孤独感对养老机构老年人生活质量的影响:抑郁与衰弱的链式中介作用

目的 探究抑郁与衰弱在孤独感与养老机构老年人生活质量之间的中介作用。方法 使用老年抑郁量表、Tilburg衰弱量表、孤独感量表及SF-12简明健康调査量表对183名养老机构老年人进行测查,采用偏差校正的百分位 Bootstrap 法（Process 插件）进行链式中介检验。结果 孤独感与抑郁、衰弱呈正相关（r¹=0.71,r²=0.60,P＜0.01）,与生活质量呈负相关(r=-0.61,P＜0.01);回归模型显示,孤独感对养老机构老年人生活质量的直接效应有统计学意义（β=-0.14,P<0.05）,抑郁、衰弱在孤独感与生活质量之间的中介作用均有统计学意义（β¹=-0.11,β²=-0.16,P<0.05),且抑郁-衰弱的链式中介作用也有统计学意义（β=-0.19,P<0.05）。结论 孤独感既可直接预测老人的生活质量,又可分别通过抑郁、衰弱的中介作用,以及抑郁-衰弱的链式中介作用间接预测生活质量。     

Loneliness and depression among older European adults: The role of perceived neighborhood built environment

Depression and loneliness act in a synergistic way among older adults. We tested two indicators of the perceived neighborhood built environment (BE) as moderators of the association between these conditions in older European adults. Positive perceptions of neighborhood BE were related to lower levels of loneliness but not to major depressive disorder (MDD). Reporting low BE usability was significantly related to a higher likelihood of feeling lonely except for those suffering from MDD, whereas reporting low BE walkability was significantly related with a high likelihood of loneliness particularly among those with MDD. Therefore, improving neighborhood BE and, specifically, its walkability, might result in a reduction in the prevalence of loneliness.     

Risk factors for loneliness in patients with cancer: A systematic literature review and meta-analysis

ObjectiveTo systematically review the literature on the severity and risk factors for loneliness in adult cancer patients.MethodsWe systematically reviewed quantitative studies addressing loneliness in cancer patients. Exclusion criteria were absence of a validated loneliness questionnaire, and studies that focused on loneliness determined by specific circumstances, and not cancer in general (e.g. appearance concerns, cultural and language barriers, requiring palliative care). We searched PsycINFO, CINAHL, Embase, Cochrane Library, and Pubmed in compliance with the predefined in- and exclusion criteria. The search, quality appraisal, and data extraction were performed by two independent reviewers. Weighted mean scores were calculated by using random effects adjusted inverse variance weighting.ResultsWe included 15 studies. In 13 studies the UCLA loneliness scale was used (range 20–80; higher scores indicate higher loneliness). The weighted mean loneliness score was 38.26 (95% CI: 35.51–41.00), which corresponds to moderate loneliness. Time since diagnosis was positively associated with degree of loneliness. Other cancer-related factors, such as cancer site, treatment type, or stage of disease were not associated with loneliness. The non-cancer related determinants of loneliness in cancer patients that emerged from our review were being unmarried (people who have never been married, are widowed or divorced), and lack of psychological or social support.ConclusionOur findings suggest that the level of loneliness rises with increasing time after cancer diagnosis. Furthermore, social functioning emerged as a consistent theme, for which it was shown that lack of social support was associated with increasing levels of loneliness.     

Loneliness and risk of mortality: A longitudinal investigation in Alameda County,California

We investigated the prospective impact of self-reported loneliness on all-cause mortality, mortality from ischemic disease and mortality from other cardiovascular diseases. We tested these effects through GEE binomial regression models applied to longitudinal data from the Alameda County Study of persons aged 21 and over arranged into person-years. Controlling for age and gender, the chances of all-cause mortality were significantly higher among respondents reporting that they often feel lonely compared to those who report that they never feel lonely. Frequent loneliness was not significantly associated with mortality from ischemic heart disease but more than doubled the odds of mortality from other ailments of the circulatory system in models controlling for age and gender. Subsequent models showed that physical activity and depression may be important mediators of loneliness-mortality associations. Finally, we find support for the contention that chronic loneliness significantly increases risk of mortality but also find reason to believe that relatively recent changes in feelings of loneliness increase risk of mortality as well.     

Loneliness in urban neighbourhoods: an Anglo-Dutch comparison

Past studies in the UK and the Netherlands indicate that loneliness varies significantly according to characteristics of older people’s residential environment. This raises questions regarding potential neighbourhood influences on individuals’ social relationships in later life. This article examines neighbourhood influences on loneliness, using multiple classification analysis on comparable empirical data collected in the UK and the Netherlands. UK data arise from a survey of 501 people aged 60+ in deprived neighbourhoods of three English cities. Netherlands data derive from the NESTOR Living Arrangements and Social Network survey, with a sub-sample of 3,508 people aged 60+ drawn from a nationally representative sample of older people, living in 11 municipalities. Both surveys incorporated the 11-item De Jong Gierveld Loneliness Scale. In addition to neighbourhood characteristics and indicators of health and social embeddedness, a typology of eight groups of persons was developed that accounted for individuals’ age, sex, and partner status. While 13% of participants in the UK were severely lonely, the proportion in the Netherlands was just four per cent. Mean loneliness scores in the UK varied significantly between the neighbourhoods under investigation. Additionally, the evaluated quality of the residential neighbourhood accounted for a relatively large degree of variance in loneliness in both countries.     

