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孤独感在 COVID-19 大流行期间的社区居住老年人中的相关性和轨迹:一项加拿大纵向研究。

Correlates and trajectories of loneliness among community-dwelling older adults during the COVID-19 pandemic: A Canadian longitudinal study.

机构信息

Department of Personality, Evaluation and Clinical Psychology, Faculty of Psychology, Universidad Complutense de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain.

Department of Psychology, Concordia University, Montreal, QC, Canada; Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada.

出版信息

Arch Gerontol Geriatr. 2023 Dec;115:105133. doi: 10.1016/j.archger.2023.105133. Epub 2023 Jul 17.

Abstract

The COVID-19 pandemic provided a unique opportunity to examine the contributions of social interaction and other non-social factors to loneliness among older adults in the context of confinement measures constraining opportunities for in-person social interactions. This study aims to identify groups of individuals with heterogeneous trajectories of loneliness during the COVID-19 pandemic and to explore the sociodemographic, health, psychological and social interaction-related factors associated with these trajectories. In this 12-month longitudinal study, 614 community-dwelling individuals aged 60+ years completed telephone-based interviews on four occasions between May 2020 and May 2021. Loneliness was evaluated using the three-item version of the UCLA Loneliness Scale. Multilevel modelling assessed average changes in loneliness over time. Group-based trajectory modelling was performed to identify distinct trajectories of loneliness over time. Multinomial logistic regressions were conducted to explore the predictors of these trajectories. On average, there was a curvilinear change in loneliness that tracked the stringency of the COVID-19-related confinement measures. In this convenience sample, three heterogeneous trajectories were identified: a stable-low (17.2%), a fluctuating-moderate (48.8%) and a sustained-elevated (34.0%) trajectory. Participants in the sustained-elevated loneliness trajectory were more likely to live alone and experience elevated psychological distress and greater COVID-19 perceived health threat compared to those in the stable-low trajectory. Participants in the fluctuating-moderate loneliness group were more likely to have multimorbidity, experience greater psychological distress, and have less frequent in-person interactions than the stable-low loneliness group. Assessing the combination of sociodemographic, health, psychological and social factors may help identify individuals at higher risk for chronic loneliness.

摘要

COVID-19 大流行提供了一个独特的机会,可以在限制人际互动机会的禁闭措施的背景下,研究社会互动和其他非社会因素对老年人孤独感的贡献。本研究旨在确定在 COVID-19 大流行期间孤独感具有异质轨迹的人群,并探讨与这些轨迹相关的社会人口学、健康、心理和社会互动相关因素。在这项为期 12 个月的纵向研究中,614 名居住在社区中的 60 岁以上个体在 2020 年 5 月至 2021 年 5 月期间通过电话进行了四次访谈。使用 UCLA 孤独感量表的三项目版本评估孤独感。多层次模型评估了孤独感随时间的平均变化。进行基于群组的轨迹建模以确定随时间变化的孤独感的不同轨迹。进行多项逻辑回归以探索这些轨迹的预测因素。平均而言,孤独感随时间呈曲线变化,与 COVID-19 相关禁闭措施的严格程度相吻合。在这个方便的样本中,确定了三种异质轨迹:稳定低度(17.2%)、波动中度(48.8%)和持续升高(34.0%)轨迹。与稳定低度轨迹相比,处于持续升高孤独感轨迹的参与者更有可能独居,经历更高的心理困扰,以及对 COVID-19 的感知健康威胁更大。处于波动中度孤独感轨迹的参与者更有可能患有多种疾病,经历更大的心理困扰,并且与稳定低度孤独感组相比,面对面互动的频率更低。评估社会人口学、健康、心理和社会因素的组合可能有助于识别出患有慢性孤独感风险较高的个体。

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