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Jiao K, Zhang J, Liu M, Xu M. Interaction of widowhood, gender, and age in predicting loneliness among older adults in China. J Women Aging 2024; 36:225-238. [PMID: 38151922 DOI: 10.1080/08952841.2023.2293446] [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: 09/02/2023] [Accepted: 12/07/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Loneliness is a significant issue for the elderly, and widowhood is considered a major risk factor. However, research on the intersectional effects of gender, age, and widowhood on loneliness is limited, especially within the Chinese cultural context. METHODS Using six waves (2002-2018) of national longitudinal data from the Chinese Longitudinal Healthy Longevity Survey (N = 22,777), this study employed multilevel mixed-effects ordered logistic regression to analyze the impact of widowhood on loneliness. Moderating roles of gender and age were examined through interaction effects. RESULTS Widowhood significantly increased loneliness across genders and age groups, but this effect diminished with age. Widowed men experienced greater loneliness than women, but this difference converged by age 90. The buffering effect of age on the widowhood-loneliness link was less pronounced among older women. CONCLUSION The study unravels the complexity of how gender, age, and widowhood interact to shape loneliness in later life. Targeted interventions considering these intersections are needed to alleviate loneliness among Chinese widowed elderly.
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Affiliation(s)
- Kaishan Jiao
- School of Ethnology and Sociology, Minzu University of China, Beijing, China
| | - Jiujuan Zhang
- School of Ethnology and Sociology, Minzu University of China, Beijing, China
| | - Meng Liu
- School of International Cultures and Social Development, Zhejiang Normal University, Zhejiang, China
| | - Mengjia Xu
- School of Social Sciences, Policy and Evaluation, Claremont Graduate University, Claremont, CA, USA
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Johnson A, Moreland M, Kiernan MD, Collins T, Wilson-Menzfeld G. Understanding evidence and provision of services around social isolation and loneliness of military widow/ers: A scoping review. PLoS One 2023; 18:e0293182. [PMID: 38011120 PMCID: PMC10681208 DOI: 10.1371/journal.pone.0293182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/08/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Whilst the uniqueness of loneliness and social isolation is now recognised for members of the Armed Forces Community, there is currently a lack of evidence examining these experiences within the Military Widow/er population. Therefore, this scoping review aimed to search and synthesise the current evidence base exploring experiences of loneliness and social isolation in this community. METHOD Six databases were searched; ASSIA; CINAHL; ProQuest Dissertation & Theses Global; PsycArticles; Medline; Web of Science. Any article type was included if they focused on UK or international Military Widows and loneliness and social isolation. In the absence of loneliness and social isolation, related aspects were included, for example, social support. RESULTS A thematic synthesis was completed on the nine eligible papers, where key findings were coded and generated into four themes; Experiences of Loneliness and Social Isolation, The Uniqueness of the Military, Access to Social Support, and The Importance of Peer Support. CONCLUSIONS Evidence supports the need for military-specific support services with peers who recognise the individuals' unique experiences of loneliness and social isolation. None of the available evidence focused specifically on social isolation, however this was often prevalent in the results. All of the studies were carried out in the USA and Israel, with none including the views of widowers. Further evidence is required, particularly relating to a UK-context.
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Affiliation(s)
- Amy Johnson
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom
| | - Mary Moreland
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom
| | - Matthew D. Kiernan
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom
| | - Tracy Collins
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom
| | - Gemma Wilson-Menzfeld
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom
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3
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Thompson PsyD MC, Kim PhD AB. Understanding the Experiences of Elderly Bereaved Men and the Bond With Their Pets. OMEGA-JOURNAL OF DEATH AND DYING 2023; 86:1291-1311. [PMID: 33840274 DOI: 10.1177/00302228211004820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The purpose of this transcendental phenomenological study was to understand the bereaved Older males' experiences with the interaction and ownership of a companion animal after the death of their partner. The primary researcher recruited 13 participants via a criterion-based purposeful sampling method to assure the quality of the information collected. Results revealed six themes: (a) bonds with their pets grew stronger and closer after the loss of their wife; (b) men were able to express their grief to their pets; (c) companion animals helped the men psychologically during grief; (d) pets were influential during times when the wife's presence would have been valuable; (e) companion animals helped men with loneliness and social connection; and (f) companion animals helped men find a new normal by providing a purpose and routine during bereavement. The pets proved to be a source of support for these widowed men.
