Morgantown Department, West Virginia University School of Nursing, Morgantown, USA.
Am J Nurs. 2013 Sep;113(9):28-37; quiz 38. doi: 10.1097/01.NAJ.0000434169.53750.14.
Loneliness is a contributing factor to various health problems in older adults, including complex chronic illness, functional decline, and increased risk of mortality.
A pilot study was conducted to learn more about the prevalence of loneliness in rural older adults with chronic illness and how it affects their quality of life. The purposes of the data analysis reported here were twofold: to describe loneliness, chronic illness diagnoses, chronic illness control measures, prescription medication use, and quality of life in a sample of rural older adults; and to examine the relationships among these elements.
A convenience sample of 60 chronically ill older adults who were community dwelling and living in Appalachia was assessed during face-to-face interviews for loneliness and quality of life, using the University of California, Los Angeles (UCLA) Loneliness Scale (version 3) and the CASP-12 quality of life scale. Chronic illness diagnoses, chronic illness control measures, and medication use data were collected through review of participants' electronic medical records.
Overall mean loneliness scores indicated significant loneliness. Participants with a mood disorder such as anxiety or depression had the highest mean loneliness scores, followed by those with lung disease and those with heart disease. Furthermore, participants with mood disorders, lung disease, or heart disease had significantly higher loneliness scores than those without these conditions. Loneliness was significantly related to total number of chronic illnesses and use of benzodiazepines. Use of benzodiazepines, diuretics, nitrates, and bronchodilators were each associated with a lower quality of life.
Nurses should assess for loneliness as part of their comprehensive assessment of patients with chronic illness. Further research is needed to design and test interventions for loneliness.
孤独是导致老年人各种健康问题的一个因素，包括复杂的慢性疾病、功能下降和死亡率增加。
进行了一项试点研究，以更多地了解患有慢性疾病的农村老年人中孤独感的流行情况，以及它如何影响他们的生活质量。这里报告的数据分析有两个目的：描述孤独感、慢性疾病诊断、慢性疾病控制措施、处方药物使用情况和农村老年人的生活质量；并检查这些因素之间的关系。
对居住在阿巴拉契亚地区的 60 名患有慢性病的社区居住的老年慢性病患者进行了面对面访谈，评估其孤独感和生活质量，使用加利福尼亚大学洛杉矶分校（UCLA）孤独量表（第 3 版）和 CASP-12 生活质量量表。通过查阅参与者的电子病历收集了慢性疾病诊断、慢性疾病控制措施和药物使用数据。
总体平均孤独感得分表明存在明显的孤独感。患有焦虑或抑郁等情绪障碍的参与者孤独感得分最高，其次是患有肺部疾病和心脏病的参与者。此外，患有情绪障碍、肺部疾病或心脏病的参与者的孤独感得分明显高于没有这些疾病的参与者。孤独感与慢性疾病总数和苯二氮䓬类药物的使用显著相关。苯二氮䓬类药物、利尿剂、硝酸盐和支气管扩张剂的使用均与生活质量降低相关。
护士应将孤独感评估作为其对慢性疾病患者全面评估的一部分。需要进一步研究以设计和测试孤独感干预措施。
