews than in lit review sections in an article or research paper)
• Summarize and synthesize: Give an overview of the main points of each source and combine them into a coherent whole
• Analyze and interpret: Don’t just paraphrase other researchers – add your own interpretations where possible, discussing the significance of findings in relation to the literature as a whole
• Critically Evaluate: Mention the strengths and weaknesses of your sources
• Write in well-structured paragraphs: Use transition words and topic sentence to draw connections, comparisons, and contrasts.

Conclusion:

• Summarize the key findings you have taken from the literature and emphasize their significance
• Connect it back to your primary research question

How should I organize my lit review?

Lit reviews can take many different organizational patterns depending on what you are trying to accomplish with the review. Here are some examples:

• Chronological : The simplest approach is to trace the development of the topic over time, which helps familiarize the audience with the topic (for instance if you are introducing something that is not commonly known in your field). If you choose this strategy, be careful to avoid simply listing and summarizing sources in order. Try to analyze the patterns, turning points, and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred (as mentioned previously, this may not be appropriate in your discipline — check with a teacher or mentor if you’re unsure).
• Thematic : If you have found some recurring central themes that you will continue working with throughout your piece, you can organize your literature review into subsections that address different aspects of the topic. For example, if you are reviewing literature about women and religion, key themes can include the role of women in churches and the religious attitude towards women.
• Qualitative versus quantitative research
• Empirical versus theoretical scholarship
• Divide the research by sociological, historical, or cultural sources
• Theoretical : In many humanities articles, the literature review is the foundation for the theoretical framework. You can use it to discuss various theories, models, and definitions of key concepts. You can argue for the relevance of a specific theoretical approach or combine various theorical concepts to create a framework for your research.

What are some strategies or tips I can use while writing my lit review?

Any lit review is only as good as the research it discusses; make sure your sources are well-chosen and your research is thorough. Don’t be afraid to do more research if you discover a new thread as you’re writing. More info on the research process is available in our "Conducting Research" resources .

As you’re doing your research, create an annotated bibliography ( see our page on the this type of document ). Much of the information used in an annotated bibliography can be used also in a literature review, so you’ll be not only partially drafting your lit review as you research, but also developing your sense of the larger conversation going on among scholars, professionals, and any other stakeholders in your topic.

Usually you will need to synthesize research rather than just summarizing it. This means drawing connections between sources to create a picture of the scholarly conversation on a topic over time. Many student writers struggle to synthesize because they feel they don’t have anything to add to the scholars they are citing; here are some strategies to help you:

• It often helps to remember that the point of these kinds of syntheses is to show your readers how you understand your research, to help them read the rest of your paper.
• Writing teachers often say synthesis is like hosting a dinner party: imagine all your sources are together in a room, discussing your topic. What are they saying to each other?
• Look at the in-text citations in each paragraph. Are you citing just one source for each paragraph? This usually indicates summary only. When you have multiple sources cited in a paragraph, you are more likely to be synthesizing them (not always, but often
• Read more about synthesis here.

The most interesting literature reviews are often written as arguments (again, as mentioned at the beginning of the page, this is discipline-specific and doesn’t work for all situations). Often, the literature review is where you can establish your research as filling a particular gap or as relevant in a particular way. You have some chance to do this in your introduction in an article, but the literature review section gives a more extended opportunity to establish the conversation in the way you would like your readers to see it. You can choose the intellectual lineage you would like to be part of and whose definitions matter most to your thinking (mostly humanities-specific, but this goes for sciences as well). In addressing these points, you argue for your place in the conversation, which tends to make the lit review more compelling than a simple reporting of other sources.

• Open access
• Published: 16 September 2024

Social isolation and loneliness among people living with experience of homelessness: a scoping review

• James Lachaud 1 , 2 ,
• Ayan A. Yusuf 2 ,
• Faith Maelzer 2 , 3 ,
• Melissa Perri 2 , 4 ,
• Evie Gogosis 2 ,
• Carolyn Ziegler 5 ,
• Cilia Mejia-Lancheros 2 , 6 &
• Stephen W. Hwang 2 , 4 , 7  

BMC Public Health volume  24 , Article number:  2515 ( 2024 ) Cite this article

Metrics details

Social isolation and loneliness (SIL) are public health challenges that disproportionally affect individuals who experience structural and socio-economic exclusion. The social and health outcomes of SIL for people with experiences of being unhoused have largely remained unexplored. Yet, there is limited synthesis of literature focused on SIL to appropriately inform policy and targeted social interventions for people with homelessness experience. The aim of this scoping review is to synthesize evidence on SIL among people with lived experience of homelessness and explore how it negatively impacts their wellbeing. We carried out a comprehensive literature search from Medline, Embase, Cochrane Library, PsycINFO, CINAHL, Sociological Abstracts, and Web of Science's Social Sciences Citation Index and Science Citation Index for peer-reviewed studies published between January 1st, 2000 to January 3rd, 2023. Studies went through title, abstract and full-text screening conducted independently by at least two reviewers. Included studies were then analyzed and synthesized to identify the conceptualizations of SIL, measurement tools and approaches, prevalence characterization, and relationship with social and health outcomes. The literature search yielded 5,294 papers after removing duplicate records. Following screening, we retained 27 qualitative studies, 23 quantitative studies and two mixed method studies. SIL was not the primary objective of most of the included articles. The prevalence of SIL among people with homelessness experience varied from 25 to 90% across studies. A range of measurement tools were used to measure SIL making it difficult to compare results across studies. Though the studies reported associations between SIL, health, wellbeing, and substance use, we found substantial gaps in the literature. Most of the quantitative studies were cross-sectional, and only one study used health administrative data to ascertain health outcomes. More studies are needed to better understand SIL among this population and to build evidence for actionable strategies and policies to address its social and health impacts.

Peer Review reports

Introduction

Social isolation and loneliness (SIL) are major social and health issues representing a growing global public health challenge, particularly for socio-economically excluded and underserved populations [ 1 , 2 ]. Social isolation is defined as a lack of close or meaningful relationships and results from multidimensional experiences associated with exclusion from mainstream society, hopelessness, abandonment, social marginalization, lack of community networks and dissatisfaction with relationships [ 3 , 4 ]. Loneliness is a more personal and subjective multifaceted experience consisting of different types of self-perceived social deficits, including social loneliness, defined as a self-perceived lack of friendships in either quality or quantity and emotional loneliness, experienced as a deficit of intimate attachments such as familial or romantic relationships or feeling alone and isolated [ 3 , 4 , 5 ].

