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Akhter-Khan SC, van Es W, Prina M, Lawrence V, Piri I, Rokach A, Heu LC, Mayston R. Experiences of loneliness in lower- and middle-income countries: A systematic review of qualitative studies. Soc Sci Med 2024; 340:116438. [PMID: 38016310 DOI: 10.1016/j.socscimed.2023.116438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/03/2023] [Accepted: 11/13/2023] [Indexed: 11/30/2023]
Abstract
Loneliness is understood as a subjective experience resulting from unmet social relationship expectations. As most loneliness research has been conducted in higher-income-countries, there is limited understanding of loneliness in relation to diverse cultural, economic, and socio-political factors. To address this gap, the present review systematically synthesises existing qualitative studies on the experience of loneliness and social relationship expectations in lower- and middle-income countries (LMICs). Between June and July 2022, six online databases (Embase, Ovid Medline, APA PsycINFO, Global Health, Web of Science, Google Scholar) were searched for peer-reviewed studies from LMICs on loneliness using qualitative methods. There were no restrictions on publication date, language, or study setting. Studies that solely focused on social isolation or were conducted with children (<16 years) were excluded. Risk of bias was assessed with the Critical Appraisal Skills Programme. After deduplication, a total of 7866 records were identified and screened for inclusion, resulting in 24 studies published between 2002 and 2022. The included studies represent data from 728 participants in 15 countries across West Africa (Ghana, Nigeria, Niger, Mali), East Africa (Uganda, Kenya), North Africa (Egypt), West Asia (Iran), South Asia (India, Pakistan, Sri Lanka) and Southeast Asia (Myanmar, Cambodia, Indonesia, Philippines). Data were analysed combining inductive and deductive coding, summarised using narrative synthesis, and examined by geographical region. Common features of loneliness included rejection, overthinking, and pain. Loneliness was related to depression across regions. Whereas loneliness tended to be distinguished from social isolation in studies from Africa, it tended to be related with being alone in studies from Asia. Poverty and stigma were common barriers to fulfilling social relationship expectations. This review illustrates how loneliness and expectations are contextually embedded, with some expectations possibly being specific to a certain culture or life stage, having implications for assessment of and interventions for loneliness worldwide.
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Affiliation(s)
- Samia C Akhter-Khan
- Department of Global Health & Social Medicine, King's College London, London, United Kingdom.
| | - Willemijn van Es
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, the Netherlands
| | - Matthew Prina
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Vanessa Lawrence
- Department of Health Service & Population Research, King's College London, London, United Kingdom
| | - Ilayda Piri
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, the Netherlands
| | - Ami Rokach
- Department of Psychology, York University, Toronto, Canada
| | - Luzia C Heu
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, the Netherlands
| | - Rosie Mayston
- Department of Global Health & Social Medicine, King's College London, London, United Kingdom
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Jøranson N, Zechner M, Korkmaz Yaylagul N, Efthymiou A, Silva R. Experienced barriers in the use of ICT for social interaction in older adults ageing in place: a qualitative systematic review protocol (SYSR-D-22-00848). Syst Rev 2023; 12:192. [PMID: 37817279 PMCID: PMC10563227 DOI: 10.1186/s13643-023-02332-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 08/18/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Several information and communication technologies (ICT) have been developed to enhance social connectedness of older adults aging in place, although they are not accessible for all. Barriers in using ICT might for example relate to health issues, sensory loss, lack of technical skills, or reluctance to use technologies. Though knowledge on these barriers is crucial for the development and implementation of ICT for older adults, no systematic review was found on this subject. The proposed qualitative systematic review aims to explore barriers experienced by older adults aging in place in using ICT for social interaction. METHODS The review will be conducted in accordance with the JBI methodology. Databases for search will include MEDLINE (via PubMed), CINAHL (via EBSCO), and Web of Science (ISI), among others. Included studies focus on older adults ageing in place 60 years or older. Pairs of authors will independently, by following agreed guidelines, assess the eligibility of studies, and extract data. The testing of eligibility criteria and screening of titles, abstracts, and full texts will be performed. The findings will describe for example populations, context, culture, and the phenomena of interest. Qualitative research findings will, where possible, be pooled by using JBI SUMARI for the meta-aggregation approach. DISCUSSION The mapping of published studies has the potential to identify research gaps in the existing literature, which again may inform developers and stakeholders in designing more user-friendly and adaptive ICT solutions for older people ageing in place. SYSTEMATIC REVIEW REGISTRATION CRD42022370044.
