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Andrade G, Campo Redondo M. Is Cryocide an Ethically Feasible Alternative to Euthanasia? THE JOURNAL OF MEDICINE AND PHILOSOPHY 2024; 49:443-457. [PMID: 38805705 DOI: 10.1093/jmp/jhae027] [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] [Indexed: 05/30/2024] Open
Abstract
While some countries are moving toward legalization, euthanasia is still criticized on various fronts. Most importantly, it is considered a violation of the medical ethics principle of non-maleficence, because it actively seeks a patient's death. But, medical ethicists should consider an ethical alternative to euthanasia. In this article, we defend cryocide as one such alternative. Under this procedure, with the consent of terminally-ill patients, their clinical death is induced, in order to prevent the further advance of their brain's deterioration. Their body is then cryogenically preserved, in the hope that in the future, there will be a technology to reanimate it. This prospect is ethically distinct from euthanasia if a different criterion of death is assumed. In the information-theoretic criterion of death, a person is not considered dead when brain and cardiopulmonary functions cease, but rather, when information constituting psychology and memory is lost.
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Ryan S, Maddison J, Baxter K, Wilberforce M, Birks Y, Morrissey E, Martin A, Lambat A, Bebbington P, Ziebland S, Robson L, Locock L. Understanding and using experiences of social care to guide service improvements: translating a co-design approach from health to social care. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-84. [PMID: 39264767 DOI: 10.3310/myht8970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/14/2024]
Abstract
Background Local authorities need to find new ways of collecting and using data on social care users' experiences to improve service design and quality. Here we draw on and adapt an approach used in the healthcare improvement field, accelerated experience-based co-design, to see if it can be translated to social care. We use loneliness support as our exemplar. Objectives To understand how loneliness is understood and experienced by members of the public and characterised by social care and voluntary sector staff; to identify service improvements around loneliness support; to explore whether accelerated experience-based co-design is effective in social care; and to produce new resources for publication on Socialcaretalk.org. Design and methods Discovery phase: in-depth interviews with a diverse sample of people in terms of demographic characteristics with experience of loneliness, and 20 social care and voluntary staff who provided loneliness support. Production of a catalyst film from the public interview data set. Co-design phase: exploring whether the accelerated experience-based co-design approach is effective in one local authority area via a series of three workshops to agree shared priorities for improving loneliness support (one workshop for staff, another for people with experience of local loneliness support, and a third, joint workshop), followed by 7-monthly meetings by two co-design groups to work on priority improvements. A process evaluation of the co-design phase was conducted using interviews, ethnographic observation, questionnaires and other written material. Results Accelerated experience-based co-design demonstrated strong potential for use in social care. Diverse experiences of participants and fuzzy boundaries around social care compared to health care widened the scope of what could be considered a service improvement priority. Co-design groups focused on supporting people to return to pre-pandemic activities and developing a vulnerable passenger 'gold standard' award for taxi drivers. This work generated short-term 'wins' and longer-term legacies. Participants felt empowered by the process and prospect of change, and local lead organisations committed to take the work forward. Conclusions Using an exemplar, loneliness support, that does not correspond to a single pathway allowed us to comprehensively explore the use of accelerated experience-based co-design, and we found it can be adapted for use in social care. We produced recommendations for the future use of the approach in social care which include identifying people or organisations who could have responsibility for implementing improvements, and allowing time for coalition-building, developing trusted relationships and understanding different perspectives. Limitations COVID-19 temporarily affected the capacity of the local authority Project Lead to set up the intervention. Pandemic work pressures led to smaller numbers of participating staff and had a knock-on effect on recruitment. Staff turnover within Doncaster Council created further challenges. Future work Exploring the approach using a single pathway, such as assessing eligibility for care and support, could add additional insights into its transferability to social care. Trial registration This trial is registered as Current Controlled Trials ISRCTN98646409. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR128616) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 27. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Sara Ryan
- Department of Social Care and Social Work, Manchester Metropolitan University, Manchester, UK
| | - Jane Maddison
- Social Policy Research Unit, University of York, York, UK
| | - Kate Baxter
- Social Policy Research Unit, University of York, York, UK
| | | | - Yvonne Birks
- Social Policy Research Unit, University of York, York, UK
| | - Emmie Morrissey
- Department of Social Care and Social Work, Manchester Metropolitan University, Manchester, UK
| | - Angela Martin
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Ahmed Lambat
- Public Involvement, LMCP Care Link, Manchester, UK
| | | | - Sue Ziebland
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Louise Locock
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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Wang G, Dong J, Zhu N, Zhu Y. Development and validation of a social alienation predictive model for older maintenance hemodialysis patients based on latent profile analysis-a cross-sectional study. BMC Geriatr 2024; 24:495. [PMID: 38840071 PMCID: PMC11154990 DOI: 10.1186/s12877-024-05116-9] [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: 01/18/2024] [Accepted: 05/29/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Social alienation refers to the state of feeling isolated, helpless, and unsatisfied due to maintaining distance from others or avoiding social interaction and activities. This phenomenon is caused by a lack of social skills, social anxiety, physical health problems, and other reasons. Older maintenance hemodialysis patients are exposed to a higher risk of social alienation. However, previous studies have been performed using the total score of the scale, which does not allow the identification of the characteristics of various patient groups with different levels of social alienation. In contrast, latent profile analysis can classify individuals into different categories based on continuous observational indicators, which improves accuracy and provides a more objective assessment by accounting for the uncertainty of variables. Given the concealed nature of social alienation and the differences in characteristics and treatment measures between different profiles, developing a predictive model for social alienation in older maintenance hemodialysis patients holds significance. OBJECTIVE To explore the latent profile analysis of social alienation in older maintenance hemodialysis patients and to develop and validate a predictive model for social alienation in this population. METHODS A total of 350 older maintenance hemodialysis patients were selected as the study subjects using convenience sampling. A cross-sectional survey was conducted using a general information questionnaire, the Generalized Alienation Scale, and the Self-Perceived Burden Scale. Based on the results of the Generalized Alienation Scale, a latent profile analysis was performed, followed by univariate analysis and multinomial logistic regression to develop a predictive model. The effectiveness of the predictive model was evaluated in terms of its authenticity, reliability, and predictive ability. RESULTS Three hundred nineteen valid questionnaires were collected. The social alienation of older maintenance hemodialysis patients based on latent profile analysis were divided into three profiles, which were named the low/medium/high-symptom groups, comprising 21%, 38.9%, and 40.1% of participants, respectively. Based on male, monthly social activity hours, Age-Adjusted Charlson Comorbidity Index, dialysis age, and Self-Perceived Burden Scale, a predictive model of social alienation for older maintenance hemodialysis patients was developed, and the Hosmer-Lemeshow tests showed no statistical significance (P > 0.05). The model has high predictive efficiency in authenticity, reliability and predictability. CONCLUSION Older maintenance hemodialysis patients exhibited moderate to high levels of social alienation. The latent profile analysis based method was used to divide patients into low/medium/high-symptom profiles, and the predictive model demonstrates excellent authenticity, reliability, and predictability.