SIL has been linked to putting people at increased risk for adverse health outcomes, social distress and premature death [ 6 ]. Lack of adequate social support has been reported to increase the odds of premature death by 50% [ 6 ]. Previous studies have also found an association between SIL and increased risk of developing dementia, coronary heart disease and stroke, poorer mental and cognitive health outcomes, and consumption of a low-quality diet [ 7 , 8 ]. While SIL affects many populations, individuals with experiences of being unhoused are among those with the highest risk of being socially isolated and lonely. First, experiences of homelessness are visible and extreme forms of social exclusion. Unhoused people are more socially disconnected, can feel rejected or abandoned, and may not have appropriate informal (family, relatives, friends) and formal support networks [ 9 , 10 ]. Second, even after being housed, structural forms of oppression (i.e., racism) and discrimination associated with previous experiences of being unhoused continue to impact individuals’ lives and deprive people of meaningful recovery and social integration, connection and relationships [ 11 , 12 , 13 ]. Individuals who have experienced homelessness often face persistent stigma and discrimination that can affect their social interactions and access to essential services [ 12 ]. People with experiences of being unhoused have self-reported higher odds of poor mental and physical health and loneliness than their housed counterparts [ 14 ]. Moreover, people with experiences of being unhoused have lower life expectancy and experience impairments associated with aging earlier compared with people without experiences of being unhoused [ 15 , 16 , 17 ]. These factors can make individuals more vulnerable to social and economic abuse, which may affect their ability to build meaningful social connections.

Recent years have seen increased initiatives to address SIL among formerly homeless populations. There is some consensus in social work to consider SIL in needs assessments for health and social care for some specific population groups, such as seniors and youth [ 18 , 19 ]. More resources are being allocated to address SIL in supportive housing programs and intervention design [ 20 ]. Social prescribing, which involves primary care physicians prescribing social activities to patients as a strategy to strengthen social engagement and lower loneliness, is becoming a growing practice [ 21 , 22 ]. Nonetheless, SIL remains complex to conceptualize, and it has been difficult to measure its prevalence and association with social and health outcomes and other indicators of wellbeing. Without a clear conceptualization and measurement approach, it is uncertain how to design adequate interventions and policies to address SIL.

The aim of this scoping review was to identify, map, and synthesize the findings of qualitative and quantitative studies that measure SIL among people over the age of 18 with lived or living experience of homelessness including those living in supportive or social housing, or staying in emergency or transitional accommodation in order to highlight the gaps in the existing literature and inform the development of future interventions. This scoping review will aim to answer the following questions:

How are SIL conceptualized across studies involving people with experience of homelessness?

What scales and tools are used to measure SIL across these studies?

What is the prevalence of SIL and the relationship between SIL and social and health outcomes in people with experience of homelessness?

Data sources and searches

The scoping review protocol followed the methodology outlined by Arksey and O’Malley, Levac et al. [ 18 ] and is guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA ScR) [ 23 ]. Initially, a preliminary search was performed in Medline and Embase to identify any existing scoping reviews related to the topic, and to refine the search strategies by pinpointing key concepts and determining an appropriate timeframe to include relevant studies [ 24 ]. Then, comprehensive literature searches were carried out by an information specialist (CZ) in Medline (Ovid platform), Embase (Ovid), Cochrane Central Register of Controlled Trials & Cochrane Database of Systematic Reviews (Ovid), PsycINFO (Ovid), CINAHL (EBSCOhost), Sociological Abstracts (ProQuest), and Web of Science's Social Sciences Citation Index and Science Citation Index. The search strategies had a broad range of subject headings and keywords, adapted for each database, for the two core concepts of SIL and homelessness or social housing, combined with the Boolean operator AND. The searches were limited to articles in English, French, and Spanish published between January 1st, 2000 to October 27, 2021, followed by an updated search to January 3rd, 2023. The publication languages were chosen for feasibility purpose, considering the linguistic capacity of the research team. Comments, editorials, and letters were excluded from the search. There were a total of 8,398 results from these two rounds of searches prior to de-duplication (7,356 at search one and 1,042 at search two) and the records were compiled in EndNote. The complete search strategies as run are included in the Supplementary material .

Definition and screening process

To refine our screening process, we defined individuals experiencing homelessness as those lacking stable, safe, permanent, and appropriate housing, or the immediate means and ability to acquire such housing [ 25 ]. This definition encompasses individuals who are marginally housed or at high risk of eviction, including individuals who are "doubled up," couch surfing, or living in overcrowded conditions [ 26 ].

To be considered eligible for inclusion, we established the following inclusion criteria for the scoping review:

studies had to include participants that were people with homelessness experience or marginally/vulnerably housed populations (people living in supportive housing or shelters). While our screening process did not establish an age criterion, we excluded studies that focused exclusively on minors (under 18 years old) experiencing homelessness. This decision was made as a recent study showed that minors experiencing homelessness might need specific considerations and theoretical framework [ 27 ];

studies had to be peer-reviewed qualitative and quantitative original research papers published in English, French, or Spanish;

studies had to be published between 2000-and January 3, 2023;

studies had to examine or include in the analyses: loneliness, social isolation, social disconnection, solitude, social withdrawal, abandonment, lack of contact, social exclusion or rejection.

We excluded papers that were systematic or scoping reviews, and papers where the studied populations was exclusively minors; where the field activities and data were collected from caregivers or other workers, and not people with homelessness experience or marginally/vulnerably housed; studies that only focused on networking, social or community integration and did not refer to social isolation or loneliness. No exclusion was made based on geographic region or countries, however we excluded studies that focused on people residing in camps due to displacement from war, insecurity, or major natural disasters, as these situations are typically addressed by different theoretical and humanitarian frameworks [ 28 ].

The results from all searches were imported to Covidence systematic review software, where duplicates were removed. The searches yielded 5,294 papers for screening after the deletion of duplicates. Four researchers (AY, EG, FM, and MP) screened the article titles and abstracts independently and in duplicate in Covidence using the predetermined inclusion and exclusion criteria. The full-text of the articles that met our eligibility criteria were then assessed by two independent reviewers. At both stages, differences in voting were discussed and resolved as a group, and included the Principal Investigator (JL). In total, 52 articles met the criteria for data extraction and analyses. The PRISMA diagram in Fig.  1 shows the flow of information through the different stages of the review.

PRISMA flow diagram

Data extraction

The main characteristics, research questions, targeted populations, measurement and findings of the selected studies were extracted in an Excel database file by the four researchers (AY, EG, FM, and MP) and reviewed by the Principal Investigator (JL). A summary of each selected paper can be found in Tables 1 and Table  2 .

