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Dewan N, Sommerlad A, Chapman H, Banerjee S, Corazzini K, Edvardsson D, Liougas MP, Livingston G, McGilton KS, O'Rourke HM, Bethell J. Assessing social connection for long-term care home residents: Systematic review using COnsensus-based Standards for the selection of health Measurement INstruments guidelines. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2024; 10:e12492. [PMID: 39104764 PMCID: PMC11299077 DOI: 10.1002/trc2.12492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 06/05/2024] [Indexed: 08/07/2024]
Abstract
Social connection is important for long-term care (LTC) residents' quality of life and care. However, there is a lack of consensus on how to measure it and this limits ability to find what improves and impairs social connection in LTC homes. We therefore aimed to systematically review and evaluate the measurement properties of existing measures of social connection for LTC residents, to identify which, if any, measures can be recommended. We searched eight electronic databases from inception to April 2022 for studies which reported on psychometric properties of a measure of any aspect(s) of social connection (including social networks, interaction, engagement, support, isolation, connectedness, and loneliness) for LTC residents. We used COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines to evaluate the measurement properties reported for each identified measure and make recommendations. We identified 62 studies reporting on 38 measures; 21 measured quality of life, well-being or life satisfaction and included a social connection subscale or standalone items and 17 measures specifically targeted social connection. We found there was little high-quality evidence on psychometric properties such as sufficient content validity (n = 0), structural validity (n = 3), internal consistency (n = 3), reliability (n = 1), measurement error (n = 0), construct validity (n = 4), criterion validity (n = 0) and responsiveness (n = 0). No measures demonstrated satisfactory psychometric properties on all these aspects, so none could be recommended for use. Thirty-four measures have the potential to be recommended but require further research to assess their quality and the remaining four are not recommended for use. Our review therefore found that no existing measures have sufficient evidence to be recommended for assessment of social connection in residents of LTC homes. Further validation and reliability studies of existing instruments or the development of new measures are needed to enable accurate measurement of social connection in LTC residents for future observational and interventional studies. Highlights Social connection is fundamental to person-centered care in long-term care homes.There is insufficient evidence for the reliability and validity of existing measures.No current measures can be recommended for use based on existing evidence.A reliable and valid measure of social connection is needed for future research.
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Affiliation(s)
- Neha Dewan
- KITE Research InstituteToronto Rehabilitation Institute – University Health NetworkTorontoOntarioCanada
- Department of Physical Therapy EducationCollege of Health SciencesWestern University of Health SciencesOregonUSA
| | - Andrew Sommerlad
- Division of PsychiatryUniversity College LondonLondonUK
- Camden and Islington NHS Foundation TrustLondonUK
| | | | - Sube Banerjee
- Faculty of Medicine and Health SciencesUniversity of NottinghamNottinghamUK
| | - Kirsten Corazzini
- College of Health and Human ServicesThe University of New HampshireDurhamUSA
| | - David Edvardsson
- School of Nursing and MidwiferyLa Trobe UniversityMelbourneVictoriaAustralia
- Sahlgrenska AcademyInstitute of Health and Care SciencesUniversity of GothenburgGothenburgSweden
| | - Madalena P. Liougas
- KITE Research InstituteToronto Rehabilitation Institute – University Health NetworkTorontoOntarioCanada
- Rehabilitation Sciences InstituteTemerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Gill Livingston
- Division of PsychiatryUniversity College LondonLondonUK
- Camden and Islington NHS Foundation TrustLondonUK
| | - Katherine S. McGilton
- KITE Research InstituteToronto Rehabilitation Institute – University Health NetworkTorontoOntarioCanada
- Rehabilitation Sciences InstituteTemerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Lawrence S. Bloomberg Faculty of NursingUniversity of TorontoTorontoOntarioCanada
| | | | - Jennifer Bethell
- KITE Research InstituteToronto Rehabilitation Institute – University Health NetworkTorontoOntarioCanada
