[Social isolation and loneliness: What can we do as Primary Care teams?]

Voice assistants' influence on loneliness in older adults: a systematic review

Purpose: This review aims to examine how the use of voice assistants influences loneliness in older adults.

Materials and methods: This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases such as CINAHL, APA PsycINFO, MEDLINE, PubMed, Web of Science, ScienceDirect, Scopus, SciELO, Google Scholar, and IEEE Xplore were used. We implemented search strategies in English to locate studies published between January 2010 and January 2023, including those examining the impact of voice assistant usage on loneliness in older adults. Descriptive information was examined, assessing its quality with the Mixed Methods Appraisal Tool.

Results: A total of 499 studies were yielded from the initial search, with 13 included in the final analysis. Positive outcomes in reducing loneliness were reported in 84.6% of these studies. There was a prevalence of quasi-experimental studies, alongside heterogeneous measurement instruments, scarce use of standardized tests, and small samples predominantly consisting of women. Commercial voice assistants were the most commonly utilized.

Conclusions: Voice assistants show potential in mitigating feelings of loneliness in older adults. Adequate training and adaptation to specific needs seem essential to maximize their effectiveness. In particular, voice assistants available in the consumer market hold significant potential in this area. Further research is necessary to comprehend their impact, encompassing potential risks and ethical considerations.

Loneliness impact on healthcare utilization in primary care: A retrospective study

BACKGROUND

An increased number of patients seek help for loneliness in primary care.

OBJECTIVE

To analyze whether loneliness was associated with a higher utilization of healthcare facilities.

METHODS

Observational, retrospective study based on the review of routinely coded data in the digital medical record system in a random sample of patients aged 65 or older, stratified by population size of their residence area. A minimum sample size was estimated at 892 medical records. Loneliness was defined as the negative feeling that arises when there is a mismatch between the quantity and quality of a person's social relationships and those, they desire. Thirty-three primary care nurses (30 females and 3 males) were reviewing the data.

RESULTS

A total of 932 medical records of patients were reviewed (72% belonged to female patients). Of these, 657 individuals were living alone (71.9%). DeJong Scale average scores was 8.9 points (SD 3.1, 95CI 8.6-9.1). The average annual attendance to primary care ranged from 12.2 visits per year in the case of family practice, 10.7 nurse, 0.7 social workers. The average number of home visits was 3.2, and the urgent consultations attended at health centers were 1.5 per year. Higher feelings of loneliness were associated with extreme values in the frequency of healthcare resource usage. Compared to their peers of the same age, the additional healthcare resource consumption amounted to €802.18 per patient per year.

CONCLUSION

Loneliness is linked to higher healthcare resource usage in primary care, with individuals experiencing poorer physical and mental health utilizing these resources up to twice as much as their peers of the same age.

Effects of a Clinical Simulation-Based Training Program for Nursing Students to Address Social Isolation and Loneliness in the Elderly: A Quasi-Experimental Study

INTRODUCTION

The population of older adults is rapidly increasing worldwide, presenting both prospects and complexities for society and healthcare professionals to maximize the functional capacity of this age group. Social isolation and loneliness significantly affect this population. The objective was to determine the effectiveness, satisfaction, and perceptions of the simulation-based education practices of a training program for nursing students, which was created to palliate the social isolation and loneliness of older adults.

METHOD

A quasi-experimental study was conducted with nursing students who participated in an online training program using teleservice based on high-fidelity clinical simulation. The program included asynchronous theoretical training and synchronous practical training using an online platform. Five scenarios were designed using simulated phone calls to address the social isolation and loneliness of older adults.

RESULTS

Twenty-five nursing students participated in the program, and they had a mean age of 27.44, with 76% of them being women. After the training program, the participants showed statistically significant improvements (p < 0.05) with respect to their knowledge and attitudes towards older adults, and the program was adapted to the best educational practices in simulations.

CONCLUSIONS

Simulation-based online training efficiently improved the knowledge and attitudes of nursing students towards older adults, improving their ability to address social isolation and loneliness. The high satisfaction and adhesion to the best educational practices underline the usefulness of high-fidelity online simulations, especially in situations in which face-to-face training is not feasible, and accessibility and equilibrium could be guaranteed between work and personal life.

[Quarantine by COVID-19 in a health professional: psychological, social and family dimensions]

OBJECTIVE

To analyze the psychological, social and family dimensions of a health professional quarantined by COVID-19.

METHOD

Case report. A matrix was used as a daily log to collect information from the three dimensions analyzed. The anonymity of the person was respected at all times.

RESULTS

A case study is presented with the main milestones in the daily life of a health professional during the 14 days of quarantine. In the psychological dimension, feelings of fear and uncertainty in the face of risk are highlighted, in the social dimension the importance of the accompaniment of family and friends who strengthened the adaptability to the process stands out, and in the family dimension the relevance of affective bonds and permanent communication.

