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采用加拿大老龄化纵向研究(CLSA),对中年和老年人孤独感与未满足医疗保健需求之间的关系进行回顾性横断面研究。

Retrospective cross-sectional study examining the association between loneliness and unmet healthcare needs among middle-aged and older adults using the Canadian Longitudinal Study of Aging (CLSA).

机构信息

Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada

Women's College Research Institute, Toronto, Ontario, Canada.

出版信息

BMJ Open. 2023 Mar 14;13(3):e068769. doi: 10.1136/bmjopen-2022-068769.

Abstract

OBJECTIVES

Our primary objective was to estimate the association between loneliness and unmet healthcare needs and if the association changes when adjusted for demographic and health factors. Our secondary objective was to examine the associations by gender (men, women, gender diverse).

DESIGN, SETTING, PARTICIPANTS: Retrospective cross-sectional data from 44 423 community-dwelling Canadian Longitudinal Study on Aging participants aged 45 years and older were used.

PRIMARY OUTCOME MEASURE

Unmet healthcare needs are measured by asking respondents to indicate (yes, no) if there was a time when they needed healthcare in the last 12 months but did not receive it.

RESULTS

In our sample of 44 423 respondents, 8.5% (n=3755) reported having an unmet healthcare need in the previous 12 months. Lonely respondents had a higher percentage of unmet healthcare needs (14.4%, n=1474) compared with those who were not lonely (6.7%, n=2281). Gender diverse had the highest percentage reporting being lonely and having an unmet healthcare need (27.3%, n=3), followed by women (15.4%, n=887) and men (13.1%, n=583). In our logistic regression, lonely respondents had higher odds of having an unmet healthcare need in the previous 12 months than did not lonely (adjusted odd ratios (aOR) 1.80, 95% CI 1.64 to 1.97), adjusted for other covariates. In the gender-stratified analysis, loneliness was associated with a slightly greater likelihood of unmet healthcare needs in men (aOR 1.90, 95% CI 1.64 to 2.19) than in women (aOR 1.73, 95% CI 1.53 to 1.95). In the gender diverse, loneliness was also associated with increased likelihood of having an unmet healthcare need (aOR 1.38, 95% CI 0.23 to 8.29).

CONCLUSIONS

Loneliness was related to unmet healthcare needs in the previous 12 months, which may suggest that those without robust social connections experience challenges accessing health services. Gender-related differences in loneliness and unmet needs must be further examined in larger samples.

摘要

目的

我们的主要目标是评估孤独感与未满足的医疗保健需求之间的关联,并在调整人口统计学和健康因素后观察这种关联是否发生变化。我们的次要目标是按性别(男性、女性、性别多样化)来研究这些关联。

设计、地点、参与者:使用了来自 44423 名年龄在 45 岁及以上的加拿大纵向老龄化研究的社区居住参与者的回顾性横断面数据。

主要结局测量

未满足的医疗保健需求通过询问受访者在过去 12 个月内是否有一次需要医疗保健但未得到满足来衡量。

结果

在我们的 44423 名受访者样本中,8.5%(n=3755)报告在过去 12 个月内存在未满足的医疗保健需求。与不孤独的受访者相比,孤独的受访者未满足医疗保健需求的比例更高(14.4%,n=1474),而不孤独的受访者为 6.7%(n=2281)。性别多样化的人群报告孤独和未满足医疗保健需求的比例最高(27.3%,n=3),其次是女性(15.4%,n=887)和男性(13.1%,n=583)。在我们的逻辑回归中,孤独的受访者在过去 12 个月中未满足医疗保健需求的可能性高于不孤独的受访者(调整后的优势比(aOR)1.80,95%置信区间(CI)1.64 至 1.97),调整了其他协变量。在按性别分层的分析中,与女性(aOR 1.73,95%CI 1.53 至 1.95)相比,孤独感与男性(aOR 1.90,95%CI 1.64 至 2.19)未满足医疗保健需求的可能性略大。在性别多样化的人群中,孤独感也与未满足的医疗保健需求的可能性增加有关(aOR 1.38,95%CI 0.23 至 8.29)。

结论

孤独感与过去 12 个月内未满足的医疗保健需求有关,这可能表明那些没有强大社交关系的人在获得医疗服务方面存在挑战。必须在更大的样本中进一步研究与性别相关的孤独感和未满足需求之间的差异。

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