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Volkos P, Linardakis M, Stamati M, Symvoulakis EK. Exploring Loneliness, Trust, and Psychosocial Meanings Among Primary Care Attendees: A Cross-Sectional Study From a General Practice Setting in Crete, Greece. Cureus 2024; 16:e61019. [PMID: 38910642 PMCID: PMC11194041 DOI: 10.7759/cureus.61019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2024] [Indexed: 06/25/2024] Open
Abstract
INTRODUCTION Loneliness is often associated with behavioral, psychological, social, and mental and physical health aspects, while the relationship between trust and loneliness is still challenging in terms of research. The present study aimed to investigate to what extent loneliness and trust interact and if there is any association between loneliness and routine events or behaviors that affect overall well-being. METHODS This cross-sectional sample of 120 participants, aged between 40 and 75 years, was collected from an urban Primary Health Care Unit, between May and July 2023, in a consecutive manner, after criteria application. The University of California, Los Angeles (UCLA) Loneliness Scale (Version 3) and the Personal Trust and Connections Scale (PerTC) were completed. Hierarchical multiple linear regression analysis in steps and multiple logistic regression analysis were performed. RESULTS The mean age of the participants was 59.8 years and the majority were females (73.3%). Only 10.8% were found to have no Behavioral Risk Factors (BRFs). A higher sense of loneliness was associated with being widowed/unmarried/divorced (unstandardized β=-4.10, p=0.045), not having children (β=-2.80, p=0.038), having more BRFs (β=2.03, p=0.032), or being in contact with fewer friends (β=-0.56, p<0.001). A higher sense of loneliness was related to lower levels of trust (β=-1.29, p=0.032). Lower odds of demonstrating high levels of loneliness were found among married individuals (odds ratio (OR): 0.38; 95% confidence interval (CI) 0.15, 0.95; p=0.039) and those who reported six or more routine contacts or meetings with friends (OR: 0.31; 95% CI 0.13, 0.74; p=0.008). A lower score on the total PerTC scale was related to higher odds of increased loneliness (OR: 2.78; 95%CI 1.01, 7.62; p=0.048). CONCLUSION Being married and coming in contact or meeting with more friends was associated with lower odds of reporting high feelings of loneliness, while lower trust was correlated with increased odds of loneliness. Also, persons with more BRFs were found to have a higher loneliness score. Given their inverse correlation, tools that measure levels of loneliness and trust, like the UCLA and PerTC scales, may be used within primary care consultation to offer new insights on health risk behaviors and their possible synergistic influences.
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Affiliation(s)
- Panagiotis Volkos
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, GRC
| | - Manolis Linardakis
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, GRC
| | - Maria Stamati
- 4th Local Health Team, Academic Unit of Heraklion, Heraklion, GRC
| | - Emmanouil K Symvoulakis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, GRC
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Volkos P, Linardakis M, Stachteas P, Anastasiou F, Tatsioni A, Kampa M, Symvoulakis EK. Association between Levels of Loneliness, Laboratory Measurements, and Behavioral Aspects in a Primary Care Setting in Crete, Greece. Eur J Investig Health Psychol Educ 2024; 14:1055-1067. [PMID: 38667824 PMCID: PMC11049108 DOI: 10.3390/ejihpe14040069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
This paper examines potential associations of loneliness with laboratory data and specific psychosocial and behavioral attitudes. The sample collection took place in an urban Primary Health Care unit between May and July 2023, consecutively, and once exclusion criteria were implemented. Participants were aged between 40 and 75 years. Routine laboratory test results upon study initiation and six months before were used. The University of California, Los Angeles (UCLA), Loneliness Scale (Version 3), blood glucose, serum lipids, Fibrosis-4 index, and Creatinine Clearance (CrCl) were assessed through hierarchical multiple logistic regression analysis. Based on full model (3rd) analysis, those who were engaged in an individual sport or activity or had contacts with more friends presented significantly lower odds for increased loneliness levels (odds ratio (OR): 0.28 [95% confidence interval (CI) 0.09-0.91], p = 0.034 and OR: 0.76 [95%CI 0.66-0.88], p < 0.001, respectively). The consumption of alcohol was associated with increased loneliness (OR: 5.55 [95%CI 1.42-21.63], p = 0.014). Elevated triglyceride levels were linked with moderate or no loneliness (OR: 0.20 [95%CI 0.05-0.83], p = 0.026), while an increased LDL/HDL atherosclerotic index was related to increased subjective loneliness (OR: 4.50 [95%CI 1.12-18.13], p = 0.035). The need for holistic approaches-involving primary care personnel-in understanding and addressing loneliness, recognizing its multifaceted nature as well as the diverse factors that contribute to this issue, is considered challenging.