CONCLUSION

The aspects developed in the different dimensions should be considered by those who participate in the management and follow-up of cases in primary care, as they are the possibility of strengthening the neuronal and hormonal mechanism through family and social support. Being a health professional and having knowledge on the subject can generate a greater effect of involuntary isolation related to the risk of COVID-19. This is not only clinical, but also psychological, social and family. In this sense those who manage the cases should consider the integrality in health conditions.

[Determinants for addressing social isolation and loneliness of non-institutionalized older adults from Primary Health Care]

Objetivo

Identificar los principales condicionantes que los profesionales de atención primaria indican a la hora de implementar y desarrollar intervenciones sobre el aislamiento y la soledad.

Diseño

Investigación cualitativa con análisis Sistemático de Teoría Fundamentada y Diseño narrativo de tópicos.

Emplazamiento

Desarrollada en 13 centros de atención primaria del Distrito Sanitario Córdoba y Guadalquivir, abarcando zonas urbanas y rurales.

Participantes

Se identificaron 3 perfiles: medicina de familia/atención comunitaria, enfermería comunitaria y enfermería de gestión de casos. La selección se llevó a cabo entre aquellos que mostraron mayor motivación y compromiso con una intervención sobre aislamiento/soledad.

Método

Muestreo intencional. El trabajo se fundamentó en entrevistas en profundidad individuales, en grupos focales y entrevistas dialógicas.

Resultados

a) Persisten imágenes deformadas sobre la soledad/aislamiento social y el vivir solo que dificultan su identificación; b) Los principales determinantes disruptivos en la estructura y organización del sistema de atención tienen que ver con la ausencia de programas de detección, la hegemonía del modelo biomédico y el déficit de recursos (a la luz de este modelo); c) Los principales facilitadores se vinculan con el rol enfermero, privilegiado para estas intervenciones según los participantes; y, finalmente, d) Es necesario contar con componentes personales, tanto de la persona mayor como de los profesionales.

Conclusiones

La intervención sobre el aislamiento social y la soledad en atención primaria está condicionada por factores, organizacionales y estructurales, profesionales y personales. Contar con ellos es fundamental a la hora de garantizar su factibilidad.

Procrastinación e incremento del estrés en docentes y estudiantes universitarios frente a la educación online

La incidencia de la pandemia en el mundo ha dado un giro exponencial a los procesos sociales y, por ende, a la modalidad de formación en los procedimientos académicos de todas las instituciones educativas. Con ello y en concordancia con el análisis de la procrastinación y su incidencia en el incremento del estrés tanto en estudiantes como en docentes universitarios, que han tenido que adaptarse a la enseñanza online que, se ha propuesto como objetivo, la necesidad de observar estas conductas mediante la aplicación metodológica que consideró el enfoque mixto cuali-cuantitativo, apoyado en un análisis descriptivo. Ha sido necesario, revisar y priorizar presupuestos teóricos de varios documentos publicados; además, se aplicó un cuestionario estructurado a una muestra intencional lo que ha permitido obtener como resultados, el análisis de conductas de procrastinación y características propias del estrés que se han visto incrementadas en la muestra estudiada tales como: emociones, pensamientos, conductas y cambios físicos los cuales coadyuvan a proponer el uso adecuado del tiempo en todas las actividades académicas y sociales, para facilitar la consecución de las tareas cotidianas, plantear alternativas de solución minimizando el impacto y desarrollando actitudes de apoyo a la gestión docente y discente de los universitarios.

[Unwanted loneliness, health and social inequalities throughout the life cycle]

OBJECTIVE

To analyse the prevalence of unwanted loneliness in our context and its association with health from a life cycle and social inequalities perspective.

METHOD

Cross-sectional study based on data from the Health Survey of the Basque Country (n = 7.228; response rate 79%). The prevalence of unwanted loneliness, its association with perceived health and mental health, and social inequalities according to social class were analysed. To analyse the association, age-adjusted prevalence ratios (PR) calculated from robust Poisson models were calculated.

RESULTS

The feeling of unwanted loneliness affects 23.3% of men and 29.7% of women, being higher in older people and young adults, and in the most disadvantaged social classes. Feeling alone is associated with worse health, both general (PRa men 2.11, 95% confidence interval [95%CI] 1.77-2.51; PRa women 2.10, 95%CI 1.83-2.41) and mental (PRa men 3.95, 95%CI 3.15-4.95; RPa women 3.50, 95%CI 2.99-4.12). Social inequalities in loneliness, as well as the association between it and poor health, was greater among young adults.

CONCLUSIONS

The results of the study have important implications for intervention in the reduction and prevention of unwanted loneliness, underlining the importance of the life cycle and social inequalities.

Intervention to reduce perceived loneliness in community-dwelling older people

AIM

We evaluated the reduction in perceived loneliness and depression and the increase in social support and quality of life in community-dwelling lonely people aged >65 years included in a community intervention compared with nonlonely controls from the same urban area.

