Hand Carri, McColl Mary Ann, Birtwhistle Richard, Kotecha Jyoti A, Batchelor Diane, Barber Karen Hall
Assistant Clinical Professor in the School of Rehabilitation Science at McMaster University in Hamilton, Ont.
Associate Director of the Centre for Health Services and Policy Research and Professor in the School of Rehabilitation Therapy and Department of Public Health Sciences at Queen's University in Kingston, Ont.
Can Fam Physician. 2014 Jun;60(6):e322, e324-9.
To describe older adults who are frequent users of primary care services and to explore associations between the number of primary care visits per year and multiple dimensions that define social isolation.
Mailed, cross-sectional survey.
An urban academic primary care practice in Kingston, Ont.
Forty patients aged 70 years and older who attended 12 or more appointments in the previous year with residents, physicians, nurses, nurse practitioners, or registered practical nurses.
Social isolation (size of close social network, loneliness, satisfaction with social participation, frequency of social participation), past and future need for health services related to social issues, and health and functional variables.
The participants reported relatively low levels of loneliness, with a mean (SD) score of 4.1 (1.3) out of 9. Overall, 18.9% of participants reported having a small close social network, 45.9% of participants wanted to do more social activities, and 57.5% of participants were isolated according to at least 1 indicator. Some participants (23.1%) had received primary care services related to social issues, and most participants (54.5%) wanted these services in the future, including receiving information about other health services or community resources, or having discussions about loneliness, relationships, or social activities. Number of primary care visits was not associated with any of the 4 indicators of social isolation.
Social isolation in older, frequent users of primary care services might be more common than previously thought, particularly the aspect of dissatisfaction with social participation. Expanded primary care services and referrals to other services might help to address this population's desires for services related to social issues. Future research could examine the social needs of older primary care attenders and the feasibility of providing related interventions in primary care settings.
描述初级保健服务的频繁使用者中的老年人,并探讨每年初级保健就诊次数与定义社会隔离的多个维度之间的关联。
邮寄横断面调查。
安大略省金斯顿的一家城市学术性初级保健机构。
40名年龄在70岁及以上的患者,他们在上一年与住院医生、内科医生、护士、执业护士或注册实用护士进行了12次或更多次预约就诊。
社会隔离(亲密社交网络规模、孤独感、对社会参与的满意度、社会参与频率)、过去和未来与社会问题相关的健康服务需求以及健康和功能变量。
参与者报告的孤独感水平相对较低,在9分制中平均(标准差)得分为4.1(1.3)分。总体而言,18.9%的参与者报告亲密社交网络较小,45.9%的参与者希望开展更多社交活动,57.5%的参与者至少根据一项指标被判定为处于社会隔离状态。一些参与者(23.1%)曾接受过与社会问题相关的初级保健服务,大多数参与者(54.5%)未来希望获得这些服务,包括获取有关其他健康服务或社区资源的信息,或就孤独感、人际关系或社交活动进行讨论。初级保健就诊次数与任何一项社会隔离指标均无关联。
在初级保健服务的老年频繁使用者中,社会隔离可能比之前认为的更为普遍,尤其是对社会参与不满意这一方面。扩大初级保健服务并转诊至其他服务可能有助于满足这一人群对与社会问题相关服务的需求。未来的研究可以考察老年初级保健就诊者的社会需求以及在初级保健环境中提供相关干预措施的可行性。