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Affiliation(s)
- Monique C Thompson PsyD
- California School of Professional Psychology, Alliant International University, San Diego, California, United States
| | - Angela B Kim PhD
- California School of Professional Psychology, Alliant International University, San Diego, California, United States
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Forward C, Khan HTA, Fox P. The experience of living alone as an older woman in the UK during the Covid pandemic: an interpretative phenomenological analysis. BMC Public Health 2023; 23:244. [PMID: 36739409 PMCID: PMC9898705 DOI: 10.1186/s12889-023-14988-2] [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: 09/06/2022] [Accepted: 01/04/2023] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES More people are living alone across the life course: in later life this can have implications for practical and psychosocial support. The Covid pandemic emphasised the importance of this when the UK government restricted movement outside of households to limit the spread of disease. This had important ramifications regarding social contact and practical support. The objectives of this study were to explore the experience of older women living alone during this time, with a focus on health and wellbeing. RESEARCH DESIGN AND METHODS This study used an Interpretative Phenomenological approach. Semi-structured interviews were undertaken with seven women (aged 65 +), living alone in the UK. Interviews were carried out between May and October 2020. Interpretative Phenomenological Analysis was used to analyse the transcripts. RESULTS Findings show that life course events shaped how living alone was experienced in later life. Convergences and divergences in lived experience were identified. Three superordinate themes emerged from the Interpretative Phenomenological Analysis: Productivity, Ownership, and Interconnectedness. DISCUSSION AND IMPLICATIONS Findings highlight the importance of life course events in shaping the experience of later life. They also provide a better understanding of the lived experience of living alone as an older woman, increasing knowledge of this group and how living alone can affect health and wellbeing. Implications for research and practice are discussed, such as the importance of recognising the specific support needs for this group in later life, and the need for further knowledge about groups whose needs are not met by standard practice.
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Affiliation(s)
- Cat Forward
- The College of Nursing, Midwifery and Healthcare, University of West London, London, TW8 9GA, UK. .,Present address: NIHR Health and Social Care Work Research Unit, The Policy Institute, King's College London, Virginia Woolf Building, 22 Kingsway, Strand, London, WC2B 6NR, UK.
| | - Hafiz T. A. Khan
- grid.81800.310000 0001 2185 7124Public Health Group, College of Nursing, Midwifery and Healthcare, University of West London, London, TW8 9GA UK
| | - Pauline Fox
- grid.81800.310000 0001 2185 7124The Graduate Centre, University of West London, London, W5 5RF UK
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5
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Norell Pejner M, Karlsson S. Restoring Balance-A Woman's Expressions of Lived Experience of Everyday Life During a Period of Aging: A Case Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231167133. [PMID: 37036069 PMCID: PMC10103273 DOI: 10.1177/00469580231167133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Bereaved older people face stressors from the changes in roles associated with the death of a spouse. To illustrate the lived experience of everyday life during a period of aging after a woman's loss of her spouse. One woman born in 1918 was followed between 74 and 80 years of age after her husband died. Data consisted of daily diary. The text from the diaries were analyzed with a phenomenological hermeneutical approach. Everyday life after becoming a widow is characterized by balancing between personal resources to manage everyday life and vulnerability. In health and social care, it is important to identify experiences of vulnerability because these are associated with poor health.
