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理解丧偶后的孤独感:社会隔离、社会支持、自我效能感及健康相关因素的作用。

Understanding loneliness after widowhood: The role of social isolation, social support, self-efficacy, and health-related factors.

作者信息

Freak-Poli Rosanne, Htun Htet Lin, Teshale Achamyeleh Birhanu, Kung Claryn

机构信息

School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.

School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.

出版信息

Arch Gerontol Geriatr. 2025 Feb;129:105692. doi: 10.1016/j.archger.2024.105692. Epub 2024 Nov 9.

Abstract

BACKGROUND

Widowhood negatively affects trajectories of social isolation and loneliness. Given the inevitability of spousal bereavement for many, further investigation into potential modifiers of bereavement-related loneliness is warranted.

AIM

To examine the moderating effects of social isolation, social support, sociodemographic, self-efficacy, health, and quality of life factors on changes in loneliness before and after widowhood.

METHODS

We analysed 19 waves of data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey, comprising 749 widowed and 8,418 married individuals (comparison). Coarsened exact matching weights were applied, controlling for age and time trends. Local polynomial smoothed plots illustrated social health trajectories from three years before to three years after spousal death. All analyses were gender-stratified.

RESULTS

Low social isolation and higher social support did not prevent increased loneliness following widowhood. Men in major cities were less likely to experience reductions in social isolation during bereavement, despite being less socially-isolated at baseline than men in regional/remote areas. The bereavement-loneliness relationship was consistent across all subgroups. For men, this relationship was weakened by older age and being born in a non-English-speaking country, but strengthened by poverty and living in a regional/remote areas. For women, it was weakened by older age, and strengthened by factors such as being born in a non-English-speaking country, poverty, employment or volunteering, and having a long-term mental health condition.

CONCLUSION

Loneliness is a common and potentially unavoidable experience during widowhood, highlighting the importance of screening by healthcare workers to improve wellbeing and prevent future mental health issues.

摘要

背景

丧偶对社会孤立和孤独的轨迹产生负面影响。鉴于许多人配偶丧亡的不可避免性,有必要进一步研究丧亲相关孤独感的潜在调节因素。

目的

研究社会孤立、社会支持、社会人口统计学、自我效能、健康和生活质量因素对丧偶前后孤独感变化的调节作用。

方法

我们分析了澳大利亚家庭、收入和劳动力动态调查(HILDA)的19轮数据,包括749名丧偶者和8418名已婚者(对照组)。应用粗化精确匹配权重,控制年龄和时间趋势。局部多项式平滑图展示了配偶死亡前三年到死亡后三年的社会健康轨迹。所有分析按性别分层。

结果

低社会孤立和较高的社会支持并不能阻止丧偶后孤独感的增加。大城市的男性在丧亲期间社会孤立感降低的可能性较小,尽管他们在基线时的社会孤立程度低于地区/偏远地区的男性。丧亲与孤独感之间的关系在所有亚组中都是一致的。对于男性来说,这种关系因年龄较大和出生在非英语国家而减弱,但因贫困和生活在地区/偏远地区而增强。对于女性来说,它因年龄较大而减弱,并因出生在非英语国家、贫困、就业或志愿服务以及患有长期心理健康问题等因素而增强。

结论

孤独是丧偶期间常见且可能不可避免的经历,这凸显了医护人员进行筛查以改善幸福感和预防未来心理健康问题的重要性。

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