- Institute of Health Policy, Management and EvaluationUniversity of TorontoTorontoOntarioCanada
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2
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Autschbach D, Hagedorn A, Halek M. Addressing loneliness and social isolation through the involvement of primary and secondary informal caregivers in nursing homes: a scoping review. BMC Geriatr 2024; 24:552. [PMID: 38918689 PMCID: PMC11197341 DOI: 10.1186/s12877-024-05156-1] [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: 10/09/2023] [Accepted: 06/17/2024] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVES To clarify the mechanisms of interventions addressing loneliness and social isolation in older adults living in nursing homes through the involvement of primary and secondary informal caregivers. METHODS This scoping review was performed by two independent reviewers, covering the period between 2011 and 2022 and the databases MEDLINE, CINAHL, PsycINFO and Scopus. It included terms related to (A) informal caregivers, (B) nursing homes, (C) psychosocial interventions, (D) involvement and (E) social isolation or loneliness. RESULTS Thirty-three studies met the inclusion criteria. Although there were various definitions and assessment tools related to social isolation and loneliness, the studies referred to three dimensions of these concepts in nursing home residents: the quantity of social interactions, the perception of these encounters and biographical changes in social relationships. Most studies did not explicate the mechanisms of these interventions. The review uncovered the following aspects of intervention mechanisms: increasing opportunities for social contact, creating meaningful encounters, maintaining existing relationships with primary informal caregivers and establishing new ones with secondary informal caregivers. CONCLUSION Studies reporting on interventions addressing loneliness and social isolation in nursing home residents need to clarify and detail their intervention mechanisms in order to foster more targeted interventions. In addition, there is a need for further research on large-scale programs or care philosophies in this field and the development of intervention designs, which allow for tailored intervention formats in order to respond to the individual perception of social relationships.
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Affiliation(s)
- Dominique Autschbach
- School of Nursing Science, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58455, Witten, Germany.
| | - Anika Hagedorn
- School of Nursing Science, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58455, Witten, Germany
| | - Margareta Halek
- School of Nursing Science, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58455, Witten, Germany
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3
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Hittner JB, Widholm CD. Meta-analysis of the association between gratitude and loneliness. Appl Psychol Health Well Being 2024. [PMID: 38741417 DOI: 10.1111/aphw.12549] [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: 12/09/2023] [Accepted: 04/15/2024] [Indexed: 05/16/2024]
Abstract
Gratitude is a positive social emotion that involves recognizing that others have brought benefits into one's life. Loneliness, on the other hand, is an unpleasant emotion resulting from a perceived lack of social connectedness. Although previous studies have reported an inverse association between gratitude and loneliness, these studies have not been systematically examined in a single review. To address this gap in the literature, we conducted a random-effects meta-analysis to examine the association between gratitude and loneliness. Analysis of 26 studies revealed a moderate sized effect (mean Fisher's z transformed correlation, zr = -.406, 95% confidence interval [CI] = -.463, -.349; mean back-transformed correlation, r = -.385, 95% CI = -.433, -.335). To complement these effect sizes, we calculated a probability-based common language effect size for correlations. Random-effects homogeneity testing suggested the presence of effect size heterogeneity. Analyses of both continuous and categorical moderators were non-significant, indicating that these variables did not influence effect size magnitude. Furthermore, publication bias tests suggested that our results were not influenced by unpublished studies. Finally, we proposed several statistical and clinical recommendations for future research. Regarding the latter, we offered suggestions for modifying gratitude enhancement programs with the aim of reducing loneliness.
