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Ho ISS, McGill K, Malden S, Wilson C, Pearce C, Kaner E, Vines J, Aujla N, Lewis S, Restocchi V, Marshall A, Guthrie B. Examining the social networks of older adults receiving informal or formal care: a systematic review. BMC Geriatr 2023; 23:531. [PMID: 37653368 PMCID: PMC10470175 DOI: 10.1186/s12877-023-04190-9] [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: 03/25/2023] [Accepted: 07/23/2023] [Indexed: 09/02/2023] Open
Abstract
PURPOSE To address the care needs of older adults, it is important to identify and understand the forms of care support older adults received. This systematic review aims to examine the social networks of older adults receiving informal or formal care and the factors that influenced their networks. METHODS A systematic review was conducted by searching six databases from inception to January 31, 2023. The review included primary studies focusing on older adults receiving long-term care, encompassing both informal and formal care. To assess the risk of bias in the included studies, validated appraisal tools specifically designed for different study types were utilized. Network analysis was employed to identify the grouping of study concepts, which subsequently formed the foundation for describing themes through narrative synthesis. RESULTS We identified 121 studies relating to the formal and informal care of older adults' networks. A variety of social ties were examined by included studies. The most commonly examined sources of care support were family members (such as children and spouses) and friends. Several factors were consistently reported to influence the provision of informal care, including the intensity of networks, reciprocity, and geographical proximity. In terms of formal care utilization, older age and poor health status were found to be associated with increased use of healthcare services. Additionally, physical limitations and cognitive impairment were identified as factors contributing to decreased social engagement. CONCLUSION This review found that older people were embedded within a diverse network. The findings of this review emphasize the importance of recognizing and incorporating the diversity of social networks in care plans and policies to enhance the effectiveness of interventions and improve the overall well-being of older adults.
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Affiliation(s)
- Iris Szu-Szu Ho
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK.
- School of Informatics, University of Edinburgh (Informatics Forum, 10 Crichton St, Newington, Edinburgh, EH8 9AB, UK.
- , 47 Potterow, Bayes Centre, Edinburgh, EH8 9BT, UK.
| | - Kris McGill
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
| | - Stephen Malden
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- School of Health in Social Science, Medical School, University of Edinburgh, Doorway 6, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Cara Wilson
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- Institute for Education, Community and Society, University of Edinburgh, Old Moray House, Holyrood Road, Edinburgh, EH8 8AQ, UK
| | - Caroline Pearce
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- Edinburgh College of Art, University of Edinburgh, 74 Lauriston Pl, Edinburgh, EH3 9DF, UK
| | - Eileen Kaner
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- Population Health Science Institute, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne, NE2 4AX, UK
| | - John Vines
- School of Informatics, University of Edinburgh (Informatics Forum, 10 Crichton St, Newington, Edinburgh, EH8 9AB, UK
| | - Navneet Aujla
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- Population Health Science Institute, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne, NE2 4AX, UK
| | - Sue Lewis
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- School of Health in Social Science, Medical School, University of Edinburgh, Doorway 6, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Valerio Restocchi
- School of Informatics, University of Edinburgh (Informatics Forum, 10 Crichton St, Newington, Edinburgh, EH8 9AB, UK
| | - Alan Marshall
- School of Social and Political Science, University of Edinburgh, 15a George Square, Edinburgh, EH8 9LD, UK
| | - Bruce Guthrie
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
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Valtorta NK, Moore DC, Barron L, Stow D, Hanratty B. Older Adults' Social Relationships and Health Care Utilization: A Systematic Review. Am J Public Health 2018; 108:e1-e10. [PMID: 29470115 DOI: 10.2105/ajph.2017.304256] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Deficiencies in older people's social relationships (including loneliness, social isolation, and low social support) have been implicated as a cause of premature mortality and increased morbidity. Whether they affect service use is unclear. OBJECTIVES To determine whether social relationships are associated with older adults' use of health services, independently of health-related needs. SEARCH METHODS We searched 8 electronic databases (MEDLINE, Embase, CINAHL, Web of Science, PsycINFO, Scopus, the Cochrane Library, and the Centre for Reviews and Dissemination) for data published between 1983 and 2016. We also identified relevant sources from scanning the reference lists of included studies and review articles, contacting authors to identify additional studies, and searching the tables of contents of key journals. SELECTION CRITERIA Studies met inclusion criteria if more than 50% of participants were older than 60 years or mean age was older than 60 years; they included a measure of social networks, received social support, or perceived support; and they reported quantitative data on the association between social relationships and older adults' health service utilization. DATA COLLECTION AND ANALYSIS Two researchers independently screened studies for inclusion. They extracted data and appraised study quality by using standardized forms. In a narrative synthesis, we grouped the studies according to the outcome of interest (physician visits, hospital admissions, hospital readmissions, emergency department use, hospital length of stay, utilization of home- and community-based services, contact with general health services, and mental health service use) and the domain of social relationships covered (social networks, received social support, or perceived support). For each service type and social relationship domain, we assessed the strength of the evidence across studies according to the quantity and quality of studies and consistency of findings. MAIN RESULTS The literature search retrieved 26 077 citations, 126 of which met inclusion criteria. Data were reported across 226 678 participants from 19 countries. We identified strong evidence of an association between weaker social relationships and increased rates of readmission to hospital (75% of high-quality studies reported evidence of an association in the same direction). In evidence of moderate strength, according to 2 high-quality and 3 medium-quality studies, smaller social networks were associated with longer hospital stays. When we considered received and perceived social support separately, they were not linked to health care use. Overall, the evidence did not indicate that older patients with weaker social relationships place greater demands on ambulatory care (including physician visits and community- or home-based services) than warranted by their needs. AUTHORS' CONCLUSIONS Current evidence does not support the view that, independently of health status, older patients with lower levels of social support place greater demands on ambulatory care. Future research on social relationships would benefit from a consensus on clinically relevant concepts to measure. Public Health Implications. Our findings are important for public health because they challenge the notion that lonely older adults are a burden on all health and social care services. In high-income countries, interventions aimed at reducing social isolation and loneliness are promoted as a means of preventing inappropriate service use. Our review cautions against assuming that reductions in care utilization can be achieved by intervening to strengthen social relationships.
