Three-item loneliness scale: psychometric properties and normative data of the Spanish version

Social Determinant of Health Framework to Examine the Impact of COVID-19 on Latino Health

OBJECTIVES

Evaluated how COVID-19 impacted Latino health across social, economic, and emotional dimensions and differentiated whether adverse COVID-19-related effects persisted across respondents.

METHODS

In both English and Spanish, a cross-sectional survey was conducted in the USA from June 2021 to April 2022. Chi-square tests, Z-tests, and T-tests were used to test for significant differences between Spanish- and English-speaking respondents. Multiple linear regressions were carried out to understand whether previously established determinants of health for Latinos accounted for greater COVID-19-related adversity across social, economic, and mental health dimensions. English as a primary language was significantly related to greater adverse emotional/mental health COVID-19 experiences after controlling for other social determinants of health factors (β = - 0.355, p < 0.001). Individuals who reported worrying about housing loss were significantly more likely to experience more adverse economic adversity due to COVID-19 (β = - 0.234, p < 0.001). Household income < $35,000 (β = 0.083, p < 0.05), having more than 5 people living in the same home (β = -0.102, p < 0.05), and work-related transportation barriers (β = - 0.114, p < 0.05) all increased the likelihood of household-related stressors occurring because of the pandemic.

CONCLUSIONS

The study highlights the heterogeneity in the Latino community and the key social, economic, and community-level factors most strongly correlated with adverse COVID-19-related outcomes.

Health Needs Assessment in Home-Living Older Adults: Protocol for a Pre-Post Study

BACKGROUND

Conducting a health needs assessment for older adults is important, particularly for early detection and management of frailty. Such assessments can help to improve health outcomes, maintain overall well-being, and support older adults in retaining their independence as they age at home.

OBJECTIVE

In this study, a systematic approach to health needs assessment is adopted in order to reflect real-world practices in municipal health care and capture the nuances of frailty. The aim is to assess changes in frailty levels in home-living older adults over 5 months and to examine the observable functional changes from a prestudy baseline (t1) to a poststudy period (t2). Additionally, the study explores the feasibility of conducting the health needs assessment from the perspective of home-living older adults and their informal caregivers.

METHODS

Interprofessional teams of registered nurses, physiotherapists, and occupational therapists will conduct 2 health needs assessments covering physical, cognitive, psychological, social, and behavioral domains. The study includes 40 home-living older adults of 75 years of age or older, who have applied for municipal health and care services in Norway. A quantitative approach will be applied to assess changes in frailty levels in home-living older adults over 5 months. In addition, we will examine the observable functional changes from t1 to t2 and how these changes correlate to frailty levels. Following this, a qualitative approach will be used to examine the perspectives of participants and their informal caregivers regarding the health needs assessment and its feasibility. The final sample size for the qualitative phase will be determined based on the participant's willingness to be interviewed. The quantitative data consist of descriptive statistics, simple tests, and present plots and correlation coefficients. For the qualitative analysis, we will apply thematic analysis.

RESULTS

The initial baseline assessments were completed in July 2023, and the second health needs assessments are ongoing. We expect the results to be available for analysis in the spring of 2024.

CONCLUSIONS

This study has potential benefits for not only older adults and their informal caregivers but also health care professionals. Moreover, it can be used to inform future studies focused on health needs assessments of this specific demographic group. The study also provides meaningful insights for local policy makers, with potential future implications at the national level.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05837728; https://clinicaltrials.gov/study/NCT05837728.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/55192.

Dementia Screening in Rural Kenya: The Prevalence and Impact of Screening Positive for Dementia

INTRODUCTION

In Kenya, there is a lack of data on the number of people with dementia. In this article, we aim to estimate the number of community-dwelling older adults (aged 60 years and above) that are potentially living with dementia in rural Kenya.

METHODS

Recruitment of older adults occurred through adopting a convenience approach based on the catchment areas served by ten trained community health workers. Screening was conducted using the Brief Community Screening Instrument for Dementia (CSI-D), in which prevalence ratios were reported. Regression analyses were run to understand the association between screening outcome and wellbeing, social isolation, and employment status (adjusted for age, sex, literacy, geography, and social status).

RESULTS

Of the 3,546 older adults who were screened for dementia, 652 screened positive (PR = 0.18, 95% CIs: 0.17-0.20). Back estimating screen positives based on established sensitivity and specificity of the tool against a gold standard (clinical diagnosis), yielded a prevalence of 9.4% (0.09, 95% CIs: 0.08-0.11). Screening positive for dementia was associated with poorer quality of life (B = -0.17, p < 0.001) and loneliness (B = 0.28, p < 0.001).

