School of Health, Care and Social Welfare, Mälardalen University, P.O 325, SE-63105, Eskilstuna/Västerås, Sweden.
School of Information and Engineering/Statistics, Dalarna University, Falun, Sweden.
BMC Geriatr. 2022 Dec 1;22(1):927. doi: 10.1186/s12877-022-03544-z.
Older people were subjected to significant restrictions on physical contacts with others during the COVID-19 pandemic. Social distancing impacts older people's experiences of anxiety and loneliness. Despite a large body of research on the pandemic, there is little research on its effects on older people in residential care facilities (RCF) and in home care services (HCS), who are the frailest of the older population. We aimed to investigate the effect of the first wave of the COVID-19 pandemic in March-May 2020 on experiences of anxiety and loneliness among older people living in RCF or receiving HCS and the impact of the progression of the pandemic on these experiences.
A retrospective cross-sectional design using data from the national user satisfaction survey (March - May 2020) by the Swedish National Board of Health and Welfare. Survey responses were retrieved from 27,872 older people in RCF (mean age 87 years) and 82,834 older people receiving HCS (mean age 84 years). Proportional-odds (cumulative logit) model was used to estimate the degree of association between dependent and independent variables.
Loneliness and anxiety were more prevalent among the older persons living in RCF (loneliness: 69%, anxiety: 63%) than those receiving HCS (53% and 47%, respectively). Proportional odds models revealed that among the RCF and HCS respondents, the cumulative odds ratio of experiencing higher degree of anxiety increased by 1.06% and 1.04%, respectively, and loneliness by 1.13% and 1.16%, respectively, for 1% increase in the COVID-19 infection rate. Poor self-rated health was the most influential factor for anxiety in both RCF and HCS. Living alone (with HCS) was the most influential factor affecting loneliness. Experiences of disrespect from staff were more strongly associated with anxiety and loneliness in RCF than in HCS.
Older people in RCF or receiving HCS experienced increasing levels of anxiety and loneliness as the first wave of the pandemic progressed. Older people' mental and social wellbeing should be recognized to a greater extent, such as by providing opportunities for social activities. Better preparedness for future similar events is needed, where restrictions on social interaction are balanced against the public health directives.
在 COVID-19 大流行期间，老年人与他人的身体接触受到了很大的限制。社交隔离会影响老年人的焦虑和孤独感。尽管有大量关于大流行的研究，但针对在养老院居住或接受家庭护理服务的老年人（最脆弱的老年人群体）的影响的研究却很少。我们旨在调查 2020 年 3 月至 5 月 COVID-19 第一波疫情对养老院居住或接受家庭护理服务的老年人的焦虑和孤独感的影响，以及疫情的进展对这些体验的影响。
这是一项使用瑞典国家卫生福利委员会（National Board of Health and Welfare）的全国用户满意度调查（2020 年 3 月至 5 月）数据的回顾性横断面设计。调查结果来自 27872 名养老院居住的老年人（平均年龄 87 岁）和 82834 名接受家庭护理服务的老年人（平均年龄 84 岁）。使用比例优势（累积对数）模型估计因变量和自变量之间的关联程度。
养老院居住的老年人比接受家庭护理服务的老年人更普遍地感到孤独和焦虑（孤独：69%，焦虑：63%）。比例优势模型显示，在养老院和家庭护理服务的受访者中，焦虑程度较高的累积优势比分别增加了 1.06%和 1.04%，孤独感分别增加了 1.13%和 1.16%，这与 COVID-19 感染率增加 1%有关。自我报告的健康状况较差是养老院和家庭护理服务中焦虑的最主要影响因素。独居（接受家庭护理服务）是影响孤独感的最主要因素。养老院的老年人比家庭护理服务的老年人更容易因受到工作人员的不尊重而感到焦虑和孤独。
随着第一波疫情的发展，养老院居住或接受家庭护理服务的老年人的焦虑和孤独感水平不断上升。老年人的心理和社会福利应该得到更大程度的认可，例如提供社交活动的机会。需要为未来类似的事件做好更好的准备，在平衡社交限制和公共卫生指令的同时，需要更好地应对此类事件。