Loneliness in mid-life and older adults from ethnic minority communities in England and Wales: measure validation and prevalence estimates

We investigated the prevalence of loneliness among 1206 adults aged 40 + from six minority communities in England and Wales: Black Caribbean, Black African, Indian, Pakistani, Bangladeshi and Chinese. Replicating the approach from the previous studies, we demonstrate robust acceptability, reliability and validity for both the six-item De Jong Gierveld (DJG) and single-item loneliness scales in our six ethnic groups. The prevalence of loneliness using a single-item question (loneliness reported as often/always) ranges from 5% (Indian) to 14% (Chinese) compared with approximately 5% for the general population aged 40 + in Britain. Levels of loneliness are very much higher using the DJG scale. Using a loneliness threshold score of 5 +, the percentage ranged from 13% (Indian) to 36% (Chinese). We explored the importance of six established loneliness vulnerability factors for our sample using regression modelling. Three factors were not associated with loneliness—number of children, gender and health rating, and three factors were protective: younger age, being married and low financial strain. The addition of ethnicity did not change these relationships or enhance statistical power of our models. Being a member of the African Caribbean group was protective against loneliness but not for the other groups included in our study. We suggest that exposure to loneliness vulnerability factors rather than ethnicity per se or measurement artefact underpins differences in loneliness across ethnic groups.Electronic supplementary materialThe online version of this article (10.1007/s10433-020-00564-9) contains supplementary material, which is available to authorized users.     

Cosmic transcendence, loneliness, and exchange of emotional support with adult children: a study among older parents in The Netherlands

Gerotranscendence defines a shift in meta-perspective from earlier materialistic and pragmatic concerns, toward more cosmic and transcendent ones in later life. Population-based studies that have empirically examined this concept using Tornstam’s gerotranscendence scale, highlight cosmic transcendence as a core component, which includes a sense of belongingness with past and future generations. Such generative concerns may increase expectations regarding the quality of the bond with one’s children in later life. This study examined whether the association between emotional support exchanged with children and feelings of loneliness later in life varied by the degree of cosmic transcendence of the older parent. Data from 1,845 older parents participating in a population-based study living in The Netherlands were analyzed from the 1995/1996 cycle of the Longitudinal Aging Study Amsterdam. Interviews included self-report measures of cosmic transcendence, loneliness, emotional support exchanged with children, health indicators, and marital status. Results indicated that a negative association between loneliness and level of emotional support exchanged with children was more pronounced among older parents with higher cosmic transcendence scores, in particular among the married. It is argued that cosmic transcendence reflects a sense of generativity and an increased emotional dependency on children in later life. Under favorable social conditions (supportive relationships with children and being married) cosmic transcendent views had a positive impact on social well-being in later life. When children no longer met emotional needs of older parents, cosmic transcendence increased feelings of loneliness.     

生活满意度在农村学生住宿类型与孤独感中调节/中介效应的分析

目的 探讨生活满意度在农村地区中小学生不同住宿类型与孤独感中的调节/中介效应,为农村中小学生心理卫生问题干预提供理论参考.方法 以农村中小学生为调查对象,采取现况研究设计,应用现场匿名问卷调查法收集资料,内容包括一般健康情况、儿童孤独量表、多维青少年生活满意度问卷.结果 住校生的孤独感评分(35.0±9.5)明显高于住家生(33.1±10.1)(P=0.000),而住校生的学校满意度(33.5±6.3)、朋友满意度(42.1±6.2)、自我满意度(32.4±5.0)评分明显低于住家生(分别为35.9±6.6、42.9±6.6、32.9±5.3)(P<0.01、P<0.01、P<0.05);住宿类型与孤独感评分的关系完全被学校满意度中介[孤独感的标准回归系数从0.043(P<0.05)降低到0.021(P>0.05)],部分被朋友满意度和自我满意度中介.调节效应分析发现,朋友满意度、自我满意度、学校满意度对寄宿制学校与孤独感评分关系的调节效应均无统计学意义.结论 住宿类型和生活满意度对巾小学生孤独感有良好的预测作用,学校满意度在住宿类型与孤独感中完全中介效应显著,对中小学生孤独感的干预可从这些方面着手.     

Anxiety,Social Deficits,and Loneliness in Youth with Autism Spectrum Disorders

The purpose of this study was to explore relationships among anxiety, loneliness, and degree of social skill deficit in a sample of youth with autism spectrum disorders (ASD). Participants (N = 20) were between 7 and 14 years of age, verbal, and had low average or higher assessed intelligence (average IQ = 92 ± 14.41). Youth who self-reported elevated levels of anxiety reported greater feelings of social loneliness. Those participants earning above average total anxiety scores reported significantly more loneliness than those with less anxiety (F = 6.60, p < .05). A significant relationship between parent-reported child withdrawal and depression and social disability also was found. Recommendations for assessment of co-occurring psychiatric problems in youth with ASD are offered.