CONCLUSION

There are potentially 258,000 older adults living with dementia in Kenya, who likely have poorer outcomes. We need to encourage a timely diagnosis and develop better ways to support people living with dementia in Kenya and other resource-limited settings.

Reliability and validity evaluation of the stigma of loneliness scale in Chinese college students

BACKGROUND

The stigma of loneliness exacerbates the negative effect of loneliness, reduces the willingness to seek help, damages interpersonal relationships, and threatens health status. However, there is currently no valid scale for measuring the stigma of loneliness in China. The study aims to translate the Stigma of Loneliness Scale (SLS) and evaluate the reliability and validity of the Chinese version.

METHODS

The investigation was conducted in two phases. In the first phase, the SLS was used to conduct a questionnaire survey on 657 college students aged 17 to 24; in the second phase, the SLS, the UCLA Loneliness Scale (ULS-8), the Distress Disclosure Index (DDI), the Revised Cheek and Buss Shyness Scale (RCBS), the Self-Concealment Scale (SCS), the Social Interaction Anxiety Scale (SIAS), the Social Phobia Scale (SPS), the Kessler Psychological Distress Scale (K10), and the Rosenberg Self-Esteem Scale (RSES) were used to conduct the questionnaire survey on 801 college and graduates students aged 18 to 39.

RESULTS

Two dimensions of Self-stigma of Loneliness and Public Stigma of Loneliness were extracted with a cumulative factor interpretation rate of 74.60% when conducting exploratory factor analysis on the first-stage data. The factor loading of each item ranged from 0.585 to 0.890, and the commonality ranged from 0.609 to 0.735. The confirmatory factor analysis and reliability and validity test were carried out on the data gathered in the second phase, indicating that the two-factor model fits well. In addition, the scores of SLS and all dimensions were significantly positively correlated with the total scores of ULS-8, RCBS, SCS, SIAS, SPS, and K10, and negatively correlated with those of DDI and RSES. The Cronbach's alpha coefficients for SLS and SSL and PSL dimensions were 0.957, 0.941, and 0.955. The cross-group invariance test found that the SLS was equivalent for males and females. Meanwhile, males scored significantly higher than females on both the total scores of SLS score and each dimension.

CONCLUSIONS

The Chinese version of SLS displayed satisfactory psychometric properties and can be a valid tool to assess the stigma of loneliness among Chinese young people.

Measuring loneliness: Psychometric properties of the three-item loneliness scale among community-dwelling adults

Loneliness is a prevalent set of negative feelings associated with unsatisfactory and reduced social interactions, inadequate social support, poor satisfaction with life and health, negative emotions, and economic burden. Thus, its measurement is of foremost importance. Therefore, this study aimed (i) to devise the Portuguese version of the three-Item Loneliness Scale (T-ILS), which is ideal for epidemiological studies, and (ii) to evaluate its psychometric properties. Three hundred forty-five community-dwelling Portuguese adults with a mean age of 54.6 ± 19.5 years, 61.7% women, recruited door-to-door, were assessed with the Portuguese versions of T-ILS, Satisfaction With Life Scale-SWLS, Lubben Social Network Scale 6-items-LSNS-6, a question regarding Happiness/Unhappiness, and a sociodemographic questionnaire. The T-ILS showed good psychometric properties and correlated moderately with SWLS and LSNS-6, and happiness, and weakly with the number of people in the household. The Portuguese version of the T-ILS proved to be a valid and reliable instrument, easy and quick to administer. It proved to be a valuable tool in screening loneliness in Portugal, being potentially useful to the identification of lonelier people in need of intervention.

Association of loneliness and social isolation with all-cause mortality among older Mexican adults in the Mexican health and aging study: a retrospective observational study

BACKGROUND

Plenty of evidence shows how social isolation and loneliness are associated with increased risk for numerous diseases and mortality. But findings about their interactive or combined effects on health outcomes and mortality remains inconclusive.

OBJECTIVE

Analyze the longitudinal association of loneliness, social isolation and their interactions, with the all-cause mortality among older adults in Mexico.

METHODS

A retrospective observational study was conducted. Mexican adults older than 50 years were included. Data from the Mexican Health and Aging Study (MHAS) in the 2015 and 2018 waves were used. The subjects were classified according to their level of loneliness and the presence of social isolation. Multivariate logistic regression analyzes were performed to determine the degree of association between loneliness and social isolation with all-cause mortality at a 3-year follow-up.