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Affiliation(s)
- Guannan Wang
- Hemodialysis Center, Li Huili Hospital, Ningbo Medical Center, No.57 Xingning Road, Ningbo, 315000, Zhejiang Province, China
| | - Jing Dong
- Hemodialysis Center, Li Huili Hospital, Ningbo Medical Center, No.57 Xingning Road, Ningbo, 315000, Zhejiang Province, China
| | - Na Zhu
- Hemodialysis Center, Li Huili Hospital, Ningbo Medical Center, No.57 Xingning Road, Ningbo, 315000, Zhejiang Province, China
| | - Yiping Zhu
- Hemodialysis Center; Medical and Health Group, First People's Hospital of Xiangshan County, No.291 Dandong Street, Xiangshan County, Ningbo, 315700, Zhejiang Province, China.
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Burns A, Leavey G, Lawlor B, Golden J, Reilly D, O’Sullivan R. Attributions of Loneliness-Life Story Interviews with Older Mental Health Service Users. Healthcare (Basel) 2024; 12:1133. [PMID: 38891208 PMCID: PMC11171849 DOI: 10.3390/healthcare12111133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/03/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
There is growing evidence on the prevalence and impact of loneliness, particularly among older people. However, much less is known about the personal origins of loneliness and how it persists, or not, over an individual's life course. This study aimed to increase understanding of the personal experiences of loneliness among older adults across the life course. Central to this study was giving voice to the participants and allowing them to define loneliness, what it meant to them, and how it affected them throughout their lives. This qualitative study employed 18 life story interviews with older adults attending a mental health service. We explored their personal experiences of loneliness and the situations and factors associated with loneliness across the life course. We identified three distinct typologies of loneliness: those who experienced (1) chronic loneliness since childhood, (2) chronic loneliness after a life-changing event in midlife, and (3) loneliness which remained situational/transitional, never becoming chronic. This study found the seeds of chronic life course loneliness are often determined in childhood. Early detection and intervention may prevent situational loneliness from becoming chronic. More research is needed from a life course approach to help understand and address the causes and consequences of loneliness.
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Affiliation(s)
- Annette Burns
- Institute of Public Health, D08 NH90 Dublin, Ireland
- Bamford Centre for Mental Health & Wellbeing, Ulster University, Coleraine BT52 1SA, UK
| | - Gerard Leavey
- Bamford Centre for Mental Health & Wellbeing, Ulster University, Coleraine BT52 1SA, UK
| | - Brian Lawlor
- Global Brain Health Institute, Trinity College, D02 PN40 Dublin, Ireland
| | - Jeannette Golden
- Martha Whiteway Day Hospital, Mercer’s Institute for Successful Ageing, St. James’s Hospital, D08 KC95 Dublin, Ireland
| | - Dermot Reilly
- Martha Whiteway Day Hospital, Mercer’s Institute for Successful Ageing, St. James’s Hospital, D08 KC95 Dublin, Ireland
| | - Roger O’Sullivan
- Institute of Public Health, D08 NH90 Dublin, Ireland
- Bamford Centre for Mental Health & Wellbeing, Ulster University, Coleraine BT52 1SA, UK
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Xu Y, Zeng K, Dong L, Zheng X, Si Y. Understanding older adults' smartphone addiction in the digital age: empirical evidence from China. Front Public Health 2023; 11:1136494. [PMID: 37483945 PMCID: PMC10360404 DOI: 10.3389/fpubh.2023.1136494] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/20/2023] [Indexed: 07/25/2023] Open
Abstract
Background Despite the fact that an increasing number of older adults are addicted to smartphones, the existing addiction literature still focuses primarily on adolescents. To address this issue, this study draws from the perspectives of subjective cognitive decline and family relationship conflict to examine older adults' smartphone addiction based on their key characteristics. Methods This study investigates the effects of subjective cognitive decline and family relationship conflict on older adults' smartphone addiction through a survey of 371 subjects in China. Results The results show that subjective cognitive decline and family relationship conflict affect older adults' smartphone addiction through a sense of alienation. In addition, older adults' perceived power moderates the relationship between alienation and smartphone addiction. Discussion This study offers new perspectives on the study of smartphone addiction from the perspective of older adults, and sheds light on how to improve the older adults' quality of life in their later years.
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Affiliation(s)
- Yujing Xu
- School of Management, Zhejiang University of Technology, Hangzhou, China
| | - Kai Zeng
- School of Management, Zhejiang University of Technology, Hangzhou, China
| | - Lucong Dong
- School of Management, Zhejiang University of Technology, Hangzhou, China
| | - Xiaofen Zheng
- School of Management, Zhejiang University of Technology, Hangzhou, China
| | - Yuxiu Si
- School of Economics, Zhejiang University of Technology, Hangzhou, China
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Manchana V. Interpersonal relationships, subjective health, psychological well-being, and quality of life among older adults in South India: Evidence from a population-based study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:150. [PMID: 37404932 PMCID: PMC10317251 DOI: 10.4103/jehp.jehp_735_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 11/24/2022] [Indexed: 07/06/2023]
Abstract
BACKGROUND Subjective health and well-being are closely linked with quality of life (QoL) in older adults. Self-reported health, happiness, satisfaction with life and interpersonal relationships, social support, loneliness, and social isolation make robust indicators for the psychological well-being of older adults. This study aimed to explore subjective health, psychological well-being and associated factors, and their relationship with QoL in older adults. MATERIALS AND METHODS This was a cross-sectional, community-based survey that included adults aged 60 years and above (n = 260) who were living in selected communities. A semi-structured questionnaire was used to collect data on self-reported health, happiness, satisfaction with family and marital relationships, and felt loneliness and isolation. The relationship between psychological well-being and QoL was identified. Data analysis was carried out by descriptive and analytical statistical applications using Statistical Package for the Social Sciences (SPSS) version 20 at P ≤ 0.05. RESULTS Study findings showed that a significant number of older adults (56%) reported poor general health; 56.4% of men and 59.2% of women were "not at all happy" with their family and interpersonal relationships, and 13.5% of respondents were not at all happy in general. Self-reported health (0.277**) and happiness (0.506**) were positively correlated with the psychological domain of QoL (P ≤ 0.01). CONCLUSIONS The study findings identified the interrelationship between changing family and social relationships and psychological well-being of older adults, which is an immediate public health concern. Inadequate social support and deficient quality of interpersonal relationships predispose loneliness and isolation in later life. Strategies to promote social support and age-friendly social and healthcare resources are urgent needs for healthy aging.
