Section of General Internal Medicine, Center for Health and the Social Sciences, and Chicago Center for Diabetes Translation Research, University of Chicago, Chicago, IL, USA.
Department of Family & Community Medicine, University of California San Francisco, San Francisco, CA, USA.
J Gen Intern Med. 2021 Jul;36(7):1951-1957. doi: 10.1007/s11606-020-06484-9. Epub 2021 Feb 2.
Social isolation is a known predictor of mortality that disproportionately affects vulnerable populations in the USA. Although experts began to recognize it as a public health crisis prior to 2020, the novel coronavirus pandemic has accelerated recognition of social isolation as a serious threat to health and well-being.
Examine patient experiences with screening and assistance for social isolation in primary care settings, and whether patient experiences with these activities are associated with the severity of reported social isolation.
Cross-sectional survey conducted in 2018.
Adults (N = 251) were recruited from 3 primary care clinics in Boston, Chicago, and San Francisco.
A modified version of the Berkman-Syme Social Network Index (SNI), endorsed by the National Academies of Sciences, Engineering, and Medicine; items to assess for prior experiences with screening and assistance for social isolation.
In the sample population, 12.4% reported the highest levels of social isolation (SNI = 0/1), compared to 36.7%, 34.7%, and 16.3% (SNI = 2-4, respectively). Most patients had not been asked about social isolation in a healthcare setting (87.3%), despite reporting no discomfort with social isolation screening (93.9%). Neither discomfort with nor participation in prior screening for social isolation was associated with social isolation levels. Desire for assistance with social isolation (3.2%) was associated with a higher level of social isolation (AOR = 6.0, 95% CI, 1.3-28.8), as well as poor or fair health status (AOR = 9.1; 95% CI, 1.3-64.1).
In this study, few patients reported being screened previously for social isolation in a primary care setting, despite low levels of discomfort with screening. Providers should consider broadening social isolation screening and referral practices in healthcare settings, especially among sicker and more isolated patients who express higher levels of interest in assistance with social isolation.
社会隔离是一个已知的死亡预测因素，它在美国的弱势群体中不成比例地产生影响。尽管专家在 2020 年之前就开始认识到这是一种公共卫生危机，但新型冠状病毒大流行加速了人们对社会隔离作为健康和福祉严重威胁的认识。
调查初级保健环境中患者对社会隔离筛查和援助的体验，以及患者对这些活动的体验是否与报告的社会隔离严重程度相关。
2018 年进行的横断面调查。
从波士顿、芝加哥和旧金山的 3 家初级保健诊所招募了 251 名成年人。
采用美国国家科学院、工程院和医学院认可的伯克曼-西梅社会网络指数（SNI）的改良版；评估社会隔离筛查和援助的先前经历的项目。
在样本人群中，12.4%报告了最高水平的社会隔离（SNI=0/1），而 36.7%、34.7%和 16.3%（SNI=2-4，分别）。尽管大多数患者对社会隔离筛查没有不适感（93.9%），但他们在医疗保健环境中没有被问及社会隔离问题（87.3%）。对社会隔离筛查既不感到不适也没有参与过筛查，这两者均与社会隔离水平无关。对社会隔离援助的渴望（3.2%）与更高水平的社会隔离（AOR=6.0，95%CI，1.3-28.8）以及较差或一般的健康状况（AOR=9.1；95%CI，1.3-64.1）相关。
在这项研究中，尽管对筛查的不适感较低，但很少有患者报告之前在初级保健环境中接受过社会隔离筛查。医疗服务提供者应考虑在医疗保健环境中扩大社会隔离筛查和转诊实践，特别是针对那些病情较重且更孤立、对社会隔离援助表示出更高兴趣的患者。
