“We see each other from a distance”: Neighbourhood social relationships during the COVID-19 pandemic matter for older adults’ social connectedness

IntroductionWe extend previous research to illustrate how individual, interpersonal and neighbourhood factors in a high-density urban setting in Vancouver, Canada, shape social connectedness experiences of community-dwelling older adults during the first wave of the COVID-19 pandemic.MethodsWe conducted 31 semi-structured interviews and collected objective measures of loneliness and social connectedness (surveys).ResultsThree dimensions of the neighbourhood environment influenced social connectedness: (i) interactions with neighbours, (ii) involvement with neighbourhood-based organizations, and (ii) outdoor pedestrian spaces. Seventy-one percent of participants felt a strong sense of belonging to their local community, while 39% were classified as high or extremely lonely.SummaryMany participants leveraged pre-existing social ties to maintain connections during the pandemic. However, volunteer outreach was vital for more isolated older adults. Although many participants felt lonely and isolated at times, the relative ease and accessibility with which they could connect with others in their neighbourhood environment, may have helped mitigate persistent loneliness.ConclusionStrategies that foster social connectedness over the longer term, need to prioritize the needs of older adults who face multiple barriers to equitable social participation.     

边疆少数民族地区寄宿制小学生同伴关系、亲子沟通与孤独感之间的关系

目的:分析边疆少数民族地区的农村寄宿制小学生同伴关系、亲子沟通和孤独感之间的关系,探讨影响孤独感的内在机制。方法:采用同伴关系量表、亲子沟通问卷和孤独感量表对463名边疆少数民族地区寄宿制小学生进行调查,用结构方程对三者之间的因果关系构建模型,并用收集来的数据进行模型拟合。结果:1同伴关系、亲子沟通和孤独感有密切的相关关系;2亲子沟通对孤独感产生直接影响,路径系数分别为-0.45和-0.30;3同伴关系是亲子沟通对孤独感产生影响的中介因素,亲子沟通通过同伴接受和同伴恐惧自卑影响孤独感的路径系数分别为-0.47和0.57。结论:亲子关系、同伴关系和孤独感之间的关系表现为亲子关系不仅对孤独感产生直接影响,还通过同伴关系这一中介对孤独感产生影响。     

The Loneliness of Aging

Isolation and loneliness have become buzz words when discussing older adults during the coronavirus disease pandemic; yet, these are age-old problems. Both have been studied extensively, yet there currently is no rapid or succinct tool that can be used in the emergency department to screen for either, or a consensus of evidence-based ways to correct these issues. This is of concern because both loneliness and social isolation have been linked to poor health. Poor health, in turn, can lead to worse isolation and loneliness. These health problems may lead to the older adult seeking care in the emergency department where screening and initial treatment could be initiated. Suggestions for questions that emergency nurses can ask to identify an older adult who is lonely or suffers from social isolation, as well as steps to consider when encountering the older adult with complaints of loneliness and/or social isolation, are provided, with the realization that these are only the first steps of many that would need to be taken. The purpose of this article is to bring forward updated information that discusses loneliness and social isolation in older adults, a timely priority during the coronavirus disease pandemic and often listed as a factor in older adult deaths. A review of relevant screening tools for use in the emergency department are provided.     

孤独感在社区老年慢性病患者述情障碍和抑郁间的中介效应研究

背景　抑郁和孤独感是老年慢性病患者普遍存在的严重心理问题,述情障碍患者因“情感表达不能”可能会加剧负性心理体验,但其关联机制尚不明确。目的　探讨孤独感在社区老年慢性病患者述情障碍和抑郁间的中介效应。方法　2020年6-8月采用便利抽样法选取合肥市4个社区（望湖城社区、逍遥津社区、三孝口社区、亳州路社区）的509例社区老年慢性病患者为研究对象。采用一般资料调查表、多伦多述情障碍量表（TAS-26,评估述情障碍或情感表达困难）、UCLA孤独感量表（评估对社会交往的渴望与实际水平的差距而产生的孤独感）、中文版患者健康问卷抑郁自评量表（中文版PHQ-9,评估过去２周内抑郁症状的严重程度）进行问卷调查。根据TAS-26得分将患者分为高述情障碍组（TAS-26得分≥平均分）、低述情障碍组（TAS-26得分<平均分）。采用IBM SPSS 19.0和Amos 23.0软件进行数据分析。结果　共回收问卷509份,回收有效问卷492份,有效回收率为96.7%。社区老年慢性病患者中文版PHQ-9得分≥10分的有59例,抑郁症状发生率为12.0%（59/492）。社区老年慢性病患者TAS-26、UCLA孤独感量表、中文版PHQ-9得分分别为（71.8±8.3）、（36.6±8.5）、（6.0±3.2）分,Pearson相关分析结果显示,TAS-26与UCLA孤独感量表得分、中文版PHQ-9得分呈正相关（P<0.01）;UCLA孤独感量表得分与中文版PHQ-9得分呈正相关（P<0.01）。社区老年慢性病患者TAS-26得分的平均值为71.82分,TAS-26得分≥71.82分的患者共243例（高述情障碍组）,TAS-26得分<71.82分的患者共259例（低述情障碍组）。高述情障碍组患者UCLA孤独感量表、中文版PHQ-9得分均高于低述情障碍组（P<0.05）。中介效应检验结果显示,社区老年慢性病患者述情障碍对抑郁有正向影响（β=0.25,P<0.01）,述情障碍对孤独感有正向影响（β=0.68,P<0.01）,孤独感对抑郁有正向影响（β=0.17,P<0.01）。孤独感在述情障碍和抑郁间的标准化间接效应为0.12,述情障碍对抑郁的标准化直接效应为0.25,中介效应占总效应的32.43%。结论　述情障碍能加重社区老年慢性病患者的孤独感和抑郁水平,且孤独感在述情障碍和抑郁间起部分中介作用。因此,社区管理者应早期识别老年慢性病患者的孤独感情绪,积极处理述情障碍对孤独的影响,从而降低其抑郁水平。     