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Affiliation(s)
- James B Hittner
- Department of Psychology, College of Charleston, Charleston, South Carolina, USA
| | - Calvin D Widholm
- Department of Psychology, College of Charleston, Charleston, South Carolina, USA
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Misiak MM, Bethell J, Chapman H, Sommerlad A. How can care home activities facilitate social connection in residents? A qualitative study. Aging Ment Health 2024:1-10. [PMID: 38669150 DOI: 10.1080/13607863.2024.2345130] [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: 11/13/2023] [Accepted: 04/13/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES Good social connection is associated with better physical and mental health but care home residents experience barriers to social connection. Activities present a potential avenue for improving social connection in care homes but residents often experience loneliness despite access to activity programmes. We therefore aimed to identify what aspects of activities facilitate social connection in care home residents. METHOD Qualitative study using semi-structured interviews that were analysed using Thematic Analysis. A purposive sample of 35 participants, including 12 residents, 10 family caregivers, nine care home staff and four clinicians, recruited from UK care homes. RESULTS We found four main themes describing features of activities important for facilitating social connection: (1) personalisation with respect to residents' interests, social preferences, and cognitive ability; (2) activities which foster a sense of community; (3) finding and emphasising things in common that residents share; and (4) facilitating a sense of involvement with others. CONCLUSION We identified the key aspects of activities which facilitate social connection in care homes. These findings can be applied to a range of existing and newly designed activities in care homes and inform the development and testing of psychosocial interventions aiming to improve social connection.
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Affiliation(s)
| | - Jennifer Bethell
- KITE Research Institute, Toronto Rehabilitation Institute,University Health Network, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | | | - Andrew Sommerlad
- Division of Psychiatry, University College London, UK
- Division of Psychiatry, Camden and Islington NHS Foundation Trust, London, UK
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Millett G, Franco G, Fiocco AJ. A Qualitative Study of the Usability and Likability of a Virtual Group-Based Social Support Program for Older Adults in Residential Care. Clin Gerontol 2024; 47:171-183. [PMID: 36519376 DOI: 10.1080/07317115.2022.2157357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Despite social engagement being a robust predictor of wellbeing for older adults living in residential care, social programming ceased during the COVID-19 pandemic to abide by social distancing guidelines. Consequently, a tablet-based program called the Java Music Club-Digital (JMC-D) was developed. The JMC-D enables residents to engage with peers through discussion and singing from the safety of their own rooms. This study investigated the likability and usability of the JMC-D for older adults living in residential care and recreation staff. METHODS Data was collected through semi-structured interviews and focus groups with seven residents and three recreation coordinators. Interviews were analyzed using thematic analysis. RESULTS Three themes emerged: 1) Addressing a need, 2) Factors that affect virtual social connection, and 3) Usability. Interest in future participation in the JMC-D program varied depending on certain personal characteristics including comfort with computers, openness to new experiences, and existing social network. CONCLUSION Findings suggest that the JMC-D is likeable and usable for residents and recreation coordinators. CLINICAL IMPLICATIONS Study findings can be applied by researchers and residential care staff who wish to increase the use of virtual social programs to improve the psychosocial health of residents. Constructive feedback was incorporated into the platform.
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Affiliation(s)
- Geneva Millett
- Department of Psychology, Toronto Metropolitan University, Canada
| | - Giselle Franco
- Department of Psychology, Toronto Metropolitan University, Canada
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Döring N, Conde M, Brandenburg K, Broll W, Gross HM, Werner S, Raake A. Can Communication Technologies Reduce Loneliness and Social Isolation in Older People? A Scoping Review of Reviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11310. [PMID: 36141581 PMCID: PMC9517063 DOI: 10.3390/ijerph191811310] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/31/2022] [Accepted: 09/03/2022] [Indexed: 05/14/2023]
Abstract
BACKGROUND Loneliness and social isolation in older age are considered major public health concerns and research on technology-based solutions is growing rapidly. This scoping review of reviews aims to summarize the communication technologies (CTs) (review question RQ1), theoretical frameworks (RQ2), study designs (RQ3), and positive effects of technology use (RQ4) present in the research field. METHODS A comprehensive multi-disciplinary, multi-database literature search was conducted. Identified reviews were analyzed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework. A total of N = 28 research reviews that cover 248 primary studies spanning 50 years were included. RESULTS The majority of the included reviews addressed general internet and computer use (82% each) (RQ1). Of the 28 reviews, only one (4%) worked with a theoretical framework (RQ2) and 26 (93%) covered primary studies with quantitative-experimental designs (RQ3). The positive effects of technology use were shown in 55% of the outcome measures for loneliness and 44% of the outcome measures for social isolation (RQ4). CONCLUSION While research reviews show that CTs can reduce loneliness and social isolation in older people, causal evidence is limited and insights on innovative technologies such as augmented reality systems are scarce.