Data synthesis

The studies reviewed exhibited considerable variability in their methodological approaches, participant demographics (including young adults, adults, and seniors) or sex and gender-based groups, measures of SIL, definitions of homelessness experience, and countries where they were conducted. To provide a thorough overview, we examined both quantitative and qualitative research. Initially, we assessed the theoretical frameworks used in these studies to better grasp the conceptualization and ongoing discussions about SIL within the target population. In our analysis of quantitative studies, we identified key similarities and differences in SIL measurements, demographic characteristics, discussions of the prevalence and patterns of SIL and its relationship with health status. To deepen our understanding, we used a crosswalk approach [ 29 ] using both quantitative and qualitative studies to examine how participants described, contextualized, and nuanced their experiences of SIL, and how SIL related to demographic factors, gender, and homelessness experience.

Overview of included studies

The main characteristics of the 52 articles included in this review are outlined in Tables 1 and Table  2 . Most articles (n = 42) were published from 2010 and later and were conducted in the US (n = 16) and Canada (n = 16). Study methodology was almost evenly split between quantitative (n = 23) and qualitative (n = 27) methods, and a very small number (n = 2) used a mixed methods approach. Among quantitative studies, 18 had a cross-sectional or one-point-in-time design, and 5 used a longitudinal design. Most of the qualitative studies (15) used a thematic analysis approach.

Characteristics of the populations covered in included studies

Among included articles, 4 focused on women [ 30 , 31 , 32 , 33 ] and older women [ 34 ]; 5 studies examined male [ 35 , 36 , 37 , 38 ] or older male populations [ 39 ]. In total, 10 articles focused on older adults, which usually included early aging starting from 50 years [ 40 ] or 55 years [ 41 ] of age and above for populations with experience of homelessness. We found no studies that focused on non-binary groups, though gender-diverse self-identified individuals were included in 6 of the studies [ 33 , 42 , 43 , 44 , 45 , 46 ]. Moreover, there were a small number of studies (n = 6) focused on youth. Three of these were quantitative studies [ 47 , 48 , 49 ] comparing homeless youth and young adults to youth in the general population. The other 3 were qualitative studies [ 50 , 51 , 52 ]; 2 described how youth experience loneliness [ 51 , 52 ]; one study identified strategies for dealing with feelings of loneliness among homeless adolescents [ 50 ]. Three studies [ 53 , 54 , 55 ] focused on a population of veterans who were currently experiencing homelessness or were formerly homeless and living in either subsidized or supportive housing. Participants’ ethnicity was reported in most of the studies (n = 32).

Social isolation and loneliness as the primary objective

Only 18 of the 52 studies focused on SIL as their primary objective or included SIL in the main research questions. Of these 18 studies, 13 were quantitative and 5 were qualitative as summarized in Tables 1 and  2 . In the remaining 34 articles, SIL neither was the main objective nor clearly stated in the objectives or research questions. In those studies, SIL was usually considered as one of the potential explicative or control factors [ 30 , 56 , 57 ], and eventually emerged or co-created from participants’ narratives.

Conceptualization of social isolation and loneliness

Different theoretical frameworks were used to contextualize SIL in relation to unhoused or homelessness experiences. For some studies, SIL was embedded in the homelessness experience, since homelessness is in itself a form of social exclusion, which limits people’s participation in society [ 36 , 58 ]. Lafuente et al. [ 36 ] explained the experience of unhoused men through the lens of social disaffiliation theory. They explained that situational changes (i.e., loss of employment) or intrinsic factors (voluntary withdrawal) caused participants to become socially disaffiliated. Narratives on isolation from this study revealed feelings of alienation, powerlessness, self-rejection, depression, loneliness and unworthiness. Similarly, the study by Burns et al. [ 39 ] explained how the transient nature of being unhoused creates interrelated dimensions of social exclusion, generating a sense of invisibility, identity exclusion, racism, exclusion of social ties and meaningful interactions with the community, thus leading to social isolation.

Bell and Walsh [ 37 ] conceptualized SIL among individuals experiencing homelessness as being driven by mainstream normative conceptions of homelessness and the stigma of homelessness. The authors suggest that conceptions of homelessness conflate between notions of “rooflessness” and “rootlessness” which “denotes the absence of support and inclusion in one’s community driving experiences of isolation and loneliness.” [ 37 ].

In the study by Baker et al., [ 58 ] SIL is discussed as part of a new landscape of a network society and digital exclusion. The rapid development of information and communication technologies (ICT) has drastically changed human communication and interactions leaving many behind and out of communication flows . The authors explained that aging combined with many social disadvantages like histories of homelessness, multiple complex needs, rural areas of residence, and economically restricted mobility can contribute to creating or keeping affected older adults disconnected and socially isolated.

Meaning and experiences of social exclusion and, in particular SIL were further voiced through semi-structured qualitative interviews or focus groups in different studies. Often, participants reflected on how broader structural stigmatization and alienation associated with housing insecurity contributed to their perceived SIL. Jurewicz et al. [ 59 ] highlighted how systemic policies and practices affecting individuals experiencing homelessness who used substances generate and contribute to ongoing experiences of housing precarity, loneliness and isolation. Participants further discussed the complex interrelationship between substance use and homelessness including the strain on social relationships as a result of substance use [ 59 ]. Similarly, Martínez et al., [ 60 ] described how experiences of loneliness are driven by a lack of meaningful relationships, conflicts with families, a lack of social inclusion, and marginalization faced by individuals residing in a residential center in Gipuzkoa, Spain. In the study by Johnstone et al., [ 61 ] social isolation was defined as being associated with not having perceived opportunities to develop multiple group memberships.

Experiences and conceptualizations of loneliness were not strictly dependent upon one’s lack of access to housing. Two studies discussed how the transition into supportive or transitional housing further exacerbated experiences of loneliness and isolation [ 53 , 62 ]. Polvere, Macnaughton and Piat [ 62 ] and Winer et al. [ 53 ] highlighted that the transition to living within congregate-supported settings or independent apartments can be linked to experiences of SIL even when people are offered social engagement activities. Some participants reported feeling voluntarily isolated as they did not want to engage with others and some participants anticipated social isolation due to transitioning into a new environment.

Measurement tools to assess social isolation and loneliness

There were multiple approaches to measuring SIL across all studies, including widely used and validated multi-item scales and single-item measures. There were three main scales that were developed, revised, tested or used to measure SIL among people experiencing homelessness: The Rokach Loneliness questionnaire, the UCLA Loneliness Scale and its revised versions, and the De Jong Gierveld Loneliness Scale. 