农村失能老年人情绪社交孤独感与家庭功能的相关性研究

目的 探讨农村失能老年人情绪社交孤独感状况，并分析家庭功能对失能老年人孤独感的影响。方法 采用便利抽样的方法，抽取329名开封市农村失能老年人为调查对象，采用一般资料调查表、情绪社交孤独感量表（ESLI）、家庭关怀度指数问卷（APGAR）进行调查。结果 农村失能老年人情绪社交孤独感总分为（30.72±15.24）分，家庭功能总分为（5.85±1.73）分。家庭功能良好组有129人（占39.2%），家庭功能良好组失能老年人情绪社交孤独感得分低于家庭功能障碍组（均P＜0.01）。失能老年人孤独感总分及各维度得分与家庭功能呈负相关，相关系数为 - 0.180～ - 0.909（均P＜0.01）。分层回归分析显示，老年人失能程度、与照顾者关系、家庭功能是失能老年人情绪社交孤独感的重要影响因素，家庭功能可独立解释失能老年人孤独感37.5%的变异量。 结论 农村失能老年人情绪社交孤独感较重，孤独感与家庭功能呈负相关。协助失能老年人建立良好的家庭功能有助于改善其孤独感。     

Mental well-being: A 16-year follow-up among older residents in Jyväskylä

This study investigated changes in perceived depression, anxiety and loneliness during a 16-year follow-up among elderly Jyväskylä residents born in 1914-1923. A further concern was with how perceived atmosphere in the formative environment was reflected in depression, anxiety and loneliness in old age. The first phase of the study took place in 1988 when interviews were conducted with 635 persons (241 men and 394 women). Depression and anxiety were assessed using the Finnish modified version of Beck's 13-item depression scale (RBDI), which was completed fully by 74% of the interviewees. Loneliness was assessed with a single four category item. In the second phase of the study in 1996, interviews were conducted with 410 persons, of whom 94% filled the RBDI questionnaire. In the third phase in 2004, the number of interviewees was 220 and the response rate 82%. There were no significant changes in the number of people with depressive symptomatology and anxiety, except in 1996 when the proportion of men with mild and moderate depression almost doubled. The number of men and women who felt lonely increased significantly during the 16-year follow-up. People who said they were lonely also had more depression and anxiety than others. People who had grown up in warm and safe environment were the most balanced mentally. The presence or absence of warmth and safety in the formative environment is reflected in mental well-being even at a very old age.     

Effects of social isolation,loneliness and frailty on health outcomes and their possible mediators and moderators in community-dwelling older adults: A scoping review

Background/ObjectivesOver the past decade, the quantity and quality of social relationships in later life have become one of the main challenges facing an aging society. Our aims were to map and synthesize the literature addressing the effects of loneliness, three aspects of social isolation, including social networks, social support, and social participation, and frailty on health outcomes and their mediators and moderators among older adults.MethodsWe conducted a scoping review and searched for articles published in English and French from 2001 up to 2019 in the following databases: Medline, Embase, CINAHL Plus, Scopus, Web of Science and PsycINFO.ResultsOur database search initially resulted in 4001 articles of which 1832 were excluded; 26 were eligible. Most of the included studies revealed associations between social isolation, loneliness and frailty. The majority of studies found evidence of associations between frailty and their adverse outcomes; however, only few studies found a relationship between social isolation and health outcomes. In spite of the established link between frailty and adverse outcomes, no study looked at how social isolation and loneliness can alter adverse outcomes of frailty. No study investigated the role of frailty or social isolation and loneliness as a mediator on the pathway related to health.ConclusionsEvidence is limited in examining the role of frailty or social isolation and loneliness as a moderator and mediator. Longitudinal research combining both social isolation and loneliness are warranted to explore whether social isolation or loneliness has more deleterious effects on frailty and health outcomes.     

造血干细胞移植患者保护性隔离期间孤独感的研究进展

造血干细胞移植（hematopoietic stem cell transplantation,HSCT）患者保护性隔离期间多具有孤独感,对其健康结局会造成不良影响。该文对HSCT患者保护性隔离期间孤独感的研究进行综述,包括孤独感的概念、相关理论、评估工具、影响因素及干预措施等。目前,国内相关研究较少,建议未来开展HSCT患者孤独感现状、影响因素及其与患者健康结局间关系的研究,为构建系统化干预方案提供依据。