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处于孤立状态:体弱老年人的孤独体验

Being in a Bubble: the experience of loneliness among frail older people.

作者信息

Taube Elin, Jakobsson Ulf, Midlöv Patrik, Kristensson Jimmie

机构信息

Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Faculty of Medicine, Lund University, Malmö, Sweden.

Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.

出版信息

J Adv Nurs. 2016 Mar;72(3):631-40. doi: 10.1111/jan.12853. Epub 2015 Nov 16.

Abstract

AIM

The aim of this study was to explore the experience of loneliness among frail older people living at home.

BACKGROUND

Loneliness is a threat to the physical and psychological well-being with serious consequences if left unattended. There are associations between frailty and poor psychological well-being, implying that frail older people who experience loneliness are vulnerable.

DESIGN

Qualitative content analysis, focusing on both latent and manifest content.

METHOD

Frail older people (65+ years), living at home and who have experienced various levels in intensity of loneliness, were purposively selected from a larger interventional study (N = 12). For this study, 'frail' means being dependent in activities of daily life and having repeated contacts with healthcare services. Data were collected between December 2009-August 2011. Semi-structured interviews were performed, audio recorded and transcribed verbatim.

FINDINGS

The analysis resulted in the overall theme 'Being in a Bubble', which illustrates an experience of living in an ongoing world, but excluded because of the participants' social surroundings and the impossibility to regain losses. The theme 'Barriers' was interpreted as facing physical, psychological and social barriers for overcoming loneliness. The theme 'Hopelessness' reveals the experience when not succeeding in overcoming these barriers, including seeing loneliness as a constant state. A positive co-existing dimension of loneliness, offering independence, was reflected in the theme 'Freedom'.

CONCLUSION

The findings suggest that future strategies for intervening should target the frail older persons' individual barriers and promoting the positive co-existing dimension of loneliness. When caring, a person centred approach, encompassing knowledge regarding physical and psychological aspects, including loneliness, is recommended.

摘要

目的

本研究旨在探索居家体弱老年人的孤独体验。

背景

孤独对身心健康构成威胁,若不加以关注会产生严重后果。体弱与心理健康不佳之间存在关联,这意味着经历孤独的体弱老年人易受伤害。

设计

定性内容分析,关注潜在内容和显性内容。

方法

从一项规模更大的干预性研究(N = 12)中,有目的地选取居家且经历过不同程度孤独感的体弱老年人(65岁及以上)。在本研究中,“体弱”指在日常生活活动中存在依赖且与医疗服务有多次接触。数据收集于2009年12月至2011年8月期间。进行了半结构化访谈,进行音频录制并逐字转录。

结果

分析得出总体主题“处于泡沫之中”,这体现了一种生活在现实世界中却因参与者的社会环境以及无法挽回损失而被排除在外的体验。“障碍”主题被解释为在克服孤独方面面临身体、心理和社会障碍。“绝望”主题揭示了在未能成功克服这些障碍时的体验,包括将孤独视为一种持续状态。孤独的一个积极并存维度,即提供独立性,在“自由”主题中得到体现。

结论

研究结果表明,未来的干预策略应针对体弱老年人的个体障碍,并促进孤独的积极并存维度。在护理时,建议采用以人为主的方法,包括了解身体和心理方面的知识,其中也包括孤独方面的知识。

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