The rokach loneliness questionnaire

Five studies used the Rokach Loneliness Questionnaire [ 47 , 48 , 49 , 63 , 64 ]. The Rokach Loneliness Questionnaire [ 47 , 48 ] measures causes of loneliness and coping strategies and has been used in studies with young people aged 15–30 in Toronto, Canada. The questionnaire measures the experience of loneliness across five factors, with yes/no items on five subscales: emotional distress such as pain or feelings of hopelessness; social inadequacy and alienation including a sense of detachment; growth and discovery such as feelings of inner strength and self-reliance; interpersonal isolation including alienation or rejection; and self-alienation such as feelings of numbness or denial. The items on the interpersonal isolation subscale relate to an overall lack of close or romantic relationships.

The UCLA loneliness scale

Six of the studies in this review used the UCLA Loneliness Scale or a revised version. Novacek et al. [ 54 ] assessed subjective feelings of SIL among Black and White identifying veterans with psychosis and recent homelessness compared with a control group at the onset of the COVID-19 pandemic. The 20-item scale was used to measure subjective feelings of SIL over the past month. Participants rated their experience ranging from “never” to “often,” with higher scores indicating higher subjective feelings of loneliness. Lehmann et al. [ 38 ] used a revised version of the UCLA Loneliness Scale to examine individual factors including loneliness relevant in people experiencing homelessness to report their victimization to police. The researcher recruited 60 self-identified adult males aged 19 to 67 currently experiencing homelessness in Germany and used a revised and shorter German UCLA Loneliness Scale developed by Bilsky and Hosser [ 65 ], to measure loneliness. The scale is composed of 12 items with a 5-point Likert scale ranging from 0 (“not at all”) to 5 (“very much”) and positively formulated items were recorded to reflect a higher level of loneliness. The load factors for the scale are experiences of general loneliness, emotional loneliness, and inner distance. Drum and Medvene [ 66 ] used the UCLA-R Loneliness Scale, which has been adapted for an older adult population to measure loneliness among older adults living in affordable seniors housing in Wichita, Kansas. This version is composed of 23 items, with a four-point Likert scale-type of response options. Participants’ total score ranged from 20 to 80, with a higher score representing greater loneliness.

Tsai et al. [ 67 ], Dost et al. [ 68 ] and Ferrari et al. [ 69 ] used a shortened revised version of the UCLA Loneliness Scale Version 3, which consists of three items: “how often they feel they lack companionship, how often they feel left out, and how often they feel isolated from others.” Participants self-reported their responses using a 3-point Likert scale (“hardly ever,” “some of the time,” and “often”) to answer questions. A summed score of 3 to 5 is defined as not lonely and a summed score of 6 or more is defined as lonely. The 3-item scale is used widely in research and clinical settings as a short assessment of loneliness.

De Jong Gierveld loneliness scale

Valerio-Urena, Herrara-Murillo and Rodriguez-Martinez [ 70 ] examined the association between perceived loneliness and internet use among 129 currently homeless single adults aged 35–60 staying in a public shelter in Monterrey, Mexico. The authors used questions from the De Jong Gierveld Loneliness Scale, which includes 11 items with three response options (1 = no, 2 = more or less, 3 = yes) asking about having friends or people to talk with or contact, feeling empty or missing other people’s company, and having people or friends you can trust. The subscales measure emotional loneliness (due to the lack of a close relationship) and social loneliness (due to the lack of a general social network) with scores ranging between 0 (no solitude) and 11 (extreme solitude).

Other social isolation and loneliness scales

Some of the quantitative studies used subscales or single questions from measurement tools that were not primarily designed to measure SIL. For example, Cruwys et al. [ 71 ] used the short form of the Young Schema Questionnaire, which included 75 items with five items assessing each of the 15 schemas. This study focused on the social isolation schema, which was described as a “feeling that one is isolated from the rest of the world, different from others, and or/ not part of a group.” Statements included “I don’t fit in; I don’t belong; I’m a loner; I feel outside the groups.” Respondents answered on a 6-point scale from 1 if “completely untrue to me” to 6 if “describes me perfectly.” In this study, participants who responded with 5 or 6 (“Mostly true of me” or “describes me perfectly”) on the scale were assigned 1 point, otherwise they were assigned 0 points.

Wrucke et al. [ 72 ] investigated factors associated with cigarette use among people with experiences of homelessness. Social isolation was one of the variables hypothesized to be associated with smoking among this population. The authors used the short form of the social isolation questionnaire developed using the Patient-Reported Outcomes Measurement Information System (PROMIS). PROMIS defines social isolation as the “perceptions of being avoided, excluded, detached, and disconnected from, or unknown by others.” It uses a 4-item social isolation questionnaire to capture each of these dimensions, for which the option of responses range from never to always.

In their study, Drum and Medvene [ 66 ] used the Lubben Social Network Scale (LSNS) to measure social isolation in addition to the UCLA-R Loneliness Scale mentioned above. LSNS was used as a measure of risk of isolation and included 10 items; three (3) items referred to family networks, three items (3) to friend networks, and four items (4) to confident relationships. Each of the items had a five-point Likert scale-type response, with the total adding up to a score between 0 and 50. A higher score on the LSNS represents greater risk of social isolation. Participants were categorized based on their LSNS score as low risk (0–20), moderate risk (21–25), high risk (26–30), or isolated (31–50).

Ferreiro et al. [ 73 ] used one question from the 22-item Camberwell Assessment of Need (CAN) to measure loneliness among Housing First program participants in Spain. One item asks, “Does the person need help with social contact?” and the answer is classified as a serious problem if a respondent answered, “Frequently feels lonely and isolated.” Rodriguez-Moreno [ 31 ] used the General Health Questionnaire (GHQ-28) which includes a subscale of somatic symptoms, anxiety and insomnia, social dysfunction and depression to study the mental health risk of women with homelessness experience. The GHQ has one question related to “feeling lonely or abandoned.” Similarly, Vazquez et al. [ 30 ] reported one question on the extent participants feel lonely or abandoned using a 4-point Likert scale ranging from “not at all” to “a lot.” Pedersen, Gronbaek and Curtis [ 74 ], Bige et al. [ 56 ] and Muir et al. [ 57 ] also measured loneliness using one question. Another study by Rivera-Rivera et al. [ 55 ] examined factors associated with readmission to a housing program for veterans with a number of measurement tools and administrative data to create a profile of participants. In their study, social isolation was measured using the relationships section of the significant psychosocial problem areas of the Social Work Behavioral Health Psychosocial Assessment Tool where isolation/withdrawal can be measured using “yes” or “no” responses [ 55 ]. Finally, Bower [ 75 ] piloted the short version of the Social and Emotional Loneliness Scale for Adults (SELSA-S) with a group of 129 Australian adults with homelessness experience. However, this paper was excluded from our review as the authors concluded that the SELSA-S seems to be inappropriate to measure loneliness among people with homelessness experience.