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Affiliation(s)
- Nina Jøranson
- Faculty of Health Studies, VID Specialized University, Vinderen, PO Box 184, N-3019, Oslo, Norway.
| | - Minna Zechner
- University of Helsinki, Faculty of Social Sciences, University of Helsinki, Helsinki, P.O. Box 54 (Unioninkatu 37), 00014, Finland
| | - Nilufer Korkmaz Yaylagul
- Faculty of Health Science, Gerontology Department, Akdeniz University, Dumlupınar Boulevard, 07058, Antalya, Turkey
| | - Areti Efthymiou
- Quality of Life Lab, Department of Social Work, Hellenic Mediterranean University, Estavromenos Heraklion, Crete, PC 71410, Greece
| | - Rosa Silva
- Center for Health Technology and Services Research (CINTESIS), Nursing School of Porto, 4200-072, Porto, Portugal
- Portugal Centre for Evidence Based Practice, A JBI Centre of Excellence (PCEBP), 3000-232, Coimbra, Portugal
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3
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Wang YC, Lin PH, Lin YL, Lee YC, Wang JY, Chen YC, Yang SY. Factors influencing loneliness among older people using homecare services during the COVID-19 pandemic. Psychogeriatrics 2023; 23:252-260. [PMID: 36577404 PMCID: PMC9880683 DOI: 10.1111/psyg.12927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/15/2022] [Accepted: 12/15/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Elderly homecare service users may reduce their level of social participation and interpersonal interactions due to physiological loss, which may lead to loneliness and depression over the years. However, there is a lack of research on loneliness among older people who use homecare services. The purpose of this study was to examine the factors influencing loneliness among older people using homecare services. METHODS This is a longitudinal study conducted in communities in Central Taiwan, and data were collected using a structured questionnaire. The questionnaire was first administered as a pre-test to obtain baseline information about the participants, and the same questionnaire was administered as a post-test after 6 months to follow-up. The pre- and post-test questionnaires included five sections, that is, participant demographics, Brief Symptom Rating Scale, Interpersonal Interaction Scale (IIS), Frenchay Activities Index, and UCLA Loneliness Scale (UCLA). RESULTS A total of 178 participants were recruited in this study. Results indicated that gender, whether participants eat alone or with others at dinner, social media use, perceived economic status, and IIS score were significantly correlated with the loneliness score on the UCLA. Furthermore, there was a significant increase in the loneliness score among male participants in the low loneliness group from baseline to 6 months follow-up. CONCLUSIONS Gender, presence of others at dinner, social media use, perceived economic status, and interpersonal interaction skills are significant factors that influence loneliness among older people using homecare services. Men tend to experience higher levels of loneliness over time.
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Affiliation(s)
- Yu-Chi Wang
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Pin-Hsuan Lin
- Department of Health and Beauty, Shu Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Ying-Lien Lin
- Department of Industrial and Information Management, National Cheng Kung University, Tainan City, Taiwan
| | - Ya-Chen Lee
- Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Jiun-Yi Wang
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Yi-Ching Chen
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Shang-Yu Yang
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Bower M, Kent J, Patulny R, Green O, McGrath L, Teesson L, Jamalishahni T, Sandison H, Rugel E. The impact of the built environment on loneliness: A systematic review and narrative synthesis. Health Place 2023; 79:102962. [PMID: 36623467 DOI: 10.1016/j.healthplace.2022.102962] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 01/09/2023]
Abstract
Loneliness is a pressing public health issue. Although quintessentially individual, it is shaped by wider environmental, cultural, socio-economic, and political circumstances. Using a systematic review methodology, this paper draws on interdisciplinary research to conceptualise the relationship between the built environment and loneliness. We present a narrative synthesis of 57 relevant studies to characterise the body of evidence and highlight specific built-environment elements. Our findings demonstrate the need for further conceptual and empirical explorations of the multifaceted ways in which built environments can prevent loneliness, supporting calls for investment into this public-health approach.
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Affiliation(s)
- Marlee Bower
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Jennifer Kent
- The University of Sydney School of Architecture, Design, and Planning, The University of Sydney, Australia.
| | - Roger Patulny
- Faculty of the Arts, Social Sciences, and Humanities, University of Wollongong, Australia
| | - Olivia Green
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Laura McGrath
- Faculty of Arts and Social Sciences, The Open University, Milton Keynes, England; UK
| | - Lily Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | | | - Hannah Sandison
- The University of Sydney School of Architecture, Design, and Planning, The University of Sydney, Australia
| | - Emily Rugel
- Westmead Applied Research Centre, The University of Sydney, Australia
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Ebimgbo SO, Okoye UO. Challenges of left-behind older family members with international migrant children in south-east Nigeria. JOURNAL OF POPULATION AGEING 2022. [DOI: 10.1007/s12062-022-09402-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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6
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Ojembe BU, Kalu ME, Donatus Ezulike C, Iwuagwu AO, Ekoh PC, Oyinlola O, Osifeso T, Makanjuola JO, Kapiriri L. Understanding Social and Emotional Loneliness among Black Older Adults: A Scoping Review. J Appl Gerontol 2022; 41:2594-2608. [PMID: 36007108 PMCID: PMC9669730 DOI: 10.1177/07334648221118357] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Black older adults’ (BOAs) experience of loneliness differs from other ethnic
groups because of the disproportionate disadvantages faced across their life
course. This scoping review aimed to describe the range of research on
loneliness or subjective social isolation among BOAs, identifying the
contributing factors to loneliness in this population, based on Weiss’ Social
provision Framework. Of the 15,345 initial retrieved citations from seven
databases and corporate websites, we included 27 studies conducted in the USA,
Nigeria, South Africa, Ghana, Canada, the United Kingdom, and Uganda. Studies
reporting on BOAs’ experience of loneliness focused on the influence of
attachment, social integration, opportunity for nurturance, reassurance of
worth, guidance, socio-economic factors, health-related factors and behaviors,
and technology, media device possession and usage. There is a need for future
studies to identify which social provisions (when targeted) could reduce
loneliness, allowing clinicians to develop relevant interventions.