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Affiliation(s)
- Varalakshmi Manchana
- School of Medical Sciences, University of Hyderabad, Gachibowli, Hyderabad, Telangana, India
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Malli MA, Ryan S, Maddison J, Kharicha K. Experiences and meaning of loneliness beyond age and group identity. SOCIOLOGY OF HEALTH & ILLNESS 2023; 45:70-89. [PMID: 36073866 PMCID: PMC10087890 DOI: 10.1111/1467-9566.13539] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
Research into loneliness has focussed on subpopulations, and in particular those defined by age, identifying specific contextual factors contributing to their experiences. We suggest that the 'essence' of loneliness cannot be fully captured by examining a unitary group and argue for broader and diverse sampling to better understand how loneliness is experienced. Informed by a symbolic interactionist approach, this study aims to elucidate experiences and meaning of loneliness among a heterogeneous group of adults. In depth interviews were conducted with a diverse sample of 37 individuals, aged 18-71 years who had experienced loneliness in the UK. Using thematic analysis, four themes were identified: Loneliness as lacking, loneliness as abandonment, lingering loneliness and the unspoken and trivialised experience of loneliness. Our analysis signals the complexity of loneliness did not necessarily conform to one-dimensional conceptualisations of the phenomenon. Loneliness is linked to interpersonal relationships, but also associated with participants' roles and identity within society. Thus, society exacerbates and creates loneliness. Implications for the support and provision of loneliness are also discussed.
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Affiliation(s)
- Melina Aikaterini Malli
- Department of Social Care and Social WorkManchester Metropolitan UniversityManchesterUK
- The Oxford Institute of Population AgeingUniversity of OxfordOxfordUK
| | - Sara Ryan
- Department of Social Care and Social WorkManchester Metropolitan UniversityManchesterUK
| | - Jane Maddison
- School for Business and SocietyUniversity of YorkYorkUK
| | - Kalpa Kharicha
- NIHR Health & Social Care Workforce Research UnitKing’s College LondonLondonUK
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A Systematic Literature Review of Loneliness in Community Dwelling Older Adults. SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci12010021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Research on loneliness is extensive. This paper presents a systematic review of intervention studies, outlining the antecedents to, and consequences of loneliness in community-dwelling older people. Using PRISMA methodology, a systematic literature review was conducted between January and August 2021 resulting in 49 useable articles. Papers were included if they: (a) investigated older people (+50); (b) were living in community dwellings; (c) had been published in English; (d) had titles or abstracts available and, (e) were published between 2016 and 2021. This study found the antecedents and consequences of social, emotional and existential loneliness differ, however, the vast majority of research has not examined the unique types of loneliness and instead kept loneliness as a generic term, despite the acceptance that various types of loneliness exist. In addition, the findings of intervention studies identified through this review have yielded mixed results. Those interventions focused on improving personal and psycho-social resources for older people fared better outcomes than those focused on technological and social connections alone. This paper reports important implications for the future of research conducted on loneliness and interventions accordingly.
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Li S, Dai Y, Zhou Y, Zhang J, Zhou C. Efficacy of group reminiscence therapy based on Chinese traditional festival activities (CTFA-GRT) on loneliness and perceived stress of rural older adults living alone in China: a randomized controlled trial. Aging Ment Health 2022; 26:1377-1384. [PMID: 34180278 DOI: 10.1080/13607863.2021.1935457] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES This study aimed to explore the efficacy of group reminiscence therapy based on Chinese traditional festival activities (CTFA-GRT) to mediate the loneliness and perceived stress of older adults living alone in rural China. The results can provide a scientific foundation for improving psychological health. METHOD A randomized controlled trial of 64 (aged 65.70 ± 3.69 years) Chinese rural older adults living alone was conducted. They were randomly divided into either an eight-month intervention group or a control group. The perceived stress scale (PSS) and the UCLA loneliness scale (UCLA-LS) evaluated the perceived stress and loneliness of the two groups at three different times. A repeated-measures analysis of variance model was used to compare each outcome measure of the two groups. RESULTS The CTFA-GRT yielded a benefit for the perceived stress and loneliness of rural older adults living alone in the intervention group. Combined with a simple effects test, the PSS and UCLA-LS of those in the intervention groups significantly decreased at eight months after the baseline (F PSS = 23.540, F UCLA-LS = 40.159; all P < 0.01). In addition, the sustainable effect of this program lasted three months after the intervention (F PSS = 65.756, F UCLA-LS = 60.983; all P < 0.01). CONCLUSION The CTFA-GRT significantly decreased the perceived stress and loneliness of rural older adults living alone in China.