Prevalence and scores of social isolation and loneliness: quantitative evidence

The prevalence of SIL varied from 25% to more than 90% across studies included in this review. Based on LSNS risk categorizations, Drum and Medvene [ 66 ] found over one-quarter (25.8%) of participants were categorized as being socially isolated and nearly one in five (19.4%) as being at high risk for social isolation. Cruwys et al. [ 71 ], using the Young Schema Questionnaire-2 found more than one-quarter (28%) of participants reported elevated social isolation at time T1 (day 1) of the study, with no change in social isolation reported at time T2 (2 weeks after leaving temporary accommodations). An examination by Rivera et al. [ 55 ] of 620 patient records of veterans who requested services at the Homeless Program of the VA Caribbean Healthcare System from 2005 to 2014 found that over one-third (34.7%) reported experiencing social isolation. In a study with 1,306 socially marginalized people recruited at shelters and drop-in centres in Denmark, more than one-quarter (28.4%) reported often unwillingly being alone [ 74 ]. Bige et al. [ 56 ] found that more than 90% of 421 people experiencing homelessness were socially isolated.

Using the De Jong Gierveld Loneliness Scale, Herrara-Murillo and Rodriguez-Martinez [ 70 ] estimated an average score of 7.12 for loneliness among surveyed participants, which is between moderate and severe loneliness (score = 8). Ferrari et al. [ 69 ] also found a high mean score among homeless adults (score = 6) at baseline, based on the revised 3-item UCLA scale. Rokach [ 64 ] reported homeless adults had significantly higher mean subscale scores than non-homeless adults on four of five subscales measuring loneliness: interpersonal isolation (3.44 vs 2.82), self-alienation (1.92 vs 1.27), emotional distress (2.97 vs 2.73), and social inadequacy and alienation (2.92 vs 2.70).

Social isolation and loneliness evidence in qualitative studies

Twenty-nine studies reported qualitative evidence with the majority (n = 15) using thematic analysis to convey experiences of SIL among participants with histories of being unhoused or experiences of housing precarity. In most qualitative studies, participants referred to a lack of social connectedness, weak relationships with community members, family, or friends, feelings of abandonment, or a desire to withdraw. In a study by Bower, Conroy and Perz [ 10 ], researchers explored experiences of social connectedness, isolation and loneliness among 16 homeless or previously homeless adults ages 22–70 in Sydney, Australia. Participants described feelings of rejection through marginalization and stigma, rejection from family, lack of companionship, and shallow and precarious relationships with others, which made them feel alone [ 10 ].

Similarly Burns et al., [ 39 ] reported social isolation among older adults with histories of chronic homelessness living at a single-site permanent supportive housing program in Montreal, Canada. Participants revealed that they were socially excluded based on their ethnicity and sexual orientation, which made them feel isolated. Participants in the study by Lafuente [ 36 ] attributed their feelings of isolation to experiences of being unhoused and narratives from 10 male-identifying participants centered on discussions of isolation, including feelings of alienation, depression, loneliness, resignation, unworthiness and withdrawal. Participants shared their feelings of being “frightened, sad, lonely, and frustrated” and wanting to “withdraw from society” [ 36 ]. Studies by Kaplan et al. [ 76 ] and Grenier et al. [ 41 ] also reported concerns of social isolation due to lack of strong familial ties among participants, which impacted their engagement with services and contributed to feeling isolated and ostracized.

In a study of 46 adults using shelters and drop-in centres in Denmark, participants reported challenges with developing lasting and meaningful social relationships with others [ 77 ]. With data from the 30 participants included in the analysis, the authors categorized SIL into 5 groups: socially related and content (n = 9) characterized by satisfying relations with social and professional groups; satisfied loners (n = 5) centered on social isolation bringing rewards of peace and quiet; socially related but lonely (n = 4) focused on superficial social relations; socially isolated (n = 9) comprised of sporadic social connections; and in-between (n = 3) characterized by broad networks, however feeling unsatisfied with social networks [ 77 ].

Other studies focused on experiences of SIL in relation to the negative consequences of being unhoused and experiencing associated stigma. Bell et al. [ 24 ] revealed participants’ feelings of worthlessness as a result of the social stigma of being unhoused. Participants described homelessness as: “ walking around with a big sign on your head that says , “ I’m worthless” … the way you are looked on by society, like you feel like an alien…you always have to leave because you’re not welcome, you’re not welcome, you’re not welcome anywhere. In a town of a million people you are made to feel like you’re by yourself and you’re alone because there is nowhere to go.”  Another study aimed to understand the experiences of SIL among 11 adults ages 22–60 (5 self-identified females; 6 self-identified males) staying in residential centers in Spain [ 60 ]. Participants reported feelings of loneliness as a chronic and persistent experience. One participant described it as follows: “I’ve always felt lonely, everywhere I’ve been, even having people around me…It’s not about being physically alone…it’s a loneliness inside.” [ 60 ].

Nonetheless, transitioning from homelessness to housing does not imply a reduction in SIL, at least in the short term. Several qualitative studies [ 53 , 62 , 78 , 79 , 80 ] were conducted with participants of the At Home / Chez Soi study, a pragmatic randomized controlled trial in Canada that used a Housing First approach to provide housing and supports to individuals experiencing homelessness and mental health problems [ 11 ]. Some participants who received housing experienced loneliness [ 80 ] whereas others expressed concerns about not being able to cope with social isolation following a transition to independent housing [ 62 ]. Moving into housing can contribute to SIL with a shift from being surrounded by people in congregate settings such as shelters or jail, to living alone [ 78 , 33 ]. One participant said: “ It’s [the transition] hard because I’m used to having people around me all the time.” [ 62 ] In a study by Winer et al. [ 53 ], some participants who received housing chose not to socialize or build relationships: “ But I don’t socialize here at all. I didn’t think, I didn’t realize that I would be so isolated. You know, I could go knocking on doors and try to be friends with people. But I just don’t bother to do that. I’m not interested in reaching out .”

Other studies examining individuals accessing transitional accommodation reported that participants’ positive comments illustrated connections with peers and program staff and these connections resulted in them no longer feeling lonely or isolated [ 61 ]. Over one-third (34%) of participants reported positive experiences with respect to their accommodations, interactions with caseworkers and with their peers/other residents, which made them not feel lonely or isolated. Another study [ 81 ] found access to supportive housing was also associated with a reduction in drug use; while some participants were spending time alone, they did not report feeling lonely. Some reported having pets and others did volunteer work to help them overcome feelings of social isolation.

