Tough Hannah, Gross-Hemmi Mirja, Stringhini Silvia, Eriks-Hoogland Inge, Fekete Christine
Swiss Paraplegic Research, Nottwil; Department of Health Sciences and Medicine, University of Lucerne, Lucerne.
Swiss Paraplegic Research, Nottwil.
Arch Phys Med Rehabil. 2022 Feb;103(2):305-312. doi: 10.1016/j.apmr.2021.08.018. Epub 2021 Sep 22.
To develop a more thorough understanding of the risk factors for loneliness in persons with a physical impairment, using a population-based sample of persons with spinal cord injury (SCI), based on regression modeling and a recursive partitioning approach.
Cross-sectional, observational cohort.
Community, Switzerland.
Community-dwelling persons with spinal cord injury (N=1283) 16 years or older.
Not applicable.
Loneliness was assessed using a modified version of the UCLA Three-Item Loneliness Scale.
Those with the most disadvantaged socioeconomic characteristics in terms of education, income, subjective social position, employment status, and financial hardship demonstrated the highest risk for loneliness. Of the sociodemographic characteristics, only age had an association with loneliness, whereby persons aged 31-45 had the highest propensity for experiencing loneliness. We also saw that those with higher lesion levels and less functional independence were associated with higher levels of loneliness. In conditional inference tree analysis subjective social position, financial hardship, and functional independence had the highest discriminative power, with nationality and living arrangement having a less important role.
Our findings highlight the vulnerability of persons with SCI with unfavorable socioeconomic status to loneliness. Furthermore, our findings show that persons who are more constrained because of functional limitations may face restrictions to social participation and therefore be at a higher risk of loneliness. This population-based evidence contributes to the better targeting of services aimed at alleviating loneliness for persons with a lower socioeconomic position and those with more functional limitations in everyday life.
基于回归模型和递归划分方法，利用脊髓损伤（SCI）患者的人群样本，更全面地了解身体有损伤者孤独感的风险因素。
横断面观察性队列研究。
瑞士社区。
16岁及以上的社区居住脊髓损伤患者（N = 1283）。
不适用。
使用UCLA三项孤独感量表的修改版评估孤独感。
在教育、收入、主观社会地位、就业状况和经济困难方面社会经济特征最不利的人群孤独感风险最高。在社会人口学特征中，只有年龄与孤独感有关，31 - 45岁的人经历孤独感的倾向最高。我们还发现，损伤水平较高且功能独立性较差的人与更高程度的孤独感相关。在条件推断树分析中，主观社会地位、经济困难和功能独立性具有最高的判别力，国籍和居住安排的作用较小。
我们的研究结果突出了社会经济地位不利的脊髓损伤患者易产生孤独感。此外，我们的研究结果表明，因功能限制而受到更多约束的人可能面临社会参与的限制，因此孤独感风险更高。这一基于人群的证据有助于更精准地提供服务，以减轻社会经济地位较低和日常生活中功能限制较多者的孤独感。