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Affiliation(s)
- Shasha Li
- Department of Nursing, College of Medical Science, Huzhou University, Zhejiang, China
| | - Yanyan Dai
- Huzhou Central Hospital, Zhejiang, China
| | - Yuqiu Zhou
- Department of Nursing, Daqing Campus, University of Harbin Medical, Heilongjiang, China
| | - Jiayuan Zhang
- Department of Nursing, Daqing Campus, University of Harbin Medical, Heilongjiang, China
| | - Chiteng Zhou
- Department of Nursing, College of Medical Science, Huzhou University, Zhejiang, China
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Resna RW, Widianti, Nofiantoro W, Iskandar R, Ashbahna DM, Royani, Susilawati S. Social environment support to overcome loneliness among older adults: A scoping review. BELITUNG NURSING JOURNAL 2022; 8:197-203. [PMID: 37547116 PMCID: PMC10401387 DOI: 10.33546/bnj.2092] [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: 03/13/2022] [Revised: 04/18/2022] [Accepted: 06/07/2022] [Indexed: 08/08/2023] Open
Abstract
Background Loneliness is a problem experienced by most older adults due to internal and external factors. This condition may lead to various physical and psychological health problems, including depression, sleep disturbances, stress, and suicidal ideation. Therefore, exploring social environment support to reduce loneliness is a necessity. Objective This study aimed to identify various kinds of social support to overcome loneliness in older adults. Methods A scoping review was performed on studies retrieved from Embase, CINAHL, Cochrane, PubMed, and Google Scholar from 2012 until early 2022. Data were analyzed according to Arksey and O'Malley's scoping review guideline. Results Ten studies were systematically selected from 2,410 articles. The analysis indicated that the social environment support, including family support (affection, attention, emotional, motivation, and financial support), friends (peer group, partnership, advice, and appreciation), neighbors (work around the house, society involvement, and emergency), and government support (healthcare facilities and community programs), contribute to loneliness in older adults. Conclusion The social environment support from families, friends, neighbors, and government may potentially help older adults to reduce their loneliness but need further validation. The variables included in each component also need construct exploration. However, the study findings may serve as basic knowledge for nurses to provide interventions to prevent and reduce loneliness among older adults.
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Affiliation(s)
- Riksa Wibawa Resna
- Department of Gerontology and Community, Program Study of Nursing Profession, School of Health Science Banten, Indonesia
| | - Widianti
- Nursing Program, School of Health Science Banten, Indonesia
| | - Wahyu Nofiantoro
- Department of Banking, Vocational Program, University of Indonesia, Indonesia
| | | | | | - Royani
- Nursing Program, School of Health Science Banten, Indonesia
| | - Susi Susilawati
- Public Health Program, School of Health Science Banten, Indonesia
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Zhang H, Chen Z, Zhang J, Zhou X, Li S, Ren H. Effects of Developmental Bibliotherapy on Subjective Well-Being of Older Adults Living in Nursing Homes: A Quasi-Experimental Study. J Psychosoc Nurs Ment Health Serv 2022; 60:15-22. [PMID: 35191766 DOI: 10.3928/02793695-20220215-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current study sought to create a developmental bibliotherapy material database (DBMD) and examine the effectiveness of developmental bibliotherapy on subjective well-being of older adults living in nursing homes. Based on the reading needs of older adults, we developed a DBMD, which included 327 materials with five themes: Health Care, Current Affairs and Politics, Historical Biographies, Geriatric Culture, and Psychological Adjustment. Fifty-four single materials were randomly selected from the DBMD to perform the intervention. This study used a quasi-experimental, single-group pre-/post-survey approach. Sixty-four older adults participated in the study for 6 weeks. Immediately before and after the intervention, older adults completed the Optimism-Pessimism Scale and Memorial University of Newfoundland Scale of Happiness. There were significant improvements in older adults' optimistic tendency and subjective well-being (p < 0.05). Reading materials in the DBMD promoted older adults' optimistic attitude toward life, reduced negative emotions, and improved subjective well-being. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].
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Ho KHM, Mak AKP, Chung RWM, Leung DYL, Chiang VCL, Cheung DSK. Implications of COVID-19 on the Loneliness of Older Adults in Residential Care Homes. QUALITATIVE HEALTH RESEARCH 2022; 32:279-290. [PMID: 34855529 DOI: 10.1177/10497323211050910] [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] [Indexed: 06/13/2023]
Abstract
With little understandings on the loneliness of older adults in residential care homes structured by social contact restrictions, the provision of person-centered care was jeopardized during the pandemic. This study employed hermeneutic phenomenology to explore the lived experiences of loneliness of this population during a 5-month period of the COVID-19 pandemic. We conducted unstructured face-to-face interviews with 15 older adults living in seven residential care homes. Thematic analysis was guided by Van Manen's approach. The essence of loneliness was uncovered as "A deprived sense of self-significance in a familiar world contributes to older adult's disconnection with prior commitments." A sub-theme "From collapse to dissolution of self-understanding" revealed how COVID-19 structured their loneliness. Another sub-theme, "Restoring meanings by establishing connections with entities" illustrated the ways to mitigate loneliness during the pandemic. Activities fostering alternative self-interpretation are important to protect older adults against loneliness.
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Affiliation(s)
- Ken H M Ho
- Nethersole School of Nursing, Faculty of Medicine, 71024The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Agnes K P Mak
- School of Nursing, 261919Tung Wah College, Kowloon, Hong Kong
| | | | - Doris Y L Leung
- School of Nursing, 26680The Hong Kong Polytechnic University, Hong Kong
| | - Vico C L Chiang
- School of Nursing, 26680The Hong Kong Polytechnic University, Hong Kong
| | - Daphne S K Cheung
- School of Nursing, 26680The Hong Kong Polytechnic University, Hong Kong
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Puranik AK, Maity S, Meena SP, Santra A, Lodha M, Badkur M. Quality of Life of Patients With Major Amputations in the Tertiary Care Center of Western Rajasthan: A Prospective Observational Study in 2019-2020. Cureus 2021; 13:e20419. [PMID: 34926097 PMCID: PMC8671130 DOI: 10.7759/cureus.20419] [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] [Accepted: 12/14/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction Amputation of a limb is a loss of physical integrity that has disastrous consequences for a person's mental, physical, and social well-being. Aim We aim to analyze the quality of life (QoL) after major amputations and long-term outcomes. Method and materials A prospective, observational study has been conducted in a health care institute in western Rajasthan from January 2019 to July 2020. This study included 64 patients who had major upper or lower limb amputations. We analyzed the sociodemographic factors of the patients, the type of procedure, postoperative hospital stay, complications, and follow-up status with both the SF-12 and the World Health Organization Quality of Life (WHOQOL)-BREF questionnaires. Mean, median, range, standard deviation, percentages, univariable, and multivariable logistic regression were analyzed with SPSS version 23.0 software (IBM Corp., Armonk, NY). Results The mean age of the study patients was 53.6 years (SD 2.6) and they were mostly male (71.9%). Atherosclerotic peripheral vascular disease (PVD) was the most common indication (37.5%) of amputation, and below-the-knee amputation (46.88%) was the most commonly performed procedure. There was a significant increment in both PCS (p-value= 0.001), MCS scores (p-value=0.0001) of SF-12 and physical (p-value=0.0001) and psychological domains (p-value=0.001) of the WHOQOL-BREF questionnaire in the postoperative period. A total of 83.9% of patients have used prostheses, and 15.6% had mortality. Conclusions Major amputations can significantly affect the quality of life of patients, and all efforts should be made to avoid factors that adversely affect their quality of life.