Other studies reported SIL among young populations with homelessness experience. A study by Rew [ 50 ] conducted interviews and focus groups with 32 homeless youth ages 16–23 participating in a community outreach project in central Texas. Participants discussed reasons for loneliness including personal loss, traveling and being away from family and friends, and at certain times, for example at night, during winter, or specific occasions such as holidays and birthdays: “ I just get lonely at night…more at night .” [ 50 ] Another study by Johari et al [ 52 ] conducted interviews and focus groups with 13 individuals ages 18–29 in Iran about their experiences of homelessness. Participants described feeling lonely, harassed and abandoned by society. Themes that emerged from the interviews included “ avoidance of/ by society, comprehensive harassment, and lack of comprehensive support. ” [ 52 ] Participants reported feeling isolated due to a loss of self-confidence and social trust. One participant shared, “ I have nothing to do with anyone, and I am alone .”

Some qualitative studies reported on SIL among people with experiences of homelessness in the context of COVID-19 [ 51 , 79 , 82 , 83 ]. These studies explained how social distancing and other public health restrictions disrupted social relationships with housing staff, other residents, family members and communities and reduced access to services. Participants discussed how an increased fear and a lack of social networks exacerbated feelings of social isolation during lockdown periods: “ Aside from not being allowed to go out the f… door aye. I’m not allowed out. Everybody else can go for a walk, I am imprisoned in the square .” [ 83 ] Another study by Noble et al. [ 51 ] analyzed the impact of COVID-19 on 45 youth ages 16–24 living in emergency shelters in Toronto, Canada. Youth stressed that the pandemic and associated public health restrictions (e.g., closed common spaces, canceled in-person activities, social distancing and single-occupancy sleeping arrangements) led to reduced access to important social networks, and an associated increase in feelings of SIL: “ Like, right now, because of everyone’s at home, because of the lockdown and you can’t really like meet people […] it’s a very challenging moment, it’s testing me, another limit of me.” [ 51 ].

Intersectionality in homelessness, social isolation and loneliness

Using an intersectionality framework, defined as an approach that explores how various forms of discrimination and privilege overlap and interact to influence an individual’s experiences and challenges [ 84 ],we analyzed how studies explored the critical role of multiple identities in shaping SIL experiences among people with homelessness experience. People reported different SIL experiences and faced different SIL-related challenges based on their gender [ 69 ], ethnicity and sexual orientation [ 39 ], and age [ 48 ]. For example, Ferrari et al. [ 69 ], using the revised 3-item UCLA scale, found women had statistically significant and higher mean loneliness scores (6.29) compared with men (5.57). Using the same scale, Dost et al. [ 68 ] reported an average loneliness score of 5.2 (SD = 1.9); among self-identified men it was 5.1 (SD = 1.9) and among self-identified women, it was 5.4 (SD = 2.0) (n = 265 reported frequency of loneliness). Using the De Jong Gierveld Loneliness Scale, Herrara-Murillo and Rodriguez-Martinez [ 70 ] found younger participants ( < 35 years of age) reported slightly higher levels of loneliness (mean score = 7.88) compared with older adult participants (between 35–60 years of age) (mean score = 7.4). Rokach [ 47 , 48 ] found homeless youth, compared to young adults, had higher mean subscale scores on interpersonal isolation (3.43 vs. 2.84) and self-alienation (1.91 vs. 1.48).

Other studies among younger populations also described how young people with experiences of being unhoused and coping with SIL are significantly different than their housed counterparts and older adults. Histories of addiction, rejection, trauma, and violence were intertwined with loneliness for young people with experience of homelessness [ 48 , 50 , 51 , 52 ]. A study by Rokach [ 48 ] focusing on the experiences of loneliness among homeless youth in a Canadian urban city found that causes of loneliness included feelings of personal inadequacy, developmental deficits, unfulfilling intimate relationships, relocation, and social marginality, which are unique to these groups of individuals when compared with older adults.

Toolis et al. [ 33 ] examined how multi-faceted forms of structural inequities faced by self-identified women experiencing homelessness (i.e., stigmatization, violence, and child apprehension) drive social exclusion experiences from services, peers, and broader society. This study illustrated how organizational settings with a culture of acceptance, support and mutuality can help women develop positive affirming relationships with one another that can alleviate feelings of social isolation. In this analysis, participants highlighted how their transgender identity contributed to experiences of isolation and loneliness and how their experiences were driven by forms of oppression prevalent across social service spaces such as co-ed shelters [ 33 ].

Association between SIL and health status or outcomes

Among the quantitative studies, only 8 reported direct associations between SIL and health status or outcomes (See Table  3 ). All of these studies utilized cross-sectional analyses and only one [ 56 ] used health administrative data to ascertain health outcomes. The health status and outcomes examined in these studies varied and included self-rated health [ 74 ], subjective health status [ 66 ], current cigarette use [ 72 ], ICU and hospital mortality [ 56 ], physical health burden [ 40 ], and risk of mental ill-health [ 31 ]. Additionally, some studies also examined social distress indicators such as sleep patterns [ 85 ], and experiences with eviction [ 67 ] or readmission to housing programs [ 55 ].

SIL was significantly associated with physical and mental health outcomes for people with experiences of homelessness. Drum and Medvene [ 66 ] found a negative correlation between subjective health and SIL (r = -0.39, p > 0.03). SIL was associated with higher odds of reporting poor health and mental health among men (OR: 1.98, 95% CI 1.36–2.88), but not statistically significant for women (OR: 1.71, 95% CI 0.96–3.05) [ 74 ]. Another study found participants who reported being sick had a higher level of SIL than those who reported being healthy (OR: Sick 1.228(0.524) p < 0.05) [ 70 ].

Moreover, a study by Patanwala et al. [ 40 ] reported that participants in the moderate-high physical symptom burden category had a significantly higher SIL score than participants in the minimal-low physical symptom burden category (AOR 2.32, 95% CI 1.26–4.28)). In addition, homeless veteran participants who reported SIL were 1.36 more likely (95% CI: 1.04–1.78) to report readmission to the Homeless Program of the VA Caribbean Healthcare System when compared to those who did not report social isolation [ 55 ].

Furthermore, people with severe mental health problems are generally at higher risk of being socially isolated or feeling alone. For example, Rodriguez-Moreno [ 31 ] compared homeless adult women at high risk of mental-ill health (HW-MI) and homeless women not at high risk of mental-ill health (HW-NMI) and found that HW-MI participants reported feeling significantly lonelier than homeless women without this risk (OR: 0.24, 95% CI 0.09–0.64).

