Theeke Laurie A, Mallow Jennifer A, Moore Julia, McBurney Ann, Rellick Stephanie, VanGilder Reyna
Department of Adult Health, School of Nursing, West Virginia University, Morgantown, WV, USA.
Department of Physiology, West Virginia University, Morgantown, WV, USA.
Int J Nurs Sci. 2016 Sep;3(3):242-251. doi: 10.1016/j.ijnss.2016.08.004. Epub 2016 Aug 20.
Loneliness is a biopsychosocial determinant of health and contributes to physical and psychological chronic illnesses, functional decline, and mortality in older adults. This paper presents the results of the first randomized trial of LISTEN, which is a new cognitive behavioral intervention for loneliness, on loneliness, neuroimmunological stress response, psychosocial functioning, quality of life, and measures of physical health.
The effectiveness of LISTEN was evaluated in a sample population comprising 27 lonely, chronically ill, older adults living in Appalachia. Participants were randomized into LISTEN or educational attention control groups. Outcome measures included salivary cortisol and DHEA, interleukin-6, interleukin-2, depressive symptoms, loneliness, perceived social support, functional ability, quality of life, fasting glucose, blood pressure, and body mass index.
At 12 weeks after the last intervention session, participants of the LISTEN group reported reduced loneliness ( = 0.03), enhanced overall social support = 0.05), and decreased systolic blood pressure ( = 0.02). The attention control group reported decreased functional ability ( = 0.10) and reduced quality of life ( = 0.13).
LISTEN can effectively diminish loneliness and decrease the systolic blood pressure in community-dwelling, chronically ill, older adults. Results indicate that this population, if left with untreated loneliness, may experience functional impairment over a period as short as 4 months. Further studies on LISTEN are needed with larger samples, in varied populations, and over longer periods of time to assess the long-term effects of diminishing loneliness in multiple chronic conditions.
孤独是健康的生物心理社会决定因素，会导致老年人身体和心理慢性疾病、功能衰退及死亡。本文介绍了“倾听”（LISTEN）首次随机试验的结果，“倾听”是一种针对孤独的新型认知行为干预措施，涉及孤独感、神经免疫应激反应、心理社会功能、生活质量及身体健康指标。
在阿巴拉契亚地区生活的27名孤独、患有慢性病的老年人样本群体中评估“倾听”的有效性。参与者被随机分为“倾听”组或教育关注对照组。结果指标包括唾液皮质醇和脱氢表雄酮、白细胞介素-6、白细胞介素-2、抑郁症状、孤独感、感知到的社会支持、功能能力、生活质量、空腹血糖、血压和体重指数。
在最后一次干预 session 后12周，“倾听”组参与者报告孤独感降低（=0.03）、总体社会支持增强（=0.05）且收缩压降低（=0.02）。关注对照组报告功能能力下降（=0.10）和生活质量降低（=0.13）。
“倾听”可有效减少社区居住、患有慢性病的老年人的孤独感并降低收缩压。结果表明，该群体若孤独感得不到治疗，可能在短短4个月内出现功能损害。需要在更大样本、不同人群及更长时间段内对“倾听”进行进一步研究，以评估减轻多种慢性病中孤独感的长期影响。