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Affiliation(s)
- Blessing Ugochi Ojembe
- Department of Health, Aging & Society, 248191McMaster University, Hamilton, ON, Canada.,Emerging Researchers & Professionals in Ageing- African Network, Abuja, Nigeria
| | - Michael Ebe Kalu
- Emerging Researchers & Professionals in Ageing- African Network, Abuja, Nigeria
| | - Chigozie Donatus Ezulike
- Emerging Researchers & Professionals in Ageing- African Network, Abuja, Nigeria.,Department of Social Work, 355428University of Nigeria, Nsukka, Nigeria.,Department of Social and Behavioural Sciences, 53025City University of Hong Kong, Hong Kong
| | - Anthony Obinna Iwuagwu
- Emerging Researchers & Professionals in Ageing- African Network, Abuja, Nigeria.,Department of Social Work, 355428University of Nigeria, Nsukka, Nigeria
| | - Prince Chiagozie Ekoh
- Emerging Researchers & Professionals in Ageing- African Network, Abuja, Nigeria.,Department of Social Work, 355428University of Nigeria, Nsukka, Nigeria.,Faculty of Social Work, 210169University of Calgary, Calgary, AB, Canada
| | - Oluwagbemiga Oyinlola
- Emerging Researchers & Professionals in Ageing- African Network, Abuja, Nigeria.,Medical Social Services Department, University College Hospital, Ibadan, Nigeria.,School of Social Work, 5620McGill University, Montreal, QC, Canada
| | - Temitope Osifeso
- Emerging Researchers & Professionals in Ageing- African Network, Abuja, Nigeria.,Health and Rehabilitation Science, 6221Western University, London, ON, Canada
| | - John Osuolale Makanjuola
- Emerging Researchers & Professionals in Ageing- African Network, Abuja, Nigeria.,Department of Adult and Mental Health Psychiatric Nursing, Faculty of Nursing Sciences, 584611University of Medical Science, Ondo, Nigeria
| | - Lydia Kapiriri
- Department of Health, Aging & Society, 248191McMaster University, Hamilton, ON, Canada
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Mussie KM, Setchell J, Elger BS, Kaba M, Memirie ST, Wangmo T. Care of Older Persons in Eastern Africa: A Scoping Review of Ethical Issues. Front Public Health 2022; 10:923097. [PMID: 35874990 PMCID: PMC9298985 DOI: 10.3389/fpubh.2022.923097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction The aging population is rapidly increasing globally, with 80% of the older population living in low- and middle-income countries. In Eastern African countries, there exists an incongruence between readiness-economically, structurally, politically, and culturally-to create a conducive environment for healthy aging, which implies public health as well as ethical concerns. The aim of this scoping review was to explore existing evidence addressing the various ethical issues in connection with elder care in the region of Eastern Africa. Methods We searched six databases (Africa-Wide Information, AgeLine, CINHAL, MEDLINE, APA PsycInfo, and SocINDEX) to identify peer-reviewed journal articles that could meet some eligibility criteria such as being a peer-reviewed journal article written in English, having been published in any year until July 2020, and focusing on ethical issues in the care of older people aged 60 years and older from Eastern Africa. We also searched for additional evidence in the references of included papers and web-based platforms. We included 24 journal articles and analyzed them using the inductive content analysis approach. Results The included articles represent seven (38.9%) of the 18 countries in the Eastern African region. The articles covered six ethical concerns: lack of government attention to older persons (n = 14, 58.3%), inaccessibility of health care services (n = 13, 54.2%), loneliness and isolation (n = 11, 45.8%), gender inequalities in old age (n = 9, 37.5%), mistreatment and victimization (n = 8, 33.3%), and medical errors (n = 2, 8.3%). Conclusion This scoping review summarized ethical issues arising in relation to providing care for older persons in the Eastern African context. In light of the rapid increase in the number of older persons in this region, it is critical for governments and responsible bodies to implement and accelerate efforts promptly to generate more evidence to inform programs and policies that improve the health and wellbeing of older persons. Further research is needed to inform global health efforts that aim at improving the lives of older persons, particularly in low- and middle-income countries. Clinical Trial Registration https://osf.io/sb8gw, identifier: 10.17605/OSF.IO/SB8GW.