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Affiliation(s)
- Ashok K Puranik
- General Surgery, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Souvik Maity
- General Surgery, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Satya P Meena
- General Surgery, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Archismita Santra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, IND
| | - Mahendra Lodha
- General Surgery, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Mayank Badkur
- General Surgery, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
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Healthcare Professionals' Perceptions of Loneliness amongst Older Adults: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212071. [PMID: 34831824 PMCID: PMC8625378 DOI: 10.3390/ijerph182212071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/11/2021] [Accepted: 11/15/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Loneliness amongst older adults is linked to poor health outcomes and constitutes a public health issue worldwide. Healthcare professionals' perceptions could influence the strategies they implement in order to prevent, detect and manage loneliness amongst older adults. The aim of this study was to describe and understand healthcare professionals' perceptions of loneliness amongst older adults. METHODS A descriptive qualitative study. Twenty-six Spanish healthcare professionals with experience caring for older adults participated in the study. Data were collected between November 2019 and September 2020 using focus groups and in-depth interviews. Data were analysed following a content analysis method using ATLAS.ti software. RESULTS Healthcare professionals' perceptions of loneliness amongst older adults is represented by three themes: (1) "when one's personal life and social context lead to loneliness"; (2) "from abandonment to personal growth: the two faces of loneliness"; and (3) "loneliness as a health issue that needs to be addressed". CONCLUSIONS Healthcare professionals perceive loneliness as a multifactorial, subjective experience that can trigger different coping mechanisms and negatively affect older people's health. Healthcare professionals consider that a greater involvement of the whole society is needed in order to fight loneliness amongst older adults as a public health issue.
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A Conceptual Review of Loneliness in Adults: Qualitative Evidence Synthesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111522. [PMID: 34770035 PMCID: PMC8582800 DOI: 10.3390/ijerph182111522] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 12/17/2022]
Abstract
The paper reports an evidence synthesis of how loneliness is conceptualised in qualitative studies in adults. Using PRISMA guidelines, our review evaluated exposure to or experiences of loneliness by adults (aged 16+) in any setting as outcomes, processes, or both. Our initial review included any qualitative or mixed-methods study, published or unpublished, in English, from 1945 to 2018, if it employed an identified theory or concept for understanding loneliness. The review was updated to include publications up to November 2020. We used a PEEST (Participants, Exposure, Evaluation, Study Design, Theory) inclusion criteria. Data extraction and quality assessment (CASP) were completed and cross-checked by a second reviewer. The Evidence of Reviews of Qualitative Research (CERQual) was used to evaluate confidence in the findings. We undertook a thematic synthesis using inductive methods for peer-reviewed papers. The evidence identified three types of distinct but overlapping conceptualisations of loneliness: social, emotional, and existential. We have high confidence in the evidence conceptualising social loneliness and moderate confidence in the evidence on emotional and existential loneliness. Our findings provide a more nuanced understanding of these diverse conceptualisations to inform more effective decision-making and intervention development to address the negative wellbeing impacts of loneliness.
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Predictors and Importance of Social Aspects in Ikigai among Older Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168718. [PMID: 34444474 PMCID: PMC8391354 DOI: 10.3390/ijerph18168718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/12/2021] [Accepted: 08/15/2021] [Indexed: 12/15/2022]
Abstract
Ikigai is a unique Japanese concept that encompasses not only joy and happiness, but also the purpose and meaning of life. The purpose of this study was to explore the factors that contribute to Ikigai, an important concept in the health of older women, and to clarify the relationship between Ikigai and the enhancement of the social aspects of their health. The participants in this longitudinal study, conducted between October 2017 and February 2020, were physically healthy older women aged 65 years and above (N = 132). Physical function and social activity were used as predictors of Ikigai. In addition, willingness for new interactions was used to examine the social aspects of health. A causal model was created from these factors, and path analysis was performed. The results demonstrated that participating in numerous interpersonal activities was predictive of increased Ikigai, but physical function was not. In addition, Ikigai was found to affect the willingness for new interactions. Further, Ikigai could be related to the willingness for new interactions. To enhance the social aspects of older women’s health, it is necessary to focus on Ikigai.
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Boulton E, Kneale D, Stansfield C, Heron P, Sutcliffe K, Hayanga B, Hall A, Bower P, Casey D, Craig D, Gilbody S, Hanratty B, McMillan D, Thomas J, Todd C. Rapid systematic review of systematic reviews: what befriending, social support and low intensity psychosocial interventions, delivered remotely, may reduce social isolation and loneliness among older adults and how? F1000Res 2021. [DOI: 10.12688/f1000research.27076.2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: During the COVID-19 pandemic ‘social distancing’ has highlighted the need to minimise loneliness and isolation among older adults (aged 50+). We wanted to know what remotely delivered befriending, social support and low intensity psychosocial interventions may help to alleviate social isolation and loneliness and how they work. Methods: We followed a systematic ‘review of reviews’ approach. Searches of 11 databases from the fields of health, social care, psychology and social science were undertaken during April 2020. Reviews meeting our PICOS criteria were included if they focussed on the evaluation of remote interventions to reduce levels of social isolation or loneliness in adults aged 50+ and were critically appraised using AMSTAR2. Narrative synthesis was used at a review and study level to develop a typology of intervention types and their effectiveness. Intervention Component Analysis (ICA) and Qualitative Comparative Analysis (QCA) were used at a study level to explore the characteristics of successful interventions. Results: We synthesised evidence from five systematic reviews and 18 primary studies. Remote befriending, social support and low intensity psychosocial interventions took the form of: (i) supported video-communication; (ii) online discussion groups and forums; (iii) telephone befriending; (iv) social networking sites; and (v) multi-tool interventions. The majority of studies utilised the first two approaches, and were generally regarded positively by older adults, although with mixed evidence around effectiveness. Focussing on processes and mechanisms, using ICA and QCA, we found that the interventions that were most successful in improving social support: (i) enabled participants to speak freely and to form close relationships; (ii) ensured participants have shared experiences/characteristics; (iii) included some form of pastoral guidance. Conclusions: The findings highlight a set of intervention processes that should be incorporated into interventions, although they do not lead us to recommend specific modes of support, due to the heterogeneity of interventions.