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Affiliation(s)
- Nicola Döring
- Media Psychology and Media Design Group, Technische Universität Ilmenau, 98693 Ilmenau, Germany
| | - Melisa Conde
- Media Psychology and Media Design Group, Technische Universität Ilmenau, 98693 Ilmenau, Germany
| | - Karlheinz Brandenburg
- Electronic Media Technology Group, Technische Universität Ilmenau, 98693 Ilmenau, Germany
| | - Wolfgang Broll
- Virtual Worlds and Digital Games Group, Technische Universität Ilmenau, 98693 Ilmenau, Germany
| | - Horst-Michael Gross
- Neuroinformatics and Cognitive Robotics Lab, Technische Universität Ilmenau, 98693 Ilmenau, Germany
| | - Stephan Werner
- Electronic Media Technology Group, Technische Universität Ilmenau, 98693 Ilmenau, Germany
| | - Alexander Raake
- Audiovisual Technology Group, Technische Universität Ilmenau, 98693 Ilmenau, Germany
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7
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Noten S, Stoop A, De Witte J, Landeweer E, Vinckers F, Hovenga N, van Boekel LC, Luijkx KG. "Precious Time Together Was Taken Away": Impact of COVID-19 Restrictive Measures on Social Needs and Loneliness from the Perspective of Residents of Nursing Homes, Close Relatives, and Volunteers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3468. [PMID: 35329154 PMCID: PMC8950639 DOI: 10.3390/ijerph19063468] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/04/2022] [Accepted: 03/11/2022] [Indexed: 11/16/2022]
Abstract
During the COVID-19 outbreak in March 2020, restrictive measures (e.g., prohibiting physical visits and group activities) were introduced in nursing homes to protect older residents. Although the importance of social contacts and social activities to fulfill social needs and avoid loneliness is known, these were challenged during the pandemic. This qualitative study specifically focused on how residents, close relatives, and volunteers in nursing homes experienced the restrictive measures in retrospect and gained insights into the impact of the restrictive measures on social needs and loneliness, and the lessons that could be learned. Thirty semi-structured, face-to-face interviews with residents and close relatives, and one online focus group with ten volunteers, were conducted. Recruitment took place at psychogeriatric and somatic units in the Northern, Eastern and Southern regions of the Netherlands and Flanders, Belgium. The interviews and focus group were transcribed verbatim, and an open, inductive approach was used for analysis. Alternative ways of social contact could not fully compensate for physical visits. Generally, participants reported that it was a difficult time, indicated by feelings of loneliness, fear, sadness, and powerlessness. A great diversity in loneliness was reported. The most important reasons for feeling lonely were missing close social contacts and social activities. The diversity in the impact of restrictive measures depended on, e.g., social needs, coping strategies, and character. Restrictive COVID-19 measures in nursing homes resulted in negative emotions and unmet social needs of residents, close relatives, and volunteers. During future outbreaks of the COVID-19 virus or another virus or bacterium, for which restrictive measures may be needed, nursing homes should actively involve residents, close relatives, and volunteers to balance safety, self-determination, and well-being.
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Affiliation(s)
- Suzie Noten
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000 LE Tilburg, The Netherlands; (S.N.); (K.G.L.)
| | - Annerieke Stoop
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000 LE Tilburg, The Netherlands; (S.N.); (K.G.L.)
| | - Jasper De Witte
- HIVA—Research Institute for Work and Society KU Leuven, P.O. Box 5300, 3000 Leuven, Belgium;
| | - Elleke Landeweer
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (E.L.); (F.V.); (N.H.)
| | - Floor Vinckers
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (E.L.); (F.V.); (N.H.)
| | - Nina Hovenga
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (E.L.); (F.V.); (N.H.)
| | - Leonieke C. van Boekel
- Department of Orthopaedic Surgery, FORCE (Foundation for Orthopaedic Research Care Education), Amphia Hospital, 4819 EV Breda, The Netherlands;
| | - Katrien G. Luijkx
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000 LE Tilburg, The Netherlands; (S.N.); (K.G.L.)