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Affiliation(s)
| | - Jenny Setchell
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Bernice Simone Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.,Center for Legal Medicine, University of Geneva, Geneva, Switzerland
| | - Mirgissa Kaba
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Solomon Tessema Memirie
- Addis Centre for Ethics and Priority Setting, Addis Ababa University, Addis Ababa, Ethiopia.,Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
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8
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Shams Ghahfarokhi M. Rising living alone among the elderly in Iran: prevalence and associated factors. BMC Geriatr 2022; 22:622. [PMID: 35883051 PMCID: PMC9327280 DOI: 10.1186/s12877-022-03309-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 07/18/2022] [Indexed: 11/29/2022] Open
Abstract
Background This study first examines the pattern and trend of elderly living alone during the last five censuses in Iran. Then, after describing the characteristics of the elderly who live alone, it determines how social, economic, and demographic characteristics relate to the solo living of the elderly. Methods The data for people aged 60 and above are from two sources, including the aggregate data from five successive Iranian censuses and the individual data of 2% of the 2016 Iranian census. To determine the relative importance of variables such as sex, age, education, and activity status of the elderly, a set of logistic regression models using STATA software has been used for individual data analysis of the 2016 census. Results The proportion of older people living alone in 1986, 1996, 2006, 2011, and 2016 was 9.1, 9.0, 10.9, 14.5, and 14.9%, respectively. City residents are less likely to live alone than villagers, and women are more likely to live alone than men. The odds of living solo among Illiterate, Primary school, Secondary & High school and Holding a high school diploma elderly higher than those with university education. Being a student and homemaker increases solo living relative to employees, but pensioners reduce solo living relative to employees. Moreover, the odds of solo living of the elderly in the early and middle stages of old age is less than in late old age. Also, the variables included in the analysis explained 16% of the variation in solo living. Conclusion The prevalence of elderly solo living is increasing. And this increase continues due to the fundamental decline in childbearing, changes in family structure, and the effects of culture and tradition. Also, due to the rise in life expectancy, which increases the number of years of life with the disease, and disability, the lack of relief organizations will create more difficult conditions for the older people living alone.
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Kousha A, Lotfalinezhad E, Nadrian H, Bhalla D, Asghari-jafarabadi M, Sohrabi A, Hashemiparast M, Honarvar MR. Determinants of Subjective Loneliness and Quality of Life among Community-Dwelling Older Adults in Gorgan, Iran. ADVANCES IN GERONTOLOGY 2022. [PMCID: PMC9774064 DOI: 10.1134/s2079057022040099] [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] [Indexed: 12/24/2022]
Abstract
The purpose of this study was to identify the determinants of, and relationship between, subjective loneliness, general health and quality of life (QoL) among lonely community-dwelling older adults. A cross-sectional study was carried out among a sample of lonely (i.e. live alone without any assistance) older adults living in Gorgan city, Iran. The older adults were invited through a census sampling technique to complete six questionnaires, namely a 20-item UCLA loneliness scale, a six-item Lubben Social Network Scale, a 12-item Multidimensional Scale of Perceived Social Support, a 17-item Self-care Ability Scale for the Elderly (SASE), a General Health Questionnaire-12, and a Control, Autonomy, Self-Realization and Pleasure (CASP-19) questionnaire. Hierarchical multiple linear regressions were done with subjective loneliness and QoL as outcome variables. In total, 213 (91% females) lonely older adults (mean age: 68.2 ± 6.2) participated. Hierarchical multiple linear regressions yield socio-demographic characteristics (p < 0.001), predictor group 1 (p < 0.001), predictor group 2 (p < 0.001) explained 12.5, 13.5 and 46.6% of the observed variance in loneliness, respectively. Moreover, socio-demographic characteristics (p < 0.001), predictor group 1 (p < 0.001), predictor group 2 (p < 0.001) and feeling of loneliness (p < 0.001) accounted for 16.9, 21.1, 48.6 and 55.3% of the observed variance in quality of life, respectively. Both subjective loneliness and QoL were moderate in our sample. We suggest the presence of a probable causal inference between subjective loneliness, general health, and QoL; implying the need of population strategies for correcting subjective loneliness for its own sake as well as to help have an improved general health and QoL among older adults. Beside several non-modifiable factors (such as age, ethnic groups), we suggest that corrective measures should be based on social support and networking, self-care behavior, leisure activities, adapted for age, literacy and racial specifications. Given its population health relevance, there should be increased research and intervention on loneliness among older adults.
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Affiliation(s)
- A. Kousha
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, 5166/15731 Tabriz, Iran
| | - E. Lotfalinezhad
- Aging Research Institute, Tabriz University of Medical Sciences, 5166/15731 Tabriz, Iran ,Department of Health Education and Promotion, Tabriz University of Medical Sciences, Attar-e-Neyshabouri St., Golgasht St., 5166/15731 Tabriz, Iran
| | - H. Nadrian
- Medical Education Research Center, Tabriz University of Medical Sciences, Attar-e-Neyshabouri St., Golgasht St., 5166/15731 Tabriz, Iran
| | - D. Bhalla
- Pôle Universitaire Euclide Intergovernmental UN Treaty, 49006/49007 Bangui, Central African Republic
| | - M. Asghari-jafarabadi
- Cabrini Research, Cabrini Health, 3144 VIC, Australia ,School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, 3800 VIC, Australia ,Road Traffic Injury Research Center, Tabriz University of Medical Sciences, 5166/15731 Tabriz, Iran
| | - A. Sohrabi
- Cancer Control Research Center, Cancer Control Foundation, Iran University of Medical Sciences, 14535 Tehran, Iran
| | - M. Hashemiparast
- Department of Health Education and Promotion Zanjan University of Medical Sciences, Gavazang road, PG36+6RX, 5166/15731 Zanjan, Iran
| | - M. R. Honarvar
- Health Management and Social Development Research Center, Golestan University of Medical Sciences, Golestan University of Medical Sciences and Health Services, 5166/15731 Gorgan, Iran
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10
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Guo Y, Ge T, Mei L, Wang L, Li J. Widowhood and Health Status Among Chinese Older Adults: The Mediation Effects of Different Types of Support. Front Public Health 2021; 9:745073. [PMID: 34869158 PMCID: PMC8637908 DOI: 10.3389/fpubh.2021.745073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/25/2021] [Indexed: 11/28/2022] Open
Abstract
Although many studies have suggested that widowhood is related to worse health conditions among older adults, few have examined the mediation effects of social support between widowhood and health. Employing mediation analysis to a sample of data from the 2014 wave of China Longitudinal Aging Social Survey (CLASS), this study examined the mediation effects of social support, including emotional support, instrumental support, and companionship, in the widowhood-health association among older adults. The results indicated that the negative effect of widowhood on older adults' health was in part attributable to decreased emotional support and companionship. Specifically, emotional support exerted a significant role in the widowhood-mental health association, and companionship exerted a significant role in widowhood-physical health and widowhood-mental health associations. In the subsample analysis, the mediation effects were only significant among female older adults, and among rural older adults. Our findings highlight the importance of emotional support and companionship in maintaining health among widowed older adults and strategies should pay more attention to female and rural widowed older adults.