Association between SIL, substance use, and social distress

None of the quantitative studies investigated the association between SIL and substance use, despite the fact that substance use is a prevalent issue among people with homelessness experience. However, some of the qualitative studies discussed how SIL and substance use are interconnected among people with experiences of homelessness [ 86 ]. Lafuente [ 36 ] reported participants relapsed to alcohol and other risk behaviors due to SIL: “I 've started drinking and at this particular time. They offered to put me back into treatment and at this time I was not homeless…and I refuse it…the alcohol has really taken over me. " Another study discussed how substance use contributed to SIL for participants who identified as male [ 59 ]. Participants discussed how the use of substances affected their social relationships in different ways including added strain, limited availability of resources from social relationships, and the interplay between substance use and feelings of social isolation at earlier and later stages in life [ 59 ].

Regarding social distress, Cruwys et al. [ 71 ] found that the social isolation schema predicted lower social identification with homelessness services. Individuals with negative experiences with homelessness services were less likely to become socially engaged with new groups, and this relationship remained over time. SIL was also associated with poor or restless sleeping patterns, particularly among women with restless sleep compared to men as reported by Davis et al. [ 85 ] Moreover, Tsai et al. [ 67 ] found that measures of loneliness (percentage relative importance = 17.12) as measured by the shortened revised version 3 of the UCLA Loneliness Scale and severity of substance use (percentage relative importance = 16.93) were the most important variables associated with any lifetime eviction and lifetime homelessness. Participants also depicted signs of social distress due to SIL, including fear of dying alone. Studies by Bazari et al. [ 87 ] and Finlay, Gaugler and Kane [ 88 ] highlighted the unique challenges of older adults with homelessness experience, including concerns of dying alone. Van Dongen et al. [ 89 ] examined medical and nursing records from 61 adults receiving end-of-life care in shelter-based nursing care settings in the Netherlands and found that one quarter (n = 15) of patients died alone.

In this scoping review, we explored social isolation and loneliness (SIL) as an under-researched social determinant of health among individuals with experiences of homelessness or those who are marginally or vulnerably housed. We summarized findings from 52 studies published between 2000 and 2023. Our review detailed how these studies conceptualized SIL, including the scales and tools used for its measurement. We also reported on the prevalence of SIL and examined its associations with well-being, health and social outcomes, and substance use among people with experiences of homelessness.

Most studies included in this review were published in 2010 or later, which shows a growing interest in this area. However, studies that have a specific focus on SIL and associated health and social outcomes continue to be scarce. Only one-third of the studies included in this review identify SIL as their primary goal or one of their main research questions. Most of the quantitative studies used a cross-sectional methodology, and we did not find any intervention studies that addressed SIL among people with histories of homelessness as the primary or secondary outcome. Despite these limitations, the studies summarized in this review provide an important overview of SIL among people with histories of homelessness.

Three main theoretical corpuses were used to conceptualize SIL in the context of housing and homelessness experience across the studies: theory of social exclusion [ 36 , 39 , 58 ], theory of social disaffiliation [ 36 ], and theory of digital exclusion (also called digital divide) [ 90 ]. Some studies mentioned structural stigma and alienation to explain systematic biases, policies and practices resulting in reinforcing SIL among people with histories of homelessness, particularly among people who use alcohol and other substances [ 37 ]. This suggests that SIL is a complex issue, embedded in a larger societal problem of socio-economic exclusion, which makes people who are marginalized by structural systems feel invisible, powerless and detached from society. Moreover, the shift to a more digital world, which requires some digital literacy and access to information and communication technologies, may lead to increased feelings of SIL and barriers to services for people with homelessness experience.

We found that the proportion of studied populations who reported SIL varies largely ranging from 25 to 90% across studies. However, the range of measurement scales used to measure SIL across studies limits consistency and comparability between studies. In addition, there are questions around the suitability and fitness of certain tools for measuring SIL among individuals who have experienced homelessness. For instance, the UCLA Loneliness Scale has been found to be challenging for Australians with cognitive disabilities [ 91 ], which is a common issue among some individuals experiencing homelessness [ 92 ]. Likewise, some tools focus on a single dimension [ 93 ] or use a single question [ 94 ], which limits their ability to capture the complex and multifaceted nature of SIL. A study conducted by Bower [ 75 ] identified several factors affecting the effectiveness and validity of SIL measures in marginalized groups while using the Social and Emotional Loneliness Scale for Adults (SELSA-S) with 128 homeless adults in Sydney, Australia. These factors included variations in loneliness dimensions (such as social, family, and romantic loneliness), the cognitive abilities of participants to understand and answer questions, and the necessity for cultural adaptation, as meanings can differ across countries and cultures.

Studies included in this review also showed how personal identities play a role in an individual’s perception of their experiences of SIL and how it affects them as they navigate health, social and housing services. In one study [ 33 ], a participant described how they were rejected from a shelter agency because they identified as transgender. This raises important questions about the inclusivity and equity of service provision and suggests that personal identity can significantly affect one's ability to access essential support. Other studies showed relationships between SIL, age and self-identifying as a woman. These findings are not only consistent with broader research [ 95 , 96 ] but also underscore deeper, often systemic issues within social service frameworks [ 97 ]. The intersection of SIL with identity-related factors indicates that care and social services may be insufficiently trained and equipped to address the unique challenges faced by different demographic groups [ 98 , 99 ].

Findings from studies included in this review show a relationship between SIL, health and social distress among people with homelessness experience. SIL was associated with poor sleeping patterns [ 85 ], and with lower social identification with homelessness services [ 71 ], with any lifetime eviction and lifetime homelessness [ 67 ]. Related to health, SIL is negatively associated with subjective health [ 66 ], self-reported illness [ 70 ], health and mental health among both men and women [ 74 ], severe mental health problems [ 31 ] and substance use [ 59 ]. These findings are in line with what has been reported in studies carried out in other population groups, where an association has been found between SIL and health behavior and physical heath [ 1 , 100 , 101 ] including risk of heart disease, stroke, hospitalization, death and mental health [ 3 , 102 , 103 , 110 , 111 ].

There are several potential reasons for the relationship between SIL, negative health [ 6 ] and desire to participate in social and physical activities [ 101 , 104 ] or use healthcare services, thereby exacerbating pre-existing conditions or contributing to the emergence of new health problems [ 105 , 106 , 109 ]. For instance, some studies indicate that SIL can lead to reduced participation in social and physical activities, as well as lower utilization of social and healthcare services [ 43 , 107 ]. This diminished engagement can subsequently heighten the likelihood of developing or worsening mental health issues, such as depression and anxiety [ 108 ].