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Affiliation(s)
- Panagiotis Volkos
- Fourth Local Health Team—Academic Unit of Heraklion, 71303 Heraklion, Greece
| | - Manolis Linardakis
- Department of Social Medicine, School of Medicine, University of Crete, 70013 Heraklion, Greece
| | - Panagiotis Stachteas
- Laboratory of Primary Health Care, General Practice and Health Services Research, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Foteini Anastasiou
- Fourth Local Primary Care Team (TOMY), Municipality Practice, Academic Practice of Heraklion, University of Crete, 71303 Heraklion, Greece
| | - Athina Tatsioni
- Research Unit for General Medicine and Primary Health Care, University of Ioannina, 45110 Ioannina, Greece
| | - Marilena Kampa
- Laboratory of Experimental Endocrinology, School of Medicine, University of Crete, 70013 Heraklion, Greece
| | - Emmanouil K. Symvoulakis
- Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, 70013 Heraklion, Greece
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Parmar M, Ma R, Attygalle S, Herath MD, Mueller C, Stubbs B, Stewart R, Perera G. Associations between recorded loneliness and adverse mental health outcomes among patients receiving mental healthcare in South London: a retrospective cohort study. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02663-9. [PMID: 38622311 DOI: 10.1007/s00127-024-02663-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 03/19/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE Loneliness disproportionately affects people with mental disorders, but associations with mental health outcomes in groups affected remain less well understood. METHOD A cohort of patients receiving mental healthcare on 30th June 2012 was assembled from a large mental health records database covering a south London catchment area. Recorded loneliness within the preceding 2 years was extracted using natural language processing and outcomes were measured between 30th June 2012 until 30th December 2019, except for survival which applied a censoring point of 6th December 2020 according to data available at the time of extraction. The following mental healthcare outcomes: (i) time to first crisis episode; (ii) time to first emergency presentation; (iii) all-cause mortality; (iv) days active to service per year; and (v) face-to-face contacts per year. RESULTS Loneliness was recorded in 4,483 (16.7%) patients in the study population and fully adjusted models showed associations with subsequent crisis episode (HR 1.17, 95% CI 1.07-1.29), emergency presentation (HR 1.30, 1.21-1.40), days active per year (IRR 1.04, 1.03-1.05), and face-to-face contacts per year (IRR 1.28, 1.27-1.30). Recorded loneliness in patients with substance misuse problems was particularly strongly associated with adverse outcomes, including risk of emergency presentation (HR 1.68, 1.29-2.18) and mortality (HR 1.29, 1.01-1.65). CONCLUSION Patients receiving mental healthcare who are recorded as lonely have a higher risk of several adverse outcomes which may require a need for higher service input.
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Affiliation(s)
- Mayur Parmar
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (King's College London), De Crespigny Park, Box 92, London, SE5 8AF, UK
| | - Ruimin Ma
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (King's College London), De Crespigny Park, Box 92, London, SE5 8AF, UK
| | | | - Maaheshi Deepika Herath
- Ministry of Health Sri Lanka, Colombo, Sri Lanka
- Faculty of Life and Health Sciences, School of Medicine, Ulster University, Belfast, Northern Ireland
| | - Christoph Mueller
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (King's College London), De Crespigny Park, Box 92, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (King's College London), De Crespigny Park, Box 92, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Robert Stewart
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (King's College London), De Crespigny Park, Box 92, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Gayan Perera
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (King's College London), De Crespigny Park, Box 92, London, SE5 8AF, UK.
- South London and Maudsley NHS Foundation Trust, London, UK.