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Affiliation(s)
| | - Staffan Karlsson
- Halmstad University, Halmstad, Sweden
- Kristianstad University, Kristianstad, Sweden
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You H, Wang Y, Xiao LD, Liu L. Prevalence of and Factors Associated with Negative Psychological Symptoms among Elderly Widows Living Alone in a Chinese Remote Sample: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010264. [PMID: 36612585 PMCID: PMC9819587 DOI: 10.3390/ijerph20010264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/15/2022] [Accepted: 12/21/2022] [Indexed: 06/12/2023]
Abstract
(1) Background: Research indicates that most elderly widows are at a high risk of experiencing negative psychological symptoms. It is common for elderly women in rural and remote areas to live alone without family support to cope with stress due to the mass rural-to-urban migration of China’s youth labor force. Such a situation further worsens their psychological health and well-being. However, the prevalence of and risk factors associated with negative psychological symptoms (loneliness, depression, and anxiety) among remote elderly widows living alone in China are currently unclear; (2) Methods: A cross-sectional study was conducted in Hunan Province, China. The loneliness was assessed through the University of California at Los Angeles Loneliness Scale (ULS-8). The depression and anxiety were assessed with the Short Form Geriatric Depression Scale (GDS-15) and Generalized Anxiety Disorder Scale (GAD-7), respectively. The Chi-square test and correlation analysis were conducted to identify factors associated with negative psychological symptoms. Logistic regression was performed to predict risk and protective factors contributing to loneliness, depression, and anxiety symptoms. The significance level was set as p < 0.05; (3) Results: A total of 271 remote elderly widows living alone were enrolled in the present study. Additionally, 234 valid questionnaires were returned (valid response rate = 86.3%). The prevalence of loneliness, depression and anxiety was 8.1%, 44.0%, and 16.7%, respectively. Acute or chronic medical conditions, marital happiness, being the primary caregiver before widowhood and anticipating the death of the spouse differed significantly in the distribution of negative psychological symptoms. Logistic regression analysis predicted that participants who were satisfied with their marriage had a lower likelihood to experience loneliness, depression, and anxiety (p < 0.05). Being the spouse’s primary caregiver before widowhood was more likely to have symptoms of loneliness (p < 0.01). Those with various acute or chronic medical conditions were more likely to suffer from depression (p < 0.01); (4) Conclusions: Remote elderly widows living alone in China are prone to loneliness, depression, and anxiety symptoms. Being the primary caregiver before widowhood and having many acute or chronic medical conditions are risk factors for loneliness and depression, respectively. Marital happiness is the protective factor against negative psychological symptoms. To accomplish the goal of equitable access to mental health care in China, evidence-based policy and resource development to support psycho-social interventions that prevent and manage negative psychological symptoms for remote elderly widows living alone are urgently needed.
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Affiliation(s)
- Hui You
- Department of Midwifery, Xiangya School of Nursing, Central South University, Changsha 410013, China
| | - Yao Wang
- Department of Midwifery, Xiangya School of Nursing, Central South University, Changsha 410013, China
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia
| | - Li Liu
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha 410013, China
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7
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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: 6] [Impact Index Per Article: 2.0] [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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8
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Exploring Recent Adverse and Positive Life Events: A Qualitative Study Among Lonely Older Adults. AGEING INTERNATIONAL 2021. [DOI: 10.1007/s12126-021-09433-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hong Y, Fu J, Kong D, Liu S, Zhong Z, Tan J, Luo Y. Benefits and barriers: a qualitative study on online social participation among widowed older adults in Southwest China. BMC Geriatr 2021; 21:450. [PMID: 34344309 PMCID: PMC8329635 DOI: 10.1186/s12877-021-02381-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 07/12/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND With the development of digital media, online activities are increasingly becoming part of the daily life of older adults. Widowed older adults generally would face changes in social interactions and activities due to widowhood; thus, the importance of online participation may be more prominent in this population. However, a detailed evidence on the experiences of online social participation among widowed older adults is relatively sparse. This study aimed to explore widowed older adults' perceptions regarding online social participation in southwestern China. METHODS This study adopted a qualitative approach. Semi-structured, in-depth individual interviews were conducted with 19 widowed older adults between September-December 2020. Thematic analysis was applied to analyse the data. RESULTS Two major themes, "benefits" and "barriers" were identified from the original data analysis. Subcategories concerning the theme "benefits" were "benefit perception (convenience, flexible time, supplementation)", "health promotion", "emotional comfort", and "social connection". Subcategories of "barriers" were "worries: personal economic loss", "concerns: security of digital device", "troubles: the diversity of online social participation", and "difficulties: using digital media". CONCLUSIONS Social participation of widowed older adults in southwestern China has begun to be integrated into the digital world; however, it remains at an early stage with the simple purpose of engagement. The older adults may face many challenges for online social participation. Although there are barriers and challenges in online social participation, widowed older adults can reap its benefits, which can be used as an important measure to facilitate a fulfilling life and successful ageing. There is no doubt that online social participation will become a trend within the foreseeable future. Family, friends and health care professionals should pay more attention to the needs of online social participation in widowed older adults and provide adequate support for them to achieve a meaningful life.
