Division of Primary Care and Population Health, Department of Medicine, School of Medicine, Stanford University, Palo Alto, California, USA.
Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA.
J Palliat Med. 2024 Nov;27(11):1467-1474. doi: 10.1089/jpm.2024.0125. Epub 2024 Aug 20.
Loneliness and social isolation coexist, making it difficult to study each separately. The COVID-19 lockdown provided an unprecedented and ethically viable opportunity to study loneliness in seriously ill nursing home residents under uniformly imposed social isolation conditions. To understand the phenomenon of loneliness of the seriously ill nursing home patients under a uniform social isolation condition imposed by the COVID-19 pandemic lockdown. Cross-sectional, semi-structured interviews were tape-recorded, transcribed verbatim, and analyzed qualitatively using an inductive thematic analysis. The University of California, Los Angeles (UCLA) Three-Item Loneliness Scale was used to measure loneliness and any relationships between self-reported loneliness and isolation were elucidated. Thirty seriously ill nursing home residents living in complete social isolation imposed by the COVID-19 pandemic lockdown. Thematic analysis identified four key themes: (1) Diverse perceptions about the impact of the COVID-19 lockdown, (2) regret over the missed opportunities for spending time with friends and family, (3) using electronic communication to maintain connections with loved ones, and (4) the impact of nursing home staff. In total, 50% of the participants reported feeling socially isolated, 60% patients reported loneliness, and 70% reported being adversely impacted by the lockdown. Patients who felt socially isolated also reported experiencing loneliness (Kendall's Tau = 0.61, 95% confidence interval [CI] = 0.30, 0.89, < 0.01, large effect size). Persons from communities of color had higher median loneliness scores compared to Non-Hispanic Whites. Participants in the last year of life also reported higher levels of loneliness. A study of loneliness under uniform social isolation conditions in seriously ill nursing home patients showed a high prevalence of loneliness and a strong correlation between self-reported loneliness and social isolation, especially in persons from minority communities and those in the last year of life. In-person support provided by nursing home staff and virtual support from family was helpful to patients.
孤独感和社会隔离并存，使得分别研究它们变得困难。COVID-19 封锁为在统一实施社会隔离条件下研究重病疗养院居民的孤独感提供了一个前所未有的、符合伦理的机会。 目的：了解 COVID-19 大流行封锁下重病疗养院患者在统一社会隔离条件下孤独的现象。 使用 UCLA 三项目孤独量表测量孤独感，并阐明自我报告的孤独感与隔离之间的任何关系。 方法：对完全处于 COVID-19 大流行封锁下社会隔离的 30 名重病疗养院居民进行横断面、半结构式访谈，并进行录音、逐字转录和定性分析，采用归纳主题分析。 结果：确定了四个关键主题：（1）对 COVID-19 封锁影响的不同看法，（2）对错过与朋友和家人共度时光机会的遗憾，（3）使用电子通讯与亲人保持联系，以及（4）疗养院工作人员的影响。共有 50%的参与者报告感到社会隔离，60%的患者报告孤独感，70%的患者报告封锁对他们产生了不利影响。感到社会隔离的患者也报告感到孤独（肯德尔 tau = 0.61，95%置信区间 [CI] = 0.30，0.89， < 0.01，大效应量）。来自有色人种社区的人比非西班牙裔白人的孤独感中位数更高。生命最后一年的参与者也报告了更高水平的孤独感。 一项关于重病疗养院患者在统一社会隔离条件下孤独感的研究表明，孤独感的患病率很高，自我报告的孤独感与社会隔离之间存在很强的相关性，尤其是在少数族裔社区的人和生命最后一年的人。疗养院工作人员提供的面对面支持和家人提供的虚拟支持对患者很有帮助。
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