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Affiliation(s)
- Yu Guo
- School of Public Policy and Administration, Institute for Population and Development Studies, Xi'an Jiaotong University, Xi'an, China
| | - Tingshuai Ge
- School of Public Policy and Administration, Institute for Population and Development Studies, Xi'an Jiaotong University, Xi'an, China
| | - Li Mei
- School of Public Policy and Administration, Institute for Population and Development Studies, Xi'an Jiaotong University, Xi'an, China
| | - Lina Wang
- School of Public Policy and Administration, Institute for Population and Development Studies, Xi'an Jiaotong University, Xi'an, China
| | - Jingbo Li
- School of Labor Economics, Capital University of Economics and Business, Beijing, China
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11
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Li H, Wang C. The Relationships Among Structural Social Support, Functional Social Support, and Loneliness in Older Adults: Analysis of Regional Differences Based on a Multigroup Structural Equation Model. Front Psychol 2021; 12:732173. [PMID: 34650489 PMCID: PMC8507854 DOI: 10.3389/fpsyg.2021.732173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/12/2021] [Indexed: 11/30/2022] Open
Abstract
Objective: This study investigated the relationship between structural social support and loneliness and explored whether functional social support had an intermediate role therein. It also employed a multigroup structural equation model to compare mediation models among older adults living in cities, towns, and rural areas. Methods: Using a self-made demographics questionnaire, the structural-functional social support scale, and the 3-item UCLA loneliness scale, this study collected information from 1,325 older adults identified via convenient sampling. Results: The results showed that as: (1) compared with older adults living in towns, older urban, and rural adults had higher structural social support and experienced less loneliness, while older adults' functional social support showed no difference among the three regions (2) An analysis of the models of regional differences indicated that functional social support served as a full mediator in the relationship between structural social support and loneliness in urban older adults, and a partial mediator for older adults living in towns and rural areas. Conclusion: The relationship between structural social support and loneliness is mediated by functional social support, and this mediation model varies between older adults in cities and towns/rural areas. This study helps us understand possible mechanisms through which structural social support impacts loneliness. It suggests that nursing strategies for older adults should be adjusted according to the region and direct greater focus on the function (or quality) of the social support network and older adults living in towns.
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Affiliation(s)
- Haifeng Li
- School of Psychology, Fujian Normal University, Fuzhou, China
| | - Cong Wang
- Fuzhou Hualun Middle School, Fuzhou, China
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12
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Loneliness in Old Age, the Related Factors, and Its Association with Demographics and Districts of Residence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179398. [PMID: 34501989 PMCID: PMC8430812 DOI: 10.3390/ijerph18179398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 12/20/2022]
Abstract
Loneliness among older people has now become a serious public health issue. There have been few previous studies conducted among Chinese populations on the correlations between loneliness, self-rated health, and instrumental activities of daily living (IADL), and their association with demographic characteristics. In this study, data were collected using quota sampling through survey interviews. Older people living in representative districts were recruited. Of the participants, 60.1% rated their health as average and 58.1% showed a high level of loneliness. IADL and self-rated health (SRH) were found to be moderately positively correlated, with r = 0.357, p < 0.001. A low negative correlation was found between the level of loneliness and IADL, with r = −0.276; and SRH, with r = −0.288, p < 0.05. Ordinal Regression results showed that subjects with higher IADL scores (OR: 0.64, 95% CI: 0.39–1.05) were less lonely, while those with a less desirable economic status (OR: 3.34, 95% CI: 1.40–7.96) and living in the central business district were more likely to have a higher loneliness score (OR: 21.33, 95% CI: 4.81–95.41). It is essential to screen for loneliness, and interventions should be focused on improving social connections and support for older people to overcome their feelings of loneliness.
