Division of Primary Care, Population Sciences and Medical Education, University of Southampton, Hampshire SO16 5ST, UK.
Foundation Doctor, St. George's University Hospital, London SW17 0QT, UK.
J R Soc Med. 2020 May;113(5):185-192. doi: 10.1177/0141076820918236.
To conduct a systematic review and develop a conceptual framework on the mechanisms linking loneliness, social isolation, health outcomes and mortality. Electronic databases were systematically searched (PubMed, MEDLINE, Scopus and EMBASE) from inception to October 2018 followed by manual searching to identify research on loneliness, social isolation and mortality in adults published in the English language. Articles were assessed for quality and synthesised into a conceptual framework using meta-ethnographical approaches. A total of 122 articles were included. These collated observational designs examining mediators and moderations of the association in addition to qualitative studies exploring potential mechanisms were included. A framework incorporating 18 discrete factors implicated in the association between loneliness, social isolation and mortality was developed. Factors were categorised into societal or individual, and sub-categorised into biological, behavioural and psychological. These findings emphasise the complex multidirectional relationship between loneliness, social isolation and mortality. Our conceptual framework may allow development of more holistic interventions, targeting many of the interdependent factors that contribute to poor outcomes for lonely and socially isolated people.
对孤独、社会隔离、健康结果和死亡率之间的联系机制进行系统回顾并构建概念框架。从建库开始，系统地在电子数据库（PubMed、MEDLINE、Scopus 和 EMBASE）中进行了检索，然后进行手工检索，以确定 2018 年 10 月前发表的关于成年人孤独、社会隔离和死亡率的英文研究。使用元民族学方法评估文章的质量并将其综合为概念框架。共纳入 122 篇文章。这些文章包括观察性设计，以检查关联的中介和调节因素，以及探索潜在机制的定性研究。构建了一个包含 18 个离散因素的框架，这些因素与孤独、社会隔离和死亡率之间的关联有关。这些因素分为社会或个体因素，并进一步细分为生物、行为和心理因素。这些发现强调了孤独、社会隔离和死亡率之间复杂的、多向的关系。我们的概念框架可能有助于开发更全面的干预措施，针对导致孤独和社会隔离的人结局较差的许多相互依存的因素。