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Morlett Paredes A, Lee EE, Chik L, Gupta S, Palmer BW, Palinkas LA, Kim HC, Jeste DV. Qualitative study of loneliness in a senior housing community: the importance of wisdom and other coping strategies. Aging Ment Health 2021; 25:559-566. [PMID: 31918561 PMCID: PMC7347442 DOI: 10.1080/13607863.2019.1699022] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Older adults are at a high risk for loneliness, which impacts their health, well-being, and longevity. While related to social isolation, loneliness is a distinct, internally experienced, distressing feeling. The present qualitative study sought to identify characteristics of loneliness in older adults living independently within a senior housing community, which is typically designed to reduce social isolation. METHOD Semi-structured qualitative interviews regarding the experience of loneliness, risk factors, and ways to combat it were conducted with 30 older adults, ages 65-92 years. The interviews were audiotaped, transcribed, and coded using a grounded theory analytic approach based on coding, consensus, co-occurrence, and comparison. RESULTS Three main themes with multiple subthemes are described: (A) Risk and Protective factors for loneliness: age-associated losses, lack of social skills or abilities, and protective personality traits; (B) Experience of loneliness: Sadness and lack of meaning as well as Lack of motivation; and (C) Coping strategies to prevent or overcome loneliness: acceptance of aging, compassion, seeking companionship, and environment enables socialization. DISCUSSION Despite living within a communal setting designed to reduce social isolation, many older adults described feeling lonely in stark negative terms, attributing it to aging-associated losses or lack of social skills and abilities. However, interviewees also reported positive personal qualities and actions to prevent or cope with loneliness, several of which mirrored specific components of wisdom. The results support the reported inverse relationship between loneliness and wisdom and suggest a potential role for wisdom-enhancing interventions to reduce and prevent loneliness in older populations.
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Affiliation(s)
- Alejandra Morlett Paredes
- Department of Psychiatry, University of California San Diego, La Jolla, CA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
| | - Ellen E. Lee
- Department of Psychiatry, University of California San Diego, La Jolla, CA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA,Veterans Affairs San Diego Healthcare System, San Diego, CA
| | - Lisa Chik
- Department of Psychiatry, University of California San Diego, La Jolla, CA
| | - Saumya Gupta
- Department of Psychiatry, University of California San Diego, La Jolla, CA
| | - Barton W. Palmer
- Department of Psychiatry, University of California San Diego, La Jolla, CA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA,Veterans Affairs San Diego Healthcare System, San Diego, CA
| | - Lawrence A. Palinkas
- Department of Family Medicine and Public Health, University of California San Diego
| | - Ho-Cheol Kim
- Scalable Knowledge Intelligence, IBM Research-Almaden, San Jose, CA, US
| | - Dilip V. Jeste
- Department of Psychiatry, University of California San Diego, La Jolla, CA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA,Department of Neurosciences, University of California San Diego, La Jolla, CA
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19
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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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Abstract
The problem of loneliness is receiving increasing attention in the popular media and among social scientists. Despite anthropology's rich engagement with emotions and experience, the anthropology of loneliness is still scant. In psychology, loneliness has been defined as relational lack. In this article, I reconsider one culturally specific form of relational lack-being unneeded among post-Soviet Muscovites. I draw on the anthropological literature on emotion, exchange, and morality to suggest that being unneeded is an ethical commentary on a lack of recognition. During Soviet times, recognition was secured through informal social exchange practices. Being unneeded among middle-aged and elderly post-Soviet Muscovites is therefore connected to a constricted ability to give and experience recognition. One avenue of analysis for an anthropology of loneliness is to consider social exchange practices and how these connect with societal and moral dimensions of loneliness.
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21
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Chu CH, Donato‐Woodger S, Dainton CJ. Competing crises: COVID-19 countermeasures and social isolation among older adults in long-term care. J Adv Nurs 2020; 76:2456-2459. [PMID: 32643787 PMCID: PMC7361866 DOI: 10.1111/jan.14467] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Charlene H. Chu
- Lawrence S. Bloomberg Faculty of NursingUniversity of TorontoTorontoCanada
- Affiliate ScientistKITEToronto RehabUniversity Health NetworkTorontoCanada
- Institute of Ageing and the Life CourseUniversity of TorontoTorontoCanada
| | | | - Christopher J. Dainton
- Grand River Hospital and St. Mary’s HospitalKitchenerONCanada
- McMaster UniversityHamiltonONCanada
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22
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From anonymous subject to engaged stakeholder: Enriching participant experience in autistic-language-use research. RESEARCH FOR ALL 2020. [DOI: 10.14324/rfa.04.2.13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The Talking Together community-engagement pilot project brought together pairs of autistic and non-autistic strangers to: (1) talk about their experiences of loneliness in their local city; and (2) think about potential, co-produced responses to the problem. The project had evolved as a secondary aim, from an initial need to acquire naturalistic conversation data for my linguistic PhD research investigating a theoretical reframing of autistic language use as ‘different’ rather than ‘deficient’. The desire to make the data collection a meaningful experience for the participants in its own right was central to the research design, and so the Talking Together loneliness project was devised as a way to achieve this. However, it was not until the research was under way that the potential for valuable, immediate impact became apparent. This article reflects on the successes and challenges of the Talking Together pilot as a piece of autistic-led participatory research, and explores how the principles of engaged, participatory research can be applied so as to maximize impact, even where engagement may not be a primary aim. It also explores the ‘participatory’ nature of participatory research where the researcher belongs to the marginalized stakeholder group.