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Chemen S, Gopalla YN. Lived experiences of older adults living in the community during the COVID-19 lockdown - The case of mauritius. J Aging Stud 2021; 57:100932. [PMID: 34083001 DOI: 10.1016/j.jaging.2021.100932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 03/27/2021] [Accepted: 04/02/2021] [Indexed: 02/06/2023]
Abstract
Adoption of strict social distancing and sanitary measures were inevitable in the attempt to thwart the spread of the Covid-19 virus. These measures, however, came at a cost for older adults who faced major mental health issues because of social isolation. The impact of social isolation remains well documented in the wake of the pandemic. This paper explored the lived experiences of older adults living in the community during the Covid-19 sanitary lockdown in the small-island state of Mauritius. As a small-island state with family structures that still skew towards extended or modified extended families, it was interesting to explore whether older adults would be reporting feelings of social isolation as was being reported elsewhere. This study utilized a qualitative approach using a lifeworld hermeneutical approach with 15 older adult participants, recruited through convenience and snowball sampling, in the community. Data were collected using a narrative approach supplemented by an interview guide. Thematic analysis was used to identify themes from transcribed and translated data. Six themes were discovered: Fears of the virus and fear of deprivation; Reliving and recreating bonds; Active contribution to family life; Being and feeling valued within the family; Rediscovering family time and family moments; and Fear of going back to 'normal'. The study revealed positive experiences of the lockdown period characterised by an increase bonding in the family, deepening of familial bond, and increased value despite an initial apprehension of the lockdown. A renewed sense of purpose as well as deepening of bonds was reported by older adults. Some limitations in relation to data trustworthiness and respondents bias, however, could not be avoided since the study was carried out during sanitary lockdown period. The feelings of social isolation and depression reported by older adults who lived alone were not seen in this study, suggesting that the family structure may have a role to play in mitigating these effects. There would also be a need to explore similar small-island states or similar cultures where the effects of sanitary lockdowns may be different from current literature.
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Affiliation(s)
- Sambaladevi Chemen
- University of Mauritius, Department of Health Sciences, Faculty of Medicine and Health Sciences, Reduit, Mauritius.
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Olawa BD, Idemudia ES. Gender Differences in the Associations Between Forms of Social Engagements and Loneliness in a Sample of Nigerian Older Adults: A Cross-Sectional Survey. PSYCHOLOGICAL STUDIES 2020. [DOI: 10.1007/s12646-020-00579-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Morgan T, Wiles J, Moeke-Maxwell T, Black S, Park HJ, Dewes O, Williams LA, Gott M. 'People haven't got that close connection': meanings of loneliness and social isolation to culturally diverse older people. Aging Ment Health 2020; 24:1627-1635. [PMID: 31256631 DOI: 10.1080/13607863.2019.1633619] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: Social isolation and loneliness among older people are known to have negative effects on health and wellbeing. Few studies, however, have enabled older people to define these concepts in their own terms. This paper based on research in Aotearoa, New Zealand is the first to comparatively outline the meanings of loneliness and social isolation from the perspective of four ethnically diverse groups of older adults (Māori, Pacific, Asian, and NZ European).Method: We interviewed 44 older people and conducted three focus groups with 32 older people. We used thematic and narrative analyses.Results: Loneliness and social isolation were conceptualized as interconnected concepts described as a 'look and feel', a 'state of mind' and as a 'lack of desired companionship'. Participants conveyed sophisticated understandings of the structural underpinnings of both loneliness and social isolation as multi-dimensional, complex, and situated.Conclusions: Older people describe complex and culturally- nuanced understanding and experience of social isolation and loneliness. More culturally appropriate services, greater mental-health support and more service provision on weekends and evenings are needed.
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Affiliation(s)
- Tessa Morgan
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Janine Wiles
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Tess Moeke-Maxwell
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Stella Black
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Hong-Jae Park
- School of Social Sciences and Psychology, Western Sydney University, Penrith, Australia
| | - Ofa Dewes
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Lisa Ann Williams
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Merryn Gott
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Jenkins JH, Sanchez G, Lidia Olivas-Hernández O. Loneliness, adolescence, and global mental health: Soledad and structural violence in Mexico. Transcult Psychiatry 2020; 57:673-687. [PMID: 31648608 DOI: 10.1177/1363461519880126] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this article, we call into question recent public health claims that loneliness is a problem of epidemic proportions. Current research on this topic is hindered by an overreliance on limited survey data and by paradigmatic imbalance that delineates the study of loneliness to psychological, cognitive, neuroendocrinological and immunological effects, social functioning, physical health, mortality, and gene effects. The article emphasizes that scientific approaches to the phenomena of loneliness are more appropriately conceived and investigated as inherently matters for social, relational, cultural, and contextual analysis of subjective experience. Studies of loneliness and possible relationships to mental health status require investigations of social, environmental, and institutional structures as well as families, peers, friends, counselors, and health providers. This article takes a step in this direction through examining the lived experience of 35 high school students and their families living under conditions of social adversity in Tijuana, B.C., Mexico, with attention to anxiety and depression. Utilizing ethnographic interviews, observations, and psychological screening tools, we provide an overview for the group and illustrate the interrelations of subjective experience and social environment through a case study. These data reveal the vital role of understandings of loneliness, depression, and anxiety from the perspectives of adolescents themselves. We conclude that future studies of loneliness are best informed by in-depth data on subjective experience in relation to social features to advance understandings within the field of global mental health and allied fields.