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8
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Place-Making through Media: How Media Environments Make a Difference for Long-Term Care Residents’ Agency. SOCIETIES 2022. [DOI: 10.3390/soc12010027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This paper explores the unique relationships care home residents have with communication media. Drawing on findings from an ethnographic case study at a long-term care site in British Columbia, Canada, I describe how care home residents’ everyday media practices are intertwined with their negotiations of longstanding attachments and new living spaces. The research draws connections between the spatiotemporal contexts of media use and residents’ experiences of social agency. Long-term care residents in this research were challenged to engage with the wider community, maintain friendships, or stay current with events and politics because their preferred ways of using communication media were not possible in long-term care. The communication inequalities experienced by care home residents were not simply about their lack of access to media or content but about their inability to find continuity with their established media habits in terms of time and place. While most research about communication media in care homes has been intervention oriented, this research suggests that long-term care service and funding policies require greater attention to create flexible, diverse, and supportive media environments.
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Naik MHSc P, Ueland PhD VI. How Elderly Residents in Nursing Homes Handle Loneliness-From the Nurses' Perspective. SAGE Open Nurs 2020; 6:2377960820980361. [PMID: 33912665 PMCID: PMC8047972 DOI: 10.1177/2377960820980361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/08/2020] [Accepted: 11/22/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Elderly people who leave their home environment and move to a
nursing home enter a phase in life with diminishing contact with
family and friends. This situation often results in a feeling of
loneliness with a concomitant deterioration in physical and
mental health. By exploring the topic through the lens of the
nurses, this study takes a novel approach to address an
under-researched area in the nursing field. Objective The objective of the study was to identify, based on the nurses’
experience, how elderly residents handle loneliness in the
nursing home. Methods This study used a qualitative explorative approach with data
collected through two focus group interviews with nine nurses at
two elderly care facilities in Norway. The resulting transcripts
were examined using an approach based on inductive content
analysis. Results Three main categories emerged as crucial to help lonely nursing
home residents cope with day-to-day life: (i) maintaining ties
to one’s earlier life; (ii) engaging in recreational pursuits;
and (iii) building new networks. Conclusion Analysing the findings based on sense of coherence (SOC) and
person-centred care (PCC) theories illustrates the importance of
maintaining a connection with both family and friends. To that
point, having access to familiar objects from their earlier life
seemingly provides meaning to the residents by bridging the past
and the present. Recreational activities, ideally adapted to
each person’s needs and ability, have a positive impact by
providing structure and meaning that help overtake feelings of
loneliness. Building a new network with fellow residents and
staff imparts a sense of meaningful community belonging and
projects both dignity and self-worth.
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10
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Frinking E, Jans-Beken L, Janssens M, Peeters S, Lataster J, Jacobs N, Reijnders J. Gratitude and loneliness in adults over 40 years: examining the role of psychological flexibility and engaged living. Aging Ment Health 2020; 24:2117-2124. [PMID: 31591900 DOI: 10.1080/13607863.2019.1673309] [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: 10/25/2022]
Abstract
OBJECTIVES The aim of the present study was to investigate the association between trait gratitude and loneliness in a Dutch population sample of adults over 40 years. In addition, the mediating role of psychological flexibility and engaged living between trait gratitude and loneliness was assessed. METHOD A total sample of 163 adults of which 65 men (40%) and 98 women (60%) between 41 and 92 years (Mage = 66, SDage = 12) participated in this study. Data from the Loneliness Questionnaire, Flexibility Index Test, Engaged Living Scale and the Short Gratitude, Resentment, and Appreciation Test were used. Mediation analysis was performed. RESULTS Analysis showed a negative association between trait gratitude and loneliness. In addition, after adjusting for the demographic variables age, gender and educational level, the association between trait gratitude and loneliness was fully mediated by psychological flexibility, and partially mediated by engaged living. CONCLUSION This study endorses the importance of trait gratitude and psychological flexibility in relation to experiencing loneliness. Further research is needed to replicate these findings in a more diverse sample and to investigate the causal relationships between these constructs. It would also be interesting to further investigate the role of different age groups and goal (dis)engagement strategies in this relation.
