Peltzer Karl, Pengpid Supa
1North West University, Potchefstroom, South Africa.
2ASEAN Institute for Health Development, Mahidol University, 25/25 Phutthamonthon Road 4, Salaya, Phutthamonton, Nakhon Pathom, 73170 Thailand.
Int J Ment Health Syst. 2019 Apr 10;13:24. doi: 10.1186/s13033-019-0281-z. eCollection 2019.
Loneliness has been commonly reported in high-income countries, while less is known about loneliness in Association of the Southeast Asian Nations (ASEAN) member states, in particular in Indonesia.
The aim of the study was to estimate the prevalence of loneliness, its correlates and associations with health variables in a national survey in the general population in Indonesia.
In the Indonesia Family Life Survey (IFLS-5) in 2014-2015, 31,447 participants 15 years and older (median age 35.0 years, interquartile range = 22.0) were interviewed and examined in a national population-based cross-sectional study. The self-reported prevalence of loneliness, blood pressure, body height and weight, physical and mental health, health behaviour and psychosocial variables were measured. Multinomial logistic regression analyses were used to estimate determinants of loneliness and logistic and linear regression analyses were applied to estimate the associations of loneliness with physical, mental and health risk behaviour variables.
The self-reported prevalence of loneliness (occasionally or all of the time or 3-7 days per week) was 10.6% (11.0% for females and 10.1% for males), and 8.0% reported sometimes (1-2 days/week) to be lonely. Loneliness was distributed in a slight U-shaped form, with adolescents and the oldest old having the highest prevalence of loneliness. In adjusted multinomial logistic regression analysis, lower education, lower economic status, adverse childhood experiences, having one or more chronic conditions, functional disability and low neighbourhood trust were associated with loneliness. Loneliness was significantly associated with most health variables, including self-reported unhealthy health status (AOR 1.70, CI 1.57, 1.84), cognitive functioning (Beta: - 0.72, CI - 0.90 to - 0.54), having one or more chronic medical conditions (AOR 1.25, CI 1.16, 1.35), having had a stroke (AOR 1.58, CI 1.08, 2.29), depression symptoms (Beta: 5.19, CI 4.98-5.39), sleep disturbance (Beta: 0.34, CI 0.31-0.37), sleep related impairment (Beta: 0.69, CI 0.64-0.73), low life satisfaction (AOR 1.78, CI 1.64, 1.93), out-patient health care utilization in the past 4 weeks (AOR 1.11, CI 1.01, 1.21), current tobacco use (AOR 1.42, CI 1.28, 1.58), and one or more days in the past week soft drink consumption (AOR 1.20, CI 1.10, 1.31).
Loneliness was found to be prevalent across the life span and was associated with a number of poorer health variables. Several factors associated with loneliness were identified, which warrant further research in Indonesia.
孤独现象在高收入国家普遍存在,而对于东南亚国家联盟(东盟)成员国,尤其是印度尼西亚的孤独情况了解较少。
本研究旨在通过对印度尼西亚普通人群的全国性调查,估算孤独的患病率、相关因素及其与健康变量的关联。
在2014 - 2015年的印度尼西亚家庭生活调查(IFLS - 5)中,对31447名15岁及以上的参与者(年龄中位数35.0岁,四分位间距 = 22.0)进行了访谈和检查,这是一项基于全国人口的横断面研究。测量了自我报告的孤独患病率、血压、身高和体重、身心健康、健康行为及心理社会变量。采用多项逻辑回归分析估算孤独的决定因素,并运用逻辑回归和线性回归分析估算孤独与身体、心理和健康风险行为变量之间的关联。
自我报告的孤独患病率(偶尔或一直或每周3 - 7天)为10.6%(女性为11.0%,男性为10.1%),8.0%的人报告有时(每周1 - 2天)感到孤独。孤独呈轻微的U形分布,青少年和最年长者的孤独患病率最高。在调整后的多项逻辑回归分析中,受教育程度较低、经济状况较差、童年不良经历、患有一种或多种慢性病、功能残疾以及邻里信任度低与孤独有关。孤独与大多数健康变量显著相关,包括自我报告的不健康健康状况(比值比1.70,置信区间1.57, 1.84)、认知功能(β: - 0.72,置信区间 - 0.90至 - 0.54)、患有一种或多种慢性疾病(比值比1.25,置信区间1.16, 1.35)、曾患中风(比值比1.58,置信区间1.08, 2.29)、抑郁症状(β:5.19,置信区间4.98 - 5.39)、睡眠障碍(β:0.34,置信区间0.31 - 0.37)、睡眠相关损害(β:0.69,置信区间0.64 - 0.73)、生活满意度低(比值比1.78,置信区间1.64, 1.93)、过去4周内门诊医疗服务利用情况(比值比1.11,置信区间1.01, 1.2)、当前吸烟情况(比值比1.42,置信区间1.28, 1.58)以及过去一周内饮用软饮料一天或多天(比值比1.20,置信区间1.10, 1.31)。
研究发现孤独在整个生命周期中普遍存在,并与一些较差的健康变量相关。确定了与孤独相关的几个因素,这在印度尼西亚值得进一步研究。