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Amurwon J. "It's Like I Never Had a Child of My Own": Care and Support for the Elderly in a Changing Socioeconomic Context in Rural Uganda. J Gerontol B Psychol Sci Soc Sci 2020; 74:1483-1491. [PMID: 30124930 DOI: 10.1093/geronb/gby094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Individual households remain important for elderly care and support in resource-limited settings. Factors such as availability of young people and ownership of assets are important for care and support for the elderly. This article examines changing trends in accessing care and support for the elderly in a context of socioeconomic changes such as increasing school attendance and outmigration of youth from rural areas. METHOD Rich data from the life stories of individuals from 22 households in rural Uganda collected in 2009-2010 were analyzed. RESULTS The elderly were lacking care and support, as the youth experienced increasing schooling and outmigration. The loss of young adults from HIV infection deprived the elderly of care and support, and increased their responsibilities of caring for the sick and the orphans. Mitigating factors included remittances and asset ownership. The availability of free health care encouraged people to stay in households to utilize these resources while also caring for the elderly members. DISCUSSION With the current socioeconomic transformations, the rules and resources used in the traditional care system no longer serve as a "safety network" for the elderly. Adaptation efforts from individual households cannot deal with the multiple concurrent changes. Programs to increase education should consider investing in additional social programs, especially for those who are negatively impacted by increased access to education.
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Affiliation(s)
- Jovita Amurwon
- Urban and Rural Development Unit, Swedish University of Agricultural Sciences, Uppsala, Sweden.,Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda
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Getting Old Well in Sub Saharan Africa: Exploring the Social and Structural Drivers of Subjective Wellbeing among Elderly Men and Women in Uganda. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072347. [PMID: 32244270 PMCID: PMC7177324 DOI: 10.3390/ijerph17072347] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/09/2020] [Accepted: 03/17/2020] [Indexed: 01/08/2023]
Abstract
While literature attempts to explain why self-reported subjective wellbeing (SWB) generally increases with age in most high-income countries based on a social determinants of a health framework, little work attempts to explain the low levels of self-report SWB among older persons in sub-Saharan Africa. Using the 2013 Uganda Study on Global Aging and Health with 470 individuals, this research examines (i) direct and indirect effects of age on SWB through social and structural determinants, and (ii) how direct and indirect effects vary by gender. Results show a significant direct and negative effect of age on SWB (β = 0.42, p = 0.01). Six indirect paths were statistically significant and their indirect effects on wellbeing varied by gender. Providing support, education, working status, asset level, financial status and financial improvement were significantly positively associated with men’s SWB, whereas younger age, providing community support, participating in group activities, number of close friends/relatives, government assistance and all socio-economic variables were significantly positively associated with women’s SWB. Strategies to address gendered economic, social and political inequalities among and between elderly populations are urgently needed.
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Chepngeno-Langat G, van der Wielen N, Evandrou M, Falkingham J. Unravelling the wider benefits of social pensions: Secondary beneficiaries of the older persons cash transfer program in the slums of Nairobi. J Aging Stud 2019; 51:100818. [DOI: 10.1016/j.jaging.2019.100818] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/20/2019] [Accepted: 09/15/2019] [Indexed: 11/25/2022]
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20
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Solitary living in South Africa: what is driving the pattern and change? JOURNAL OF POPULATION RESEARCH 2019. [DOI: 10.1007/s12546-019-09222-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Maniragaba F, Kwagala B, Bizimungu E, Wandera SO, Ntozi J. Predictors of quality of life of older persons in rural Uganda: A cross sectional study. AAS Open Res 2018; 1:22. [PMID: 32259022 PMCID: PMC7118782 DOI: 10.12688/aasopenres.12874.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2018] [Indexed: 06/24/2024] Open
Abstract
Background: Little is known about the quality of life of older persons (OPs) in Uganda in particular, and Africa in general. This study examined factors associated with quality of life of older persons in rural Uganda. Method: We performed a cross-sectional survey of 912 older persons from the four regions of Uganda. Data were analyzed at univariate, bivariate and multivariate level where ordinal logistic regression was applied. Results: Older persons in northern (OR=0.39; CI=0.224-0.711) and western (OR=0.33; CI=0.185-0.594) regions had poor quality of life relative to those in central region. Those who were HIV positive had poor quality of life (OR=0.45; CI=0.220-0.928) compared to those who were HIV negative. In contrast, living in permanent houses predicted good quality of life (OR=2.04; CI=1.391-3.002). Older persons whose household assets were controlled by their spouses were associated with good quality of life (OR=2.06;CI=1.032-4.107) relative to those whose assets were controlled by their children. Conclusion: Interventions mitigating the HIV and AIDS related Quality of life should target older persons. The government of Uganda should consider improving housing conditions for older persons in rural areas.