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23
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Badal VD, Graham SA, Depp CA, Shinkawa K, Yamada Y, Palinkas LA, Kim HC, Jeste DV, Lee EE. Prediction of Loneliness in Older Adults Using Natural Language Processing: Exploring Sex Differences in Speech. Am J Geriatr Psychiatry 2020; 29:853-866. [PMID: 33039266 PMCID: PMC7486862 DOI: 10.1016/j.jagp.2020.09.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/02/2020] [Accepted: 09/04/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The growing pandemic of loneliness has great relevance to aging populations, though assessments are limited by self-report approaches. This paper explores the use of artificial intelligence (AI) technology to evaluate interviews on loneliness, notably, employing natural language processing (NLP) to quantify sentiment and features that indicate loneliness in transcribed speech text of older adults. DESIGN Participants completed semi-structured qualitative interviews regarding the experience of loneliness and a quantitative self-report scale (University of California Los Angeles or UCLA Loneliness scale) to assess loneliness. Lonely and non-lonely participants (based on qualitative and quantitative assessments) were compared. SETTING Independent living sector of a senior housing community in San Diego County. PARTICIPANTS Eighty English-speaking older adults with age range 66-94 (mean 83 years). MEASUREMENTS Interviews were audiotaped and manually transcribed. Transcripts were examined using NLP approaches to quantify sentiment and expressed emotions. RESULTS Lonely individuals (by qualitative assessments) had longer responses with greater expression of sadness to direct questions about loneliness. Women were more likely to endorse feeling lonely during the qualitative interview. Men used more fearful and joyful words in their responses. Using linguistic features, machine learning models could predict qualitative loneliness with 94% precision (sensitivity = 0.90, specificity = 1.00) and quantitative loneliness with 76% precision (sensitivity = 0.57, specificity = 0.89). CONCLUSIONS AI (e.g., NLP and machine learning approaches) can provide unique insights into how linguistic features of transcribed speech data may reflect loneliness. Eventually linguistic features could be used to assess loneliness of individuals, despite limitations of commercially developed natural language understanding programs.
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Affiliation(s)
- Varsha D Badal
- Department of Psychiatry (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA; Sam and Rose Stein Institute for Research on Aging (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA
| | - Sarah A Graham
- Department of Psychiatry (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA; Sam and Rose Stein Institute for Research on Aging (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA
| | - Colin A Depp
- Department of Psychiatry (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA; Sam and Rose Stein Institute for Research on Aging (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA; VA San Diego Healthcare System (CAD, EEL), La Jolla, CA
| | - Kaoru Shinkawa
- Accessibility and Aging, IBM Research-Tokyo (KS, YY), Tokyo, Japan
| | - Yasunori Yamada
- Accessibility and Aging, IBM Research-Tokyo (KS, YY), Tokyo, Japan
| | - Lawrence A Palinkas
- Suzanne Dworak Peck School of Social Work (LAP), University of Southern California, Los Angeles, CA
| | - Ho-Cheol Kim
- AI and Cognitive Software, IBM Research-Almaden (HCK), San Jose, CA
| | - Dilip V Jeste
- Department of Psychiatry (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA; Sam and Rose Stein Institute for Research on Aging (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA; Department of Neurosciences (DVJ), University of California San Diego, La Jolla, CA
| | - Ellen E Lee
- Department of Psychiatry (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA; Sam and Rose Stein Institute for Research on Aging (VDB, SAG, CAD, DVJ, EEL), University of California San Diego, San Diego, CA; VA San Diego Healthcare System (CAD, EEL), La Jolla, CA.
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The experiences and needs of Asian older adults who are socially isolated and lonely: A qualitative systematic review. Arch Gerontol Geriatr 2020; 92:104254. [PMID: 32957019 DOI: 10.1016/j.archger.2020.104254] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 09/02/2020] [Accepted: 09/07/2020] [Indexed: 02/03/2023]
Abstract
PURPOSE To examine the experiences and needs of Asian older adults who are socially isolated and lonely living in Asian and western countries. MATERIALS AND METHODS Six databases were searched for qualitative studies from each database's inception to December 2019. Qualitative data were meta-summarized and then meta-synthesized. RESULTS Fourteen studies were included in this review. Five themes emerged: (1) association with older adults' well-being, (2) loss of social support, (3) dealing with social isolation and loneliness (4) unique experiences of Asian older adults in western countries, and (5) wish list of older adults. The older adults felt psychologically down and experienced a lack of social support from their family members. They coped using strategies such as religious reliance and social engagement with peers. Asian older adults in western countries faced cultural barriers and tried to form ethnic communities. The older adults wished for more community resources and care. CONCLUSION There were multiple associations of social isolation and loneliness on the Asian older adults' well-being and social support. Coping mechanisms such as acceptance and social engagement were adopted. They expressed support needs such as social programs and healthcare services. More geographically distributed studies are needed to gather a more comprehensive and causality-related perspectives of socially isolated and lonely older adults. Lay-led programs, technology, and active coping strategies are proposed and can be incorporated in healthcare services and social programs to assist these older adults.
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25
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Urban P, Rezaei Tabar V, Denkiewicz M, Bokota G, Das N, Basu S, Plewczynski D. The Mixture of Autoregressive Hidden Markov Models of Morphology for Dentritic Spines During Activation Process. J Comput Biol 2020; 27:1471-1485. [PMID: 32175768 DOI: 10.1089/cmb.2019.0383] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The dendritic spines play a crucial role in learning and memory processes, epileptogenesis, drug addiction, and postinjury recovery. The shape of the dendritic spine is a morphological key to understand learning and memory process. The classification of the dendritic spines is based on their shapes but the major questions are how the shapes changes in time, how the synaptic strength changes, and is there a correlation between shapes and synaptic strength? Because the changes of the classes by dendritic spines during activation are time dependent, the forward-directed autoregressive hidden Markov model (ARHMM) can be used to model these changes. It is also more appropriate to use an ARHMM directed backward in time. Thus, the mixture of forward-directed ARHMM and backward-directed ARHMM (MARHMM) is used to model time-dependent data related to the dendritic spines. In this article, we discuss (1) how to choose the initial probability vector and transition and dependence matrices in ARHMM and MARHMM for modeling the dendritic spines changes and (2) how to estimate these matrices. Many descriptors to classify dendritic spines in two-dimensional or/and three-dimensional (3D) are available. Our results from sensitivity analysis show that the classification that comes from 3D descriptors is closer to the truth, and estimated transition and dependence probability matrices are connected with the molecular mechanism of the dendritic spines activation.