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Affiliation(s)
- Esther Frinking
- Faculty of Psychology and Educational Sciences, Open University, Heerlen, The Netherlands
| | - Lilian Jans-Beken
- Faculty of Psychology and Educational Sciences, Open University, Heerlen, The Netherlands.,Institute for Globally Distributed Open Research and Education (IGDORE), Oudorp, The Netherlands
| | - Mayke Janssens
- Faculty of Psychology and Educational Sciences, Open University, Heerlen, The Netherlands.,Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Sanne Peeters
- Faculty of Psychology and Educational Sciences, Open University, Heerlen, The Netherlands.,Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Johan Lataster
- Faculty of Psychology and Educational Sciences, Open University, Heerlen, The Netherlands.,Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Nele Jacobs
- Faculty of Psychology and Educational Sciences, Open University, Heerlen, The Netherlands.,Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jennifer Reijnders
- Faculty of Psychology and Educational Sciences, Open University, Heerlen, The Netherlands
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11
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Jain B, Syed S, Hafford-Letchfield T, O'Farrell-Pearce S. Dog-assisted interventions and outcomes for older adults in residential long-term care facilities: A systematic review and meta-analysis. Int J Older People Nurs 2020; 15:e12320. [PMID: 32394594 DOI: 10.1111/opn.12320] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 03/26/2020] [Accepted: 04/03/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To comprehensively review studies on dog-assisted interventions (DAIs) among older people in residential long-term care facilities (RLTCFs) and to provide an overview of their interventions, outcomes and methodological quality. METHOD We searched 18 electronic databases to identify English articles (published January 2000-December 2019) reporting on well-defined DAIs targeting older adults (≥65 years) in RLTCF. Data were extracted by two independent reviewers. Descriptive statistics were produced for quantitative studies, with key themes identified among qualitative studies. Where possible, estimates were pooled from randomised controlled trials using random effects meta-analyses. RESULTS Forty-three relevant studies (39 quantitative; 4 qualitative) were identified. The majority of quantitative studies were assessed as low-quality according to the MMAT criteria (n = 26, 67%). Almost half of the quantitative studies (n = 18, 46%) found no significant changes over time or between groups across outcomes measured. The most salient intervention effects included improved social functioning (n = 10), reduced depressive symptoms (n = 6) and loneliness (n = 5). A random-effects meta-analysis revealed a medium effect in favour of DAT on reducing depressive or loneliness symptoms (pooled SMD: 0.66, 95%CI 0.21-1.11; I2 = 50.5; five trials), relative to treatment as usual. However, compared to treatment as usual, no overall effect of DAI on activities of daily living was detected (p = .737). Key themes from qualitative studies included (a) animals as effective transitional objects, (b) the therapeutic value of pets and (c) the significance of the care environment and stakeholders in facilitating DAI. IMPLICATIONS FOR PRACTICE The findings of this review indicate that while DAI has value for older people in RLTCF, challenges remain in accurately measuring its impact to provide a stronger evidence-base. Standardisation of DAI service design, delivery and evaluation is required for future research and practice in providing holistic care for older adults.