RESULTS

From the total sample of 11,713 adults aged 50 years or over, 707 (6%) did not survive, 42% presented loneliness, and 53% were classified as socially isolated. After multivariate adjustment only social isolation (OR = 1.30, 95%CI:1.03-1.64) was associated with all-cause mortality, loneliness (Mild: OR = 0.83, 95%CI:0.59-1.16; Severe: OR = 1.03, 95%CI:0.71-1.64), and the interaction between loneliness and social isolation were not associated with all-cause mortality.

CONCLUSION

Social isolation, but not loneliness or their interaction, was associated with all-cause mortality in Mexican adults older than 50 years. This finding may help direct possible future interventions that help improve mental health in older adults from a highly collectivistic country.

The Health Literacy in Pregnancy (HeLP) Program Study Protocol: Development of an Antenatal Care Intervention Using the Ophelia Process

A pregnant woman needs adequate knowledge, motivation, and skills to access, understand, appraise, and apply health information to make decisions related to the health of herself and her unborn baby. These skills are defined as health literacy: an important factor in relation to the woman’s ability to engage and navigate antenatal care services. Evidence shows variation in levels of health literacy among pregnant women, but more knowledge is needed about how to respond to different health literacy profiles in antenatal care. This paper describes the development protocol for the HeLP program, which aims to investigate pregnant women’s health literacy and co-create health literacy interventions through a broad collaboration between pregnant women, partners, healthcare providers, professionals, and other stakeholders using the Ophelia (Optimising Health Literacy and Access) process. The HeLP program will be provided at two hospitals, which provide maternity care including antenatal care: a tertiary referral hospital (Aarhus University Hospital) and a secondary hospital (the Regional Hospital in Viborg). The Ophelia process includes three process phases with separate objectives, steps, and activities leading to the identification of local strengths, needs and issues, co-design of interventions, and implementation, evaluation, and ongoing improvement. No health literacy intervention using the Ophelia process has yet been developed for antenatal care.

The effect of loneliness and social support on the course of major depressive disorder among adults aged 50 years and older: A longitudinal study

BACKGROUND

Previous research indicates that social support, loneliness, and major depressive disorder (MDD) are interrelated. Little is known about the potential pathways among these factors, in particular in the case of adults aged 50 years and older and suffering from MDD. The objective was to investigate whether loneliness mediates the association between low social support and recurrent episodes of MDD.

METHODS

We used data from a cohort of the Spanish general population interviewed at three time-points over a 7-year period. We included 404 individuals aged 50+ suffering from MDD in the baseline assessment. A 12-month major depressive episode was assessed with the Composite International Diagnostic Interview (CIDI) at each interview. The University of California, Los Angeles Loneliness Scale was used to measure loneliness, whereas social support was assessed through the Oslo Social Support Scale. We tested cross-lagged and autoregressive longitudinal associations using structural equation modeling.

RESULTS

We identified two significant longitudinal mediation patterns: lower social support predicted higher subsequent levels of loneliness (Coef. = -0.16; p < .05), which in turn predicted an increase in MDD recurrence (Coef. = 0.05; p < .05).

CONCLUSIONS

Interventions focused on promoting social support among older adults suffering from MDD may decrease feelings of loneliness and prevent recurrent episodes of MDD.

Gender Differences in Psychological Stress Factors of Physical Therapy Degree Students in the COVID-19 Pandemic: A Cross-Sectional Study

(1) Background: The aim of the study was to investigate how the COVID-19 pandemic impacted the mental health and quality of life of male and female physical therapy students at the European University of Madrid. (2) Methods: A cross-sectional online survey was conducted including a range of tests capturing different domains: 36-item Short Form Health Survey, six-item state version of the State–Trait Anxiety Inventory, Acceptance and Action Questionnaire, Three Items Loneliness Scale, four-item version of the Perceived Stress Scale, Beck Depression Inventory revised version, and Sleep Quality Numeric Rating Scale. (3) Results: A total of 151 students completed the study, consisting of 78 females and 73 males. Gender differences were observed on most of the domains evaluated. Female participants showed worse levels of general health perception, quality of life, depression symptoms, anxiety, stress, experiential avoidance and psychological inflexibility, sleep quality and loneliness compared to male physical therapy students. (4) Conclusions: The results of this study support the need of psychological interventions as preventive programs in situations such as COVID-19 pandemic. The aims of this study comprise of improving knowledge, awareness, and self-coping strategies or other psychological domains oriented to mitigate the effects of COVID-19 on mental health and health-related quality of life in university students, especially among female ones.