配偶丧亡后孤独感和社会隔离的发展：关于丧偶的纵向研究的系统综述
Development of loneliness and social isolation after spousal loss: A systematic review of longitudinal studies on widowhood.
作者信息
Niino Kerri, Patapoff Molly A, Mausbach Brent T, Liu Hui, Moore Alison A, Han Benjamin H, Palmer Barton W, Jester Dylan J
机构信息
John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA.
Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California, USA.
出版信息
J Am Geriatr Soc. 2025 Jan;73(1):253-265. doi: 10.1111/jgs.19156. Epub 2024 Aug 22.
BACKGROUND
Spousal loss is a stressful life event that is associated with loneliness and social isolation, both of which affect mental and physical health. The primary objective of this paper was to synthesize longitudinal studies that investigated loneliness and social isolation in widowhood.
METHODS
A systematic search of the literature was conducted using three electronic databases. 26 longitudinal studies published through June 2024 were included for further analysis. Participant characteristics, study design, and key findings were extracted.
RESULTS
Most studies were from the United States or Europe, included more widows than widowers, and assessed loneliness in older adults aged >60 years. Loneliness peaked directly following spousal death, but findings were inconsistent regarding the lasting effects of widowhood. Heterogeneity in the longitudinal trajectories of loneliness was noted, with studies showing linear increases, decreases, or curvilinear relationships over time. Several factors modified the relationship between widowhood and loneliness, including volunteerism, military experience, income, and age. Widowers consistently reported greater loneliness and worse social isolation when compared with widows. Few studies investigated social isolation specifically, but those that did found that social isolation may decrease in widowhood.
CONCLUSIONS
As the world grapples with a social pandemic of loneliness and social isolation, widowed adults may be uniquely affected. Few studies investigated the longitudinal trajectory of loneliness and especially social isolation in widowhood, and those that did found heterogenous results. Future work is needed to understand why some widowed adults are uniquely affected by feelings of loneliness and social isolation while others are not, and whether potentially modifiable factors that moderate or mediate this relationship could be leveraged by psychosocial interventions.
背景
配偶离世是一种压力巨大的生活事件，与孤独感和社会隔离相关，而这两者都会影响身心健康。本文的主要目的是综合调查丧偶期间孤独感和社会隔离情况的纵向研究。
方法
使用三个电子数据库对文献进行系统检索。纳入了截至2024年6月发表的26项纵向研究进行进一步分析。提取了参与者特征、研究设计和主要发现。
结果
大多数研究来自美国或欧洲，纳入的寡妇比鳏夫更多，且评估的是60岁以上老年人的孤独感。孤独感在配偶死亡后直接达到峰值，但关于丧偶的长期影响，研究结果并不一致。研究发现孤独感的纵向轨迹存在异质性，随着时间推移，有的研究显示呈线性增加，有的呈线性减少，还有的呈曲线关系。几个因素改变了丧偶与孤独感之间的关系，包括志愿服务、军事经历、收入和年龄。与寡妇相比，鳏夫一直报告有更强烈的孤独感和更严重的社会隔离。很少有研究专门调查社会隔离情况，但那些进行了调查的研究发现，丧偶期间社会隔离可能会减少。
结论
在世界应对孤独和社会隔离这一社会“大流行”之际，丧偶成年人可能受到独特影响。很少有研究调查丧偶期间孤独感尤其是社会隔离的纵向轨迹，而那些进行了调查的研究得到了异质性结果。未来需要开展研究，以了解为何一些丧偶成年人会受到孤独感和社会隔离感的独特影响，而另一些人则不会，以及心理社会干预是否可以利用那些调节或介导这种关系的潜在可改变因素。
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