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Affiliation(s)
- Fred Maniragaba
- Department of Population Studies, Makerere University, Kampala, 7062, Uganda
| | - Betty Kwagala
- Department of Population Studies, Makerere University, Kampala, 7062, Uganda
| | | | | | - James Ntozi
- Department of Population Studies, Makerere University, Kampala, 7062, Uganda
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Maniragaba F, Kwagala B, Bizimungu E, Wandera SO, Ntozi J. Predictors of quality of life of older persons in rural Uganda: A cross sectional study. AAS Open Res 2018; 1:22. [PMID: 32259022 PMCID: PMC7118782 DOI: 10.12688/aasopenres.12874.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2018] [Indexed: 01/22/2023] Open
Abstract
Background: Little is known about the quality of life of older persons (OPs) in Uganda in particular, and Africa in general. This study examined factors associated with quality of life of older persons in rural Uganda. Method: We performed a cross-sectional survey of 912 older persons from the four regions of Uganda. Data were analyzed at univariate, bivariate and multivariate level where ordinal logistic regression was applied. Results: Older persons in northern (OR=0.39; CI=0.224-0.711) and western (OR=0.33; CI=0.185-0.594) regions had poor quality of life relative to those in central region. Those who were HIV positive had poor quality of life (OR=0.45; CI=0.220-0.928) compared to those who were HIV negative. In contrast, living in permanent houses predicted good quality of life (OR=2.04; CI=1.391-3.002). Older persons whose household assets were controlled by their spouses were associated with good quality of life (OR=2.06;CI=1.032-4.107) relative to those whose assets were controlled by their children. Conclusion: Interventions mitigating the HIV and AIDS related Quality of life should target older persons. The government of Uganda should consider improving housing conditions for older persons in rural areas.
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Affiliation(s)
- Fred Maniragaba
- Department of Population Studies, Makerere University, Kampala, 7062, Uganda
| | - Betty Kwagala
- Department of Population Studies, Makerere University, Kampala, 7062, Uganda
| | | | | | - James Ntozi
- Department of Population Studies, Makerere University, Kampala, 7062, Uganda
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Ojembe BU, Ebe Kalu M. Describing reasons for loneliness among older people in Nigeria. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2018; 61:640-658. [PMID: 29920168 DOI: 10.1080/01634372.2018.1487495] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The rural-urban migration of family members often leads to a higher probability of older people living alone, and minimizes family/social networks, which increases old age loneliness. In this study, we describe the existence of loneliness among older adults in Nigeria and its factors, aiming to inform the development of interventions for reducing old age loneliness. We adopted a descriptive phenomenological approach to the qualitative design, purposefully selecting and conducting face-to-face interviews with 12 older adults aged 58-88. We analyzed the data using a Thematic Analysis. Results of the analysis revealed three major themes: perception and existence of loneliness, factors for loneliness, and context-dependent coping strategies. We described results based on the theory of interactionist perspectives of loneliness and drew policy implications from this. Participants drew interesting associations between loneliness, decreasing family/social networks, recent family ties structures, disability-associated ageing, and lack of social programs, and suggested context-dependent coping strategies to reduce loneliness.
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Affiliation(s)
- Blessing Ugochi Ojembe
- a Centre for Research on Ageing , University of Southampton , Southampton , United Kingdom
| | - Michael Ebe Kalu
- b School of Rehabilitation Science , McMasters University , Hamilton , ON , Canada
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Abstract
This study aimed at investigating the prevalence and factors associated with living alone among older persons in Uganda. A secondary analysis of the 2010 Uganda National Household Survey (UNHS) data was conducted. A complementary log-log regression model was used to estimate the association between living alone and demographic, socio-economic and health factors. Nearly one out of ten (9%) older persons lived alone in Uganda. Living alone was associated with being divorced / separated (OR 18.5, 95% CI: 10.3–33.3), being widowed (OR 8.8, 95% CI: 5.1–15.2), advanced age (OR 2.1, 95% CI: 1.4–3.2), residence in western region (OR 0.6, 95% CI: 0.3–0.93), poor wealth status (OR 0.3, 95% CI: 0.2–06), receiving remittances (OR 1.6, 95% CI: 1.1–2.3) and being disabled (OR 1.6, 95% CI: 1.2–2.1). Living alone among older persons did not vary by gender.
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McQuaid K, Vanderbeck R, Plastow J, Valentine G, Liu C, Chen L, Zhang M, Diprose K. Intergenerational Community-Based Research and Creative Practice: Promoting Environmental Sustainability in Jinja, Uganda. JOURNAL OF INTERGENERATIONAL RELATIONSHIPS 2017. [DOI: 10.1080/15350770.2017.1368357] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Katie McQuaid
- School of Geography, University of Leeds, Leeds, United Kingdom
| | | | - Jane Plastow
- School of English, University of Leeds, Leeds, United Kingdom
| | - Gill Valentine
- Department of Geography, University of Sheffield, Sheffield, United Kingdom
| | - Chen Liu
- Department of Geography, University of Sheffield, Sheffield, United Kingdom
| | - Lily Chen
- School of East Asian Studies, University of Sheffield, Sheffield, United Kingdom
| | - Mei Zhang
- School of East Asian Studies, University of Sheffield, Sheffield, United Kingdom
| | - Kristina Diprose
- Department of Geography, University of Sheffield, Sheffield, United Kingdom
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