孤独、隔离和独居的类型与台北老年人的心理健康有关:一项横断面研究。
Typologies of Loneliness, Isolation and Living Alone Are Associated with Psychological Well-Being among Older Adults in Taipei: A Cross-Sectional Study.
机构信息
School of Public Health, Research Center of Health Equity, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan.
出版信息
Int J Environ Res Public Health. 2020 Dec 8;17(24):9181. doi: 10.3390/ijerph17249181.
BACKGROUND
Loneliness, isolation, and living alone are emerging as critical issues in older people's health and well-being, but the effects are not consistent. The purpose of this study was to examine the clustering of loneliness, isolation, and living alone, the risk factors and the associations with psychological well-being.
METHODS
The data were collected from the 2019 Taipei City Senior Citizen Condition Survey by face-to-face interviews and included a community-based sample (n = 3553). Loneliness, isolation, and living arrangement were analyzed by cluster analysis to define Loneliness-Isolation-Living-Alone clusters. Multinomial logistic regression was used to examine the factors related to Loneliness-Isolation-Living-Alone clusters, and linear regression was used to examine association of clusters with psychological well-being.
RESULTS
Five clusters of older adults were identified and named as follows: Not Lonely-Connected-Others (53.4%), Not Lonely-Isolated-Others (26.6%), Not Lonely-Alone (5.0%), Lonely-Connected (8.1%), and Lonely-Isolated-Others (6.9%). Demographics, financial satisfaction, physical function, family relationship, and social participation were related to the Loneliness-Isolation-Living-Alone clusters. Compared with the Not Lonely-Connected-Others cluster, the Lonely-Connected cluster and Lonely-Isolated-Others cluster had higher depressive symptoms and lower life satisfaction, and the Not Lonely-Isolated-Others cluster reported lower life satisfaction; the Not Lonely-Alone cluster was not different.
DISCUSSION
Loneliness and isolation are negatively associated with psychological well-being, and living arrangement is not the determinant to loneliness or isolation. Older adults are suggested to strengthen their informal social support, and the government may encourage social care and create an age friendly environment to reduce loneliness and isolation.
背景
孤独、隔离和独居正成为老年人健康和福祉的重要问题,但影响并不一致。本研究旨在探讨孤独、隔离和独居的聚类情况、危险因素以及与心理健康的关联。
方法
数据来自 2019 年台北市老年人状况调查的面对面访谈,包括一个社区样本(n=3553)。采用聚类分析对孤独、隔离和居住安排进行分析,以定义孤独-隔离-独居聚类。采用多项逻辑回归分析与孤独-隔离-独居聚类相关的因素,采用线性回归分析聚类与心理健康的关联。
结果
确定了五种老年人聚类,分别命名为:不孤独-有联系-他人(53.4%)、不孤独-孤立-他人(26.6%)、不孤独-独居(5.0%)、孤独-有联系(8.1%)和孤独-孤立-他人(6.9%)。人口统计学、经济满意度、身体功能、家庭关系和社会参与与孤独-隔离-独居聚类有关。与不孤独-有联系-他人聚类相比,孤独-有联系聚类和孤独-孤立-他人聚类的抑郁症状更高,生活满意度更低,而不孤独-孤立-他人聚类的生活满意度更低;不孤独-独居聚类没有差异。
讨论
孤独和隔离与心理健康呈负相关,居住安排不是孤独或隔离的决定因素。建议老年人加强非正式社会支持,政府鼓励社会关怀并创造一个适合老年人的环境,以减少孤独和隔离。