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Githinji P, Uribe ALM, Seguin-Fowler RA, Ayine P, On A, Villarreal DL, McNeely A, Szeszulski J, Rethorst CD. A qualitative exploration of the health needs and goals of urban women to inform the tailoring and adaptation of Strong Hearts Healthy Communities: a community-based cardiovascular disease prevention intervention. BMC Public Health 2024; 24:296. [PMID: 38273284 PMCID: PMC10811835 DOI: 10.1186/s12889-024-17818-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND In the United States, cardiovascular diseases (CVD) are the leading cause of death and disability in women. CVD-modifiable risk factors, including poor diet quality and inadequate physical activity, can be addressed through evidence-based interventions (EBIs). Strong Hearts Healthy Communities (SHHC) is an EBI that has demonstrated effectiveness in reducing CVD risk and improving health outcomes among rural white women. The aims of this study were to understand the general health, diet, and physical activity-related needs and goals of women living in an urban community, to inform the tailoring and adaptation of the SHHC EBI to an urban setting and more diverse population. METHODS Focus groups (FGs) were conducted with African American/Black and Hispanic/Latinx women in the Dallas metropolitan area who had a BMI ≥ 25 kg/m2 and engaged in ≤ 150 min per week of moderate physical activity. The data were coded using a team-based, deductive, and thematic analysis approach, that included multiple coders and in-depth discussions. RESULTS Four FGs with a total of 18 participants (79% Black and 21% Latinx) were conducted, and three themes were developed: (1) participants had adequate knowledge and positive attitudes towards healthy living but faced many barriers to practicing healthy behaviors; (2) culturally-based beliefs and community practices exerted a strong influence on behaviors related to food and stress, revealing barriers to healthy eating and generational differences in stress and stress management; (3) participants desired a more individualized approach to nutrition and physical activity interventions that included familiar and enjoyable activities and social support centered around shared health goals. CONCLUSIONS The SHHC intervention and similar health programs for Black/African American and Hispanic/Latinx women in urban settings should emphasize individualized nutrition and practical skills for healthy eating with accessible, familiar, and enjoyable exercises. Additionally, stress management strategies should be culturally and generationally sensitive and social support, whether through family, friends, or other program participants, should be based on shared health goals.
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Affiliation(s)
- Phrashiah Githinji
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Dallas, TX, USA.
| | | | - Rebecca A Seguin-Fowler
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Dallas, TX, USA
| | - Priscilla Ayine
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Dallas, TX, USA
| | - Anita On
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Dallas, TX, USA
| | - Deyaun L Villarreal
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Dallas, TX, USA
| | - Andrew McNeely
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Dallas, TX, USA
| | - Jacob Szeszulski
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Dallas, TX, USA
| | - Chad D Rethorst
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Dallas, TX, USA
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Park SY, Yourell J, McAlister KL, Huberty J. Exploring Generation Z and Young Millennials' Perspectives of a Spiritual Self-Care App and Their Spiritual Identity (Skylight): Qualitative Semistructured Interview Study. JMIR Form Res 2023; 7:e54284. [PMID: 38064199 PMCID: PMC10784987 DOI: 10.2196/54284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Generation Z and young millennials (ages 18-35 years), collectively referred to as GenZennials, are connected to technology and the internet like no other generation before them. This has mental health implications, such as increased rates of anxiety and stress. Recent research has shown that app-based mental health interventions can be useful to address such mental health concerns. However, spirituality is an untapped resource, especially since GenZennials largely identify as spiritual and already integrate spiritual practices into their self-care. OBJECTIVE There were four objectives to this study: (1) comprehensively explore reasons why GenZennials use a spiritual self-care app (ie, Skylight; Radiant Foundation), (2) understand how GenZennials identify spiritually, (3) understand the app's relevance to GenZennials, and (4) gather feedback and suggestions to improve the app. METHODS Semistructured interviews were conducted with 23 GenZennials (ages 18-35 years; mean 28.7, SD 5.0 years; n=20, 87% female) who used the Skylight app. Interviews were 30 to 60 minutes and conducted on Zoom. Thematic analysis was used to analyze interviews. RESULTS Five major categories emerged from the analysis, each encompassing one to several themes: (1) reasons for using the Skylight app, (2) content favorites, (3) defining spiritual identity, (4) relevance to GenZennials, and (5) overall improvement recommendations. Participants used the app for various reasons including to relax, escape, or ground themselves; improve mood; and enhance overall health and wellness. Participants also cited the app's variety of content offerings and its free accessibility as their primary reasons for using it. Most participants identified themselves as solely spiritual (8/23/35%) among the options provided (ie, spiritual or religious or both), and they appreciated the app's inclusive content. Participants felt that the app was relevant to their generation as it offered modern content (eg, spiritual self-care activities and short content). Participants recommended adding more personalization capabilities, content, and representation to the app. CONCLUSIONS This is the first study to qualitatively explore GenZennials' perspectives and the use of a spiritual self-care app. Our findings should inform the future creation and improvement of spiritual self-care apps aimed at cultivating GenZennials' spiritual and mental well-being. Future research is warranted to examine the effects of using a spiritual self-care app on GenZennial mental health.
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Affiliation(s)
- Susanna Y Park
- Skylight, Radiant Foundation, Salt Lake City, UT, United States
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