DESIGN

Randomised clinical trial without blind evaluation.

LOCATION

Urban area of Barcelona.

PARTICIPANTS

Community dwellers aged >65 years with loneliness identified by the primary care team.

INTERVENTIONS

The primary care team together with community agents (municipal social services, community civil and religious associations) carried out 18 sessions developing activities including educational workshops, mindfulness, yoga, walking and visits to urban gardens.

RESULTS

We included 55 patients (87% female, mean age 80.6 ± 6.86 years) of whom 82% had moderate and 18% severe loneliness. Six months postintervention, 48.3% of the intervention group did not feel lonely compared with 26.9% of controls (p = 0.001). Social support (DUKE-UNC-11) increased from 33.5 ± 9.3 to 41.4 ± 6.6, and mental health (SF-12) from 36 ± 610.4 to 48 ± 11.1 and depressive symptoms (Yesavage test) decreased from 9.2 ± 3.6 to 5.2 ± 5.0 in the intervention but not the control group.

CONCLUSIONS

The intervention mainly reached people with moderate loneliness and significantly improved the perception of loneliness, depressive symptoms, social support and the mental health component of the quality of life. The intervention may be more suitable for people with moderate loneliness, but these types of activities may be difficult to accept by people with severe loneliness not related to the barriers to socialisation generated by ageing.

Soledad en el adulto mayor: implicaciones para el profesional de enfermería

Introducción: La soledad es una vivencia desfavorable, relacionada con la sensación de tristeza, que afecta la cotidianidad de la persona, el adulto mayor es más propenso a tener sentimientos de soledad debido a la falta de interacción con amigos, la enfermedad, la viudez o el deterioro cognitivo. El objetivo de este estudio fue integrar los hallazgos sobre la soledad en el adulto mayor e identificar los aspectos que influyen en la misma.  Materiales y Métodos: Se realizó una revisión sistemática de alcance integrativo. La búsqueda de información se realizó en 9 bases de datos, durante el periodo 2007 al 2018, se incluyeron en la revisión 36 estudios. Resultados: De acuerdo con la información encontrada emergieron 4 temas: características de la soledad en el adulto mayor, causas de la soledad, consecuencias de la soledad y factores que disminuyen los sentimientos de soledad. Discusión: La literatura indica que la soledad se relaciona principalmente con el aislamiento social, debido a la falta de interacción con otras personas y el desapego familiar lo que genera baja calidad de vida y riesgo de padecer enfermedades crónicas, es por esta situación que los profesionales de la salud deben prestar atención a una valoración holística del adulto mayor. Conclusiones: Los estudios muestran que existen varios aspectos que influyen en el proceso de soledad del adulto mayor, así como las principales acciones que puede realizar el profesional de la salud para intervenir este fenómeno.Como citar este artículo: Chaparro LD, Carreño SM, Arias-Rojas M. Soledad en el adulto mayor: implicaciones para el profesional de enfermería. Rev Cuid. 2019; 10(2): e633. http://dx.doi.org/10.15649/cuidarte.v10i2.633

[Profiles of loneliness and social isolation in urban population]

Objetivo

Determinar la prevalencia de soledad y aislamiento social en la población mayor de 65 años cubierta por un equipo de atención primaria urbano e identificar sus principales características.

Diseño

Encuesta telefónica.

Emplazamiento

Área básica de Barcelona.

Participantes

Muestra aleatoria de población asignada de edad igual o superior a 65 años.

Mediciones principales

Encuesta de soledad de UCLA, escala de red social de Lubben.

Resultados

Se entrevistó a 278 personas (respuesta 61,36%), 172 mujeres y 106 hombres, con una edad media de 76,7 ± 7,9 años. Existía una mayor proporción de factores de riesgo de soledad en los que no respondieron. La soledad se correlaciona estrechamente con el aislamiento social r = 0,736. La soledad moderada, con una prevalencia del 16,54%, se asocia a presentar dificultades a la marcha (OR 3,09, IC del 95%, 1,03-9,29), deterioro cognitivo (OR 3,97, IC del 95%, 1,19-13,27) y a barreras arquitectónicas (OR 5,29, IC del 95%, 2,12-13,23), mientras que la soledad severa, con una prevalencia de 18,71%, solo se asocia a convivir con menos personas (OR 0,61, IC del 95%, 0,40-0,93). El riesgo de aislamiento social, con una prevalencia del 38,85%, se asocia a la edad (OR 1,06, IC del 95%, 1,02-1,10) y a problemas de salud (OR 4,35, IC del 95%, 1,11-16,99).

Conclusiones

La soledad y el aislamiento social son muy prevalentes. Existen 2 perfiles de soledad, una moderada relacionada con las dificultades a la sociabilidad que aparecen con el envejecimiento y otra severa que no está asociada a la salud o las barreras. Las intervenciones deberían adecuarse a cada uno de estos perfiles.