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Affiliation(s)
- Yan Hong
- School of Nursing, Army Medical University / Third Military Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038 People’s Republic of China
| | - Jingjing Fu
- School of Nursing, Army Medical University / Third Military Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038 People’s Republic of China
| | - Dehui Kong
- School of Nursing, Army Medical University / Third Military Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038 People’s Republic of China
| | - Siqi Liu
- School of Nursing, Army Medical University / Third Military Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038 People’s Republic of China
| | - Zhu Zhong
- School of Nursing, Army Medical University / Third Military Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038 People’s Republic of China
| | - Jing Tan
- School of Nursing, Army Medical University / Third Military Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038 People’s Republic of China
| | - Yu Luo
- School of Nursing, Army Medical University / Third Military Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038 People’s Republic of China
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10
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Kharicha K, Manthorpe J, Iliffe S, Chew-Graham CA, Cattan M, Goodman C, Kirby-Barr M, Whitehouse JH, Walters K. Managing loneliness: a qualitative study of older people's views. Aging Ment Health 2021; 25:1206-1213. [PMID: 32091237 DOI: 10.1080/13607863.2020.1729337] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Engaging with older people who self-identify as lonely may help professionals in mental health and other services understand how they deal with loneliness. The evidence-base for effective interventions to address loneliness is inconclusive. This study aimed to explore how community-dwelling lonely older people in England manage their experiences of loneliness. Twenty eight community-dwelling older people identifying as lonely, based on responses to two loneliness measures (self-report and a standardised instrument), participated in in-depth interviews between 2013 and 2014. Fifteen lived alone. Thematic analysis of transcribed interviews was conducted by a multidisciplinary team including older people.Participants drew on a range of strategies to ameliorate their distress which had been developed over their lives and shaped according to individual coping styles and contexts. Strategies included physical engagement with the world beyond their home, using technologies, planning, and engagement with purpose in an 'outside world', and acceptance, endurance, revealing and hiding, positive attitude and motivation, and distraction within an 'inside world'. Strategies of interests and hobbies, comparative thinking, religion and spirituality and use of alcohol straddled both the inside and outside worlds. Participants conveyed a personal responsibility for managing feelings of loneliness rather than relying on others. This study includes the experiences of those living with loneliness whilst also living with other people. When developing policy and practice responses to loneliness it is important to listen attentively to the views of those who may not be engaging with services designed for 'the lonely' and to consider their own strategies for managing it.
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Affiliation(s)
- K Kharicha
- Department of Primary Care and Population Health, University College London, Royal Free Campus, London, UK
| | - J Manthorpe
- NIHR Policy Research Unit on Health and Social Care Workforce, King's College London, London, UK
| | - S Iliffe
- Department of Primary Care and Population Health, University College London, Royal Free Campus, London, UK
| | - C A Chew-Graham
- School of Primary, Community and Social Care, Faculty of Medicine and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - M Cattan
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - C Goodman
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UK
| | - M Kirby-Barr
- Patient and Public Involvement Member, London, UK
| | | | - K Walters
- Department of Primary Care and Population Health, University College London, Royal Free Campus, London, UK
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11
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Chao YY, Li M, Lu SE, Dong X. Elder mistreatment and psychological distress among U.S. Chinese older adults. J Elder Abuse Negl 2020; 32:434-452. [PMID: 32886054 DOI: 10.1080/08946566.2020.1814180] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aimed to examine the associations between different types of elder mistreatment, anxiety symptoms, and depressive symptoms among U.S. Chinese older adults. METHODS Data were derived from the Population Study of Chinese Elderly (PINE), a study of Chinese older adults aged 60 years and above in the greater Chicago area from 2011-2013. Measurements include elder mistreatment screening tools, Hospital Anxiety and Depression Scale, and Patient Health Questionnaire-9. Negative binomial regressions and logistic regressions were performed. RESULTS Participants with any mistreatment, psychological mistreatment, physical mistreatment, financial exploitation, and caregiver neglect were more likely to have anxiety symptoms and depressive symptoms. Sexual mistreatment was not associated with symptoms of anxiety and depression. CONCLUSION AND IMPLICATIONS The rate of psychological distress differs based on the types of mistreatment among U.S. Chinese older adults. The findings underline the need for public and community awareness and improved education for health care professionals.
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Affiliation(s)
- Ying-Yu Chao
- School of Nursing, Rutgers, the State University of New Jersey , Newark, New Jersey, USA.,Health Care Policy and Aging Research, Rutgers Institute for Health , New Brunswick, New Jersey, USA
| | - Mengting Li
- School of Nursing, Rutgers, the State University of New