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Affiliation(s)
- Paulina Urban
- Center of New Technologies, University of Warsaw, Warsaw, Poland.,College of Inter-Faculty Individual Studies in Mathematics and Natural Sciences, University of Warsaw, Warsaw, Poland
| | - Vahid Rezaei Tabar
- Center of New Technologies, University of Warsaw, Warsaw, Poland.,Department of Statistics, Faculty of Mathematics and Computer Sciences, Allameh Tabataba'i University, Tehran, Iran.,School of Biological Science, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
| | - Michał Denkiewicz
- Center of New Technologies, University of Warsaw, Warsaw, Poland.,College of Inter-Faculty Individual Studies in Mathematics and Natural Sciences, University of Warsaw, Warsaw, Poland
| | - Grzegorz Bokota
- Center of New Technologies, University of Warsaw, Warsaw, Poland.,Faculty of Mathematics, Informatics and Mechanics, University of Warsaw, Warsaw, Poland
| | - Nirmal Das
- Department of Computer Science and Engineering, Jadavpur University, Kolkata, India
| | - Subhadip Basu
- Department of Computer Science and Engineering, Jadavpur University, Kolkata, India
| | - Dariusz Plewczynski
- Center of New Technologies, University of Warsaw, Warsaw, Poland.,Faculty of Mathematics and Information Science, Warsaw University of Technology, Warsaw, Poland
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A Multi-Criteria Decision-Making Model for Evaluating Senior Daycare Center Locations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16245031. [PMID: 31835613 PMCID: PMC6950606 DOI: 10.3390/ijerph16245031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 12/05/2019] [Accepted: 12/05/2019] [Indexed: 12/01/2022]
Abstract
Many developed and developing countries are facing an imminent population aging and rapid demographics changing problem. The need of various kinds of eldercare is increasing tremendously. A senior daycare center, very similar to a daycare center for toddlers and preschoolers, can provide the elderly a place to go during daytime and have a more diversified social life. In this research, a senior daycare center location evaluation problem is studied, and a model for facilitating the decision-making of the senior daycare center location is constructed by considering the benefits, opportunities, costs, and risks (BOCR) of the locations. Senior daycare center location evaluation factors are listed first through literature review and interview with experts. These factors are used to construct a network, which is applied to prepare a questionnaire to ask about the influences of a criterion to other criteria. The interrelationships among the criteria are calculated by adopting fuzzy interpretative structural modeling (FISM). Based on the results from the FISM, a fuzzy analytic network process (FANP) questionnaire is given out, and the results are used to determine the priorities of the criteria. In addition, the final ranking of the senior daycare center locations can be obtained. The research results can provide references for prospective senior daycare center providers for making relevant decisions.
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Shin O, Park S, Amano T, Kwon E, Kim B. Nature of Retirement and Loneliness: The Moderating Roles of Social Support. J Appl Gerontol 2019; 39:1292-1302. [PMID: 31711350 DOI: 10.1177/0733464819886262] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Drawing from the social convoy model, this study investigates whether the nature of retirement (voluntary or involuntary) influences loneliness among retirees, and how different social support types may affect this association. Data come from the 2014 Health and Retirement Study (N = 2,055). Five social support types were identified: weak, ambivalent, strong positive, children strain, and family strain. Involuntary retirement was associated with a higher level of loneliness; however, involuntarily retired individuals with strong positive social support had a relatively lower level of loneliness. Findings from this study suggest that social support may alleviate the negative impacts of involuntary retirement. Our research provides a theoretical basis for developing a practical program to reduce the negative impacts of involuntary retirement on well-being.
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Affiliation(s)
- Oejin Shin
- University of Illinois at Urbana-Champaign, USA
| | | | | | | | - BoRin Kim
- University of New Hampshire, Durham, USA
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28
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Wee LE, Tsang TYY, Yi H, Toh SA, Lee GL, Yee J, Lee S, Oen K, Koh GCH. Loneliness amongst Low-Socioeconomic Status Elderly Singaporeans and its Association with Perceptions of the Neighbourhood Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16060967. [PMID: 30889851 PMCID: PMC6466029 DOI: 10.3390/ijerph16060967] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 03/13/2019] [Accepted: 03/14/2019] [Indexed: 01/08/2023]
Abstract
In Singapore, a densely urbanised Asian city state, more than 80% of the population stays in public housing estates and the majority (90%) own their own homes. For the needy who cannot afford home ownership, public rental flats are available. We were interested in exploring social-environmental factors that are associated with loneliness among elderly residents of public rental housing in Singapore. We surveyed residents aged ≥60 in two Singapore public housing precincts in 2016. Loneliness was measured using a three-item scale. Sociodemographic information was obtained via standardised questionnaires. We used chi-square to identify associations between loneliness and sociodemographic characteristics, as well as neighbourhood perceptions (safety, convenience and the physical environment), on univariate analysis; and logistic regression for multivariate analysis. The response rate was 62.1% (528/800). On multivariate analysis, staying in a rental flat block was independently associated with loneliness (adjusted odds ratio, aOR = 2.10, 95% confidence interval (CI) = 1.32⁻3.36), as was staying in a poorer physical environment (aOR = 1.92, 95% CI = 1.15⁻3.22). Although needy Singapore residents share the same built environment as more well-to-do neighbours, differences in the impact of loneliness do exist.
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Affiliation(s)
- Liang En Wee
- Department of Infectious Diseases, Singapore General Hospital, Singapore 169608, Singapore.
- Duke-NUS Graduate Medical School, Singapore 169857, Singapore.
| | | | - Huso Yi
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore 119228, Singapore.
| | - Sue Anne Toh
- Regional Health System Planning and Development, National University Health System, National University of Singapore, Singapore 119228, Singapore.
| | - Geok Ling Lee
- Department of Social Work, Faculty of Arts and Social Sciences, National University of Singapore, Singapore 119077, Singapore.
| | - Jaime Yee
- Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore 119228, Singapore.
| | - Shannon Lee
- Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore 119228, Singapore.
| | - Kellynn Oen
- Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore 119228, Singapore.
| | - Gerald Choon Huat Koh
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore 119228, Singapore.
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How Can We Achieve Healthy Aging? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14121583. [PMID: 29244771 PMCID: PMC5751001 DOI: 10.3390/ijerph14121583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 11/30/2017] [Accepted: 12/05/2017] [Indexed: 11/16/2022]
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