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Affiliation(s)
- Nicole K Valtorta
- Nicole K. Valtorta, Lynn Barron, Daniel Stow, and Barbara Hanratty are with the Institute of Health and Society/Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom. Danielle Collingridge Moore is with the International Observatory on End of Life Care, Lancaster University, Lancaster, United Kingdom
| | - Danielle Collingridge Moore
- Nicole K. Valtorta, Lynn Barron, Daniel Stow, and Barbara Hanratty are with the Institute of Health and Society/Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom. Danielle Collingridge Moore is with the International Observatory on End of Life Care, Lancaster University, Lancaster, United Kingdom
| | - Lynn Barron
- Nicole K. Valtorta, Lynn Barron, Daniel Stow, and Barbara Hanratty are with the Institute of Health and Society/Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom. Danielle Collingridge Moore is with the International Observatory on End of Life Care, Lancaster University, Lancaster, United Kingdom
| | - Daniel Stow
- Nicole K. Valtorta, Lynn Barron, Daniel Stow, and Barbara Hanratty are with the Institute of Health and Society/Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom. Danielle Collingridge Moore is with the International Observatory on End of Life Care, Lancaster University, Lancaster, United Kingdom
| | - Barbara Hanratty
- Nicole K. Valtorta, Lynn Barron, Daniel Stow, and Barbara Hanratty are with the Institute of Health and Society/Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom. Danielle Collingridge Moore is with the International Observatory on End of Life Care, Lancaster University, Lancaster, United Kingdom
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Lu L, Chang CJ. Social Support, Health and Satisfaction among the Elderly with Chronic Conditions in Taiwan. J Health Psychol 2016; 2:471-80. [DOI: 10.1177/135910539700200404] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study examines possible relationships between perceived social support, physical and mental health, satisfaction towards hospital services, and satisfaction towards life-asa-whole, among the community elderly with chronic conditions. A sample of 172 Chinese elderly living in a metropolitan Taiwanese city were home-interviewed. Results indicated that (a) the elderly perceived good social support, and tangible support was the most important aspect; (b) the elderly did not perceive great impact of illness(es) upon their life, and both physical and mental health were satisfactory; (c) the elderly were generally satisfied with both the hospital services and life-as-a-whole; (d) apart from health and illness factors, social support appeared to have profound and pervasive protective effects on adjustment and satisfaction of the elderly.
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Affiliation(s)
- Luo Lu
- Kaohsiung Medical College, Taiwan,
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Luo Lu, Kao SF, Hsieh YH. Positive Attitudes Toward Older People and Well-being Among Chinese Community Older Adults. J Appl Gerontol 2009. [DOI: 10.1177/0733464809343289] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We aimed to explore older people’s attitudes toward aging and to further examine associations of such attitudes with their well-being in a Chinese society— Taiwan. Face-to-face interviews were conducted to collect data using structured questionnaires from a random sample of community older people ( N = 316). We found that (a) older people possessed positive attitudes toward aging in general, but there were some group attitudinal differences associated with education attainment and urban residence; (b) older age, fewer social support, and less positive attitudes toward aging were related to more depressive symptoms; (c) younger age, greater social support, greater community participation, and more positive attitudes were related to higher happiness. The associations of positive attitudes with well-being were found after controlling for those of social support and community participation.
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Affiliation(s)
- Luo Lu
- Department of Business Administration, National Taiwan University, Taiwan,
| | - Shu-Fang Kao
- Department of Applied Psychology, Hsuan Chuang University, Taiwan
| | - Ying-Hui Hsieh
- Department of Human Development, Tzu Chi University, Taiwan
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Seeman TE, Berkman LF. Structural characteristics of social networks and their relationship with social support in the elderly: who provides support. Soc Sci Med 1988; 26:737-49. [PMID: 3358145 DOI: 10.1016/0277-9536(88)90065-2] [Citation(s) in RCA: 340] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The analyses presented here examine relationships between structural characteristics of social networks and two types of support (instrumental and emotional support) in a sample of community-dwelling individuals aged 65 and older. For each type of support, two dimensions are examined (1) the availability of such support and (2) the perceived adequacy of that support. Regression models, adjusting for age, sex, race and income show that structural characteristics such as total network size, number of face-to-face contacts and number of proximal ties are associated with greater availability of both instrumental and emotional support. The perceived adequacy of both types of support is most strongly related to the number of monthly face-to-face contacts. Comparisons of specific types of ties show that neither ones' spouse nor ones' children are primary sources of support. Rather the presence of a confidant is strongly associated with both dimensions of instrumental and emotional support; the presence of a spouse is not. And, while ties with children are most strongly related to aspects of instrumental support, ties with close friends and relatives are more strongly related to aspects of emotional support. Analyses of possible interactions show that for those without a spouse, confidants assume greater importance in providing emotional support. For those without children, ties with close friends and relatives assume a larger role relative to the perceived adequacy of both emotional and instrumental support.
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Affiliation(s)
- T E Seeman
- Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06510
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