农村老年人就地养老中的社会隔离和孤独预防：需求评估。

Social isolation and loneliness prevention among rural older adults aging-in-place: a needs assessment.

机构信息

Department of Community and Behavioral Health, East Tennessee State University, Johnson City, TN, United States.

Department of Epidemiology and Biostatistics, East Tennessee State University, Johnson City, TN, United States.

出版信息

Front Public Health. 2024 Oct 15;12:1404869. doi: 10.3389/fpubh.2024.1404869. eCollection 2024.

DOI:10.3389/fpubh.2024.1404869

PMID:

Abstract

INTRODUCTION

The adverse effects of social isolation and loneliness (SI/L) have been documented among older adults in rural communities and contribute to poor health outcomes, premature disability and mortality, and increased burden on the healthcare system. The identification of factors contributing to SI/L among older adults can build the foundation for rural policymakers and leaders to allocate resources and develop tailored strategies more efficiently. The purpose of this article is to describe findings from a needs assessment designed to understand local factors that contribute to SI/L among rural older adults in a county in Northeast Tennessee. Findings from the needs assessment will be used by local stakeholders to develop strategies to promote age-friendly initiatives.

METHODS

Eighty-two older adults [ages 62 to 74 years (59%); non-Hispanic white (95%); female (71%)] from three senior apartment complexes in a Northeast Tennessee county completed an 87-item needs assessment survey. The evaluation of social isolation utilized Lubben's 6-item Social Network Scale, while loneliness was assessed using the 3-item UCLA Loneliness Scale. Logistic regression analysis was used to identify predictors of SI/L. Given the limited sample size, statistical significance was considered at < 0.10.

RESULTS

The prevalence of social isolation and loneliness was 42% and 37%, respectively. Residing in the county <5 years [Adjusted OR (AOR): 3.35; 95% CI: 1.04-10.81; = 0.04] and reporting resource-related barriers to aging-in-place (AOR: 6.56; 95% CI: 2.00-21.57; = 0.004) were associated with increases in the odds of social isolation; whereas interest in intergenerational activities decreased the odds of social isolation (AOR: 0.19; 95% CI: 0.05-0.69; = 0.01). Boredom (AOR: 4.06; 95% CI: 1.63-12.11; = 0.01) and limited knowledge about community services (AOR: 4.61; 95% CI: 1.42-15.02; = 0.01) quadrupled the odds of loneliness. Similarly, older adults who were frail (AOR: 2.69; 95% CI: 0.88-8.17; = 0.08) and who rated their community livability as low (AOR: 3.35; 95% CI: 0.81-13.87; = 0.09) were more likely to experience loneliness.

DISCUSSION

This needs assessment provided important information about the individual and social drivers of SI/L among rural older adults in the community. Findings support the generation of localized data to support muti-partner efforts to design sustainable programs to address SI/L.

摘要

介绍

社交孤立和孤独（SI/L）对农村社区老年人的不良影响已得到证实，并导致健康状况恶化、过早残疾和死亡，以及医疗保健系统负担加重。确定导致老年人 SI/L 的因素可以为农村政策制定者和领导人奠定基础，以便更有效地分配资源和制定有针对性的策略。本文的目的是描述一项需求评估的结果，该评估旨在了解田纳西州东北部一个县农村老年人中导致 SI/L 的当地因素。需求评估的结果将由当地利益相关者用于制定促进适合老年人的举措的策略。

方法

82 名年龄在 62 至 74 岁（59%；非西班牙裔白人（95%）；女性（71%））的老年人来自田纳西州东北部一个县的三个高级公寓楼，完成了 87 项需求评估调查。社交孤立的评估采用了 Lubben 的 6 项社交网络量表，而孤独感则采用了 UCLA 孤独量表的 3 项指标。使用逻辑回归分析来确定 SI/L 的预测因素。由于样本量有限，统计意义上认为 < 0.10。

结果

社会孤立和孤独的患病率分别为 42%和 37%。居住在该县不到 5 年（调整后的 OR [AOR]：3.35；95%CI：1.04-10.81； = 0.04）和报告与就地老龄化相关的资源障碍（AOR：6.56；95%CI：2.00-21.57； = 0.004）与社会孤立的几率增加相关；而对代际活动的兴趣则降低了社会孤立的几率（AOR：0.19；95%CI：0.05-0.69； = 0.01）。无聊（AOR：4.06；95%CI：1.63-12.11； = 0.01）和对社区服务的了解有限（AOR：4.61；95%CI：1.42-15.02； = 0.01）使孤独的几率增加了四倍。同样，身体虚弱的老年人（AOR：2.69；95%CI：0.88-8.17； = 0.08）和对社区宜居性评价较低的老年人（AOR：3.35；95%CI：0.81-13.87； = 0.09）更有可能感到孤独。