Additionally, individuals with SIL combined with homelessness experience often suffer from a significant loss of self-esteem, self-worth, and self-confidence [ 36 , 52 ].This situation can be worsened when individuals perceive that their SIL is related to ageism, racial or ethnic background or discrimination based on gender identity or sexual orientation [ 39 ]. The interplay of these factors can result in increased social withdrawal, decreased physical activity, and diminished engagement with healthcare services, all of which further elevate the risks for a range of physical and mental health problems [ 59 , 103 ], including obesity and associated health issues, depression, food and sleeping issues, suicidal ideation and premature deaths [ 82 , 83 , 84 ].

Gaps in the existing literature and recommendations

We identified several gaps in the studies included in this review. First, SIL was not the primary objective of the majority of the included studies. Thus, there was limited interest to provide a clear definition of SIL or a detailed description of its measurement. Second, the quantitative studies used different measurement tools, with some of them not primarily conceived to measure SIL, thus making comparisons across studies difficult. Additionally, many of these studies used cross-sectional design and covered very small and not generally representative samples. Thus, the estimation of the prevalence of SIL among people with homelessness experience and living in supportive or social housing remained exploratory, and the studies cannot establish causality between SIL and physical or mental health conditions or with social wellbeing. Studies that are mainly focused on SIL, and more longitudinal and targeted interventions are required to better understand the potential links between SIL and these outcomes. Future studies must also include more specific and objective health outcomes like depression or anxiety disorder, drug and alcohol disorder, service use, suicidal ideation and attempts or premature aging, which are prevalent among people with homelessness experience [ 86 ]. Third, the existing literature is very limited in analyzing how SIL impacts some populations differently, in particular women [ 112 , 113 ] and non-binary or gender-diverse groups [ 114 , 115 ]. Mayock and Bretherton [ 116 ] discussed how gender shapes the trajectories of women experiencing homelessness. Research has demonstrated that women are often affected by and respond to homelessness in different ways than males, and thus have different experiences of homelessness [ 112 ]. Self-identified queer people/people who are sexually diverse and/or trans- and gender-diverse and are experiencing homelessness similarly have a distinct experience [ 114 ]. Hail-Jares et al. [ 115 ] discussed how queer youth experience higher rates of homelessness and greater housing instability compared to their cisgender and heterosexual counterparts. Gender diverse youth who must choose between staying in the family home, maintaining their LGBTQ2S identity, and continuing to be physically and mentally safe, often consider homelessness as the perceived safer option [ 117 ]. In addition, future homelessness-related studies examining SIL should seek to make methodological distinctions that reflect differences based on gender identity and not consider queer/gender-diverse people as a homogenous group.

Finally, we found no studies that specifically explored SIL among people with homelessness experience from a particular ethnicity. Given the significant impact of ethnicity on experiences of homelessness, it is likely that ethnicity plays an important role or has a multiplier effect in the way SIL is experienced [ 118 , 119 ]. There is also a lack of geographic and regional representation across the studies, since most of them were conducted in the US and Canada. Further, research that includes diverse population and geographic regions would help inform broader policy change and programming for people from different cultural and ethnic groups.

Limitations

This study has some limitations. First, to ensure feasibility, the review exclusively included peer-reviewed articles published in English, French, and Spanish from the year 2000 onwards. This restriction could introduce publication bias and potentially omit relevant studies published in other languages or formats. Second, the review utilized a broad definition of both homelessness experience and health outcomes. This inclusive approach allowed the incorporation of a diverse range of studies from various countries and methodological approaches. However, this broad scope might have introduced heterogeneity that complicates the synthesis of findings. This lack of standardized definitions and measurements makes it challenging to compare and aggregate results across different studies.

Conclusions

Despite these limitations, our scoping review is the first in the literature to provide a deep and nuanced understanding of SIL that accounts for the theoretical conceptualizations, the measurement and complex interplay of identity and systemic barriers among people with homelessness experience. Our review points to the critical need for more research to better understand SIL among different populations experiencing marginalization and to assess the relationship between SIL and health and social outcomes. Testing and validating SIL measurement tools would help to improve the quality of evidence. Additional research with diverse populations and countries is urgently needed, along with interventional studies to build evidence to inform the development of actionable strategies to address SIL among people with homelessness experience. As implications for public policies, these studies highlight that SIL is a prevalent and significant issue in the lives of people with homelessness experience. There is a lack of awareness and training of healthcare providers to recognize and understand SIL as a health risk factor in addition to other challenges for marginalized groups and in particular people with homeliness experience. It is crucial to develop and implement policies to create awareness and best practices that are sensitive to SIL as a growing public health issue and to advocate for systemic changes that address the root causes of discrimination and exclusion, in particular among people with homelessness experience or housing precarity.

Availability of data and materials

All data generated or analysed during this study are included in supplementary information files.

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Acknowledgements

The authors thank the members of MAP Centre for Urban Health Solutions Community Expert Group for participating in reviewing the scoping review protocol and manuscript. We also thank Parvin Merchant the Director of Support Services Department at Houselink and Mainstay Community Housing for her input and support of this project. Lastly, we are grateful for the review by Jesse I.R. Jenkinson at MAP Centre for Urban Health Solutions.

This research was supported by a Canadian Institutes of Health Research (CIHR) Foundation Grant (FDN-167263) awarded to Stephen Wesley Hwang, and a Canadian Institutes of Health Research (CIHR)- Fellowship Award (RAT-171348) in partnership with Canada Mortgage and Housing Corporation awarded to James Lachaud. Stephen Wesley Hwang is supported by funding from the Canada Research Chairs Program. The funding institutions had no role in the collection, analysis, and interpretation of the data, nor in the preparation, revision, or approval of the present manuscript. The views expressed in this publication are solely those of the authors.

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JL had full access to all of the data and takes responsibility for the integrity of the data and the accuracy of the results. JL, AY, and SH conceptualized and designed the review. JL, AY, MF, MP, EG, CZ, CM-L, and SW performed data acquisition, analysis, or interpretation. JL, AY, MF, MP, and EG drafted the manuscript. JL, AY, MF, MP, EG, CZ, CM-L, and SW performed critical revision of the manuscript for important intellectual content. JL, AY, EG, and SH were responsible for administrative, technical, or material support. JL and SH obtained funding.

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Lachaud, J., Yusuf, A.A., Maelzer, F. et al. Social isolation and loneliness among people living with experience of homelessness: a scoping review. BMC Public Health 24 , 2515 (2024). https://doi.org/10.1186/s12889-024-19850-7

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DOI : https://doi.org/10.1186/s12889-024-19850-7

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