Kousha Ahmad, Lotfalinezhad Elham, Nadrian Haidar, Andersen-Ranberg Karen, Freeman Shannon, Barati Fatemeh, Mosazadeh Hasan, Hashemiparast Mina, Jafarabadi Mohammed Asghari, Sohrabi Ahmad, Honarvar Mohammad Reza
Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Psychiatry and Community Health Nursing, School of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran.
Korean J Fam Med. 2025 May;46(3):185-194. doi: 10.4082/kjfm.23.0269. Epub 2024 Jun 7.
Establishing cost-effective informal care services for lonely older adults living at home in developing countries can be an innovative approach for improving their well-being. This study investigated the effectiveness of an informal home care support intervention program (HoSIP) reducing the loneliness and improving quality of life of lonely community-dwelling older adults.
This quasi-experimental pre-post study employed a non-randomized control group design with a 12-week intervention period and three follow-up points at the end of the HoSIP. Questionnaires were used to measure feelings of loneliness (20-item UCLA Loneliness Scale), quality of life (Control, Autonomy, Self-Realization and Pleasure Scale), general health (12-item General Health Questionnaire), social network (six-item Lubben Social Network Scale), social support (12-item Multidimensional Scale of Perceived Social Support), and self-care ability (17-item Self-care Ability Scale for the Elderly). Repeated-measures analysis of variance was used to gauge the effect of the intervention program over time and in comparison to the control group. Data analyses were performed using the IBM SPSS Statistics software (IBM Corp.).
We found a significant relationship between the outcome variables, including feelings of loneliness (P<0.001) and quality of life (P<0.001), at different stages of measurement. Despite the positive feasibility results, the implementation of the HoSIP faced challenges due to a lack of facilities (e.g., place restriction for holding educational classes, educational facilities like computers, video projector, and whiteboard at daycare center) and the absence of supporting organizations.
Utilizing the existing capabilities of older adults to provide online and face-to-face care services can be a cost-effective way to improve their quality of life and reduce loneliness. The process of facilitating such informal care services for lonely older adults should be managed by either governmental or non-governmental organizations to reduce the rate of social isolation among this vulnerable population.
为发展中国家居家的孤独老年人建立具有成本效益的非正式护理服务，可能是改善其福祉的一种创新方法。本研究调查了非正式家庭护理支持干预项目（HoSIP）在减少孤独感和改善社区独居孤独老年人生活质量方面的有效性。
本准实验性前后对照研究采用非随机对照组设计，干预期为12周，在HoSIP结束时设置三个随访点。使用问卷来测量孤独感（20项UCLA孤独量表）、生活质量（控制、自主、自我实现和愉悦量表）、总体健康状况（12项一般健康问卷）、社交网络（6项Lubben社交网络量表）、社会支持（12项多维感知社会支持量表）和自我护理能力（17项老年人自我护理能力量表）。采用重复测量方差分析来评估干预项目随时间的效果以及与对照组相比的效果。使用IBM SPSS Statistics软件（IBM公司）进行数据分析。
我们发现在不同测量阶段，包括孤独感（P<0.001）和生活质量（P<0.001）在内的结果变量之间存在显著关系。尽管可行性结果积极，但由于缺乏设施（例如举办教育课程的场地限制、日托中心的电脑、视频投影仪和白板等教育设施）以及缺乏支持组织，HoSIP的实施面临挑战。
利用老年人现有的能力提供在线和面对面护理服务，可能是提高其生活质量和减少孤独感的一种具有成本效益的方式。为孤独老年人提供此类非正式护理服务的过程应由政府或非政府组织管理，以降低这一弱势群体的社会孤立率。