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Affiliation(s)
- Briony Jain
- Department of Mental Health and Social Work, Middlesex University, London, UK
| | - Shabeer Syed
- Department of Mental Health and Social Work, Middlesex University, London, UK
| | - Trish Hafford-Letchfield
- Department of Mental Health and Social Work, Middlesex University, London, UK.,School of Social Work and Social Policy, University of Strathclyde, Glasgow, UK
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12
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Ayalon L. Subjective Social Status as a Predictor of Loneliness: The Moderating Effect of the Type of Long-Term Care Setting. Res Aging 2019; 41:915-935. [PMID: 31455156 DOI: 10.1177/0164027519871674] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Much has been written about the important role that subjective social status plays in older adults' well-being and subjective health. Less is known, however, about the potential role played by subjective social status in people's sense of loneliness. In the present study, the author examined the role of subjective social status as a predictor of loneliness in adult day care centers (ADCCs) and continuing care retirement communities (CCRCs) over a 1-year period. The main analyses consist of data from 245 respondents (141 ADCC participants and 104 CCRC residents) who completed the interviews in Waves 1 and 2. A significant interaction between subjective social status and type of long-term care setting was found. Higher levels of subjective social status were associated with lower levels of loneliness in CCRCs, but no such association was evident in ADCCs. These findings are interpreted in view of the characteristics of the CCRC as a total institution versus the ADCC as a setting that provides support for only several hours per day, several days per week.
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Affiliation(s)
- Liat Ayalon
- The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat-Gan, Israel
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13
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Wijesiri HSMSK, Samarasinghe K, Edberg AK. Loneliness among older people living in care homes in Sri Lanka. Int J Older People Nurs 2019; 14:e12253. [PMID: 31274242 DOI: 10.1111/opn.12253] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 04/16/2019] [Accepted: 06/04/2019] [Indexed: 10/26/2022]
Abstract
AIM AND OBJECTIVES The aim of this study was to explore loneliness in older people (aged 65+) living in care homes in Colombo, Sri Lanka. BACKGROUND Loneliness, defined as the subjective, unwelcome feeling of the lack or loss of companionship, is known to be associated with old age, especially among older people living in care homes. Although several studies have shown that loneliness is highly prevalent, we lack knowledge about older people's personal experience of loneliness when residing in a care home and the strategies that older people use by themselves on a day-to-day basis to alleviate loneliness. METHODS The participants (n = 75) were randomly selected from three different types of care homes: governmental, non-governmental and private, and loneliness was screened using the Revised University of California-Los Angeles (R-UCLA) Loneliness Scale. The 15 participants with the highest score on the loneliness scale were purposively selected for individual interviews. RESULTS The median loneliness score was 45 (range 20-80); no significant differences concerning loneliness were found between the care homes. No differences concerning loneliness were found for any demographic variable except marital status. Loneliness was experienced as coping with inner pain, which older people described as emotional suffering caused by feeling abandoned from the family network and fettered to the care home, anxious about their future and depressed. Participants managed their loneliness by accepting their loneliness, practising religion, staying in touch with family, engaging in daily activities and participating in social activities. CONCLUSION Reliable and socio-culturally validated tools for screening loneliness and culturally applicable interventions targeting factors associated with loneliness are necessary in the care of older people residing in care homes. A person-centred approach involving family or significant others is recommended in clinical practice, and an increase in the number of nurses with specialist education in geriatric nursing seems urgent.
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Affiliation(s)
- H S Maliga S K Wijesiri
- Department of Nursing and Midwifery, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Boralesgamuwa, Sri Lanka
| | | | - Anna-Karin Edberg
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
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Ericson-Lidman E. Struggling between a sense of belonging and a sense of alienation: Residents' experiences of living in a residential care facility for older people in Sweden. ACTA ACUST UNITED AC 2019. [DOI: 10.1177/2057158519825766] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Living in residential care facilities for older people is described in both positive and negative terms. To maintain care quality of a vulnerable group in a constantly changing care context, it is important to continually describe their experiences. This qualitative study aims to describe residents’ experiences of living in a residential care facility for older people in Sweden. Six residents were interviewed and the interviews were analyzed using qualitative content analysis. The analysis resulted in nine sub-categories, two categories and one overall theme. Living in a residential care facility for older people is revealed as ‘Struggling between a sense of belonging and a sense of alienation’. It is of great importance for care providers to explore and try to understand what individuals perceive as factors for feelings of belonging, thereby preventing alienation.
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