Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colorado
Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia.
Ann Fam Med. 2019 Mar;17(2):108-115. doi: 10.1370/afm.2358.
Loneliness has important health consequences. Little is known, however, about loneliness in primary care patient populations. This study describes the prevalence of loneliness in patients presenting for primary care and associations with self-reported demographic factors, health care utilization, and health-related quality of life.
We conducted cross-sectional surveys of adults presenting for routine care to outpatient primary care practices in 2 diverse practice-based research networks. The 3-item University of California, Los Angeles Loneliness Scale was utilized to determine loneliness.
The prevalence of loneliness was 20% (246/1,235). Loneliness prevalence was inversely associated with age ( <.01) and less likely in those who were married ( <.01) or employed ( <.01). Loneliness was more common in those with lower health status ( <.01), including when adjusting for employment and relationship status (odds ratio [OR] = 1.05; 95% CI, 1.03-1.07). Primary care visits (OR = 1.07; 95% CI, 1.03-1.10), urgent care/emergency department visits (OR = 1.24; 95% CI, 1.12-1.38), and hospitalizations (OR = 1.15; 95% CI, 1.01-1.31) were associated with loneliness status. There was no significant difference in rates of loneliness between sexes ( = .08), racial categories ( = .57), or rural and urban respondents ( = .42).
Our findings demonstrate that loneliness is common in primary care patients and is associated with adverse health consequences including poorer health status and greater health care utilization. Further work is needed to understand the value of screening for and using interventions to treat loneliness in primary care.
孤独对健康有重要影响。然而,人们对初级保健患者群体中的孤独知之甚少。本研究描述了初级保健就诊患者中孤独的流行情况,并探讨了其与自我报告的人口统计学因素、医疗保健利用和健康相关生活质量的关联。
我们对 2 个不同的基于实践的研究网络中的门诊初级保健诊所就诊的成年人进行了横断面调查。采用加利福尼亚大学洛杉矶分校孤独量表的 3 项条目来确定孤独感。
孤独感的患病率为 20%(246/1,235)。孤独感的患病率与年龄呈负相关(<0.01),且在已婚(<0.01)或有工作(<0.01)的人群中发生率较低。孤独感在健康状况较差的人群中更为常见(<0.01),包括在调整了就业和关系状况后(优势比[OR] = 1.05;95%置信区间[CI],1.03-1.07)。初级保健就诊(OR = 1.07;95% CI,1.03-1.10)、急诊/急诊就诊(OR = 1.24;95% CI,1.12-1.38)和住院治疗(OR = 1.15;95% CI,1.01-1.31)与孤独状态相关。在孤独感发生率方面,不同性别(=0.08)、不同种族类别(=0.57)或城乡受访者(=0.42)之间无显著差异。
我们的研究结果表明,孤独在初级保健患者中较为常见,与不良健康后果相关,包括较差的健康状况和更多的医疗保健利用。需要进一步研究以了解在初级保健中筛查和使用干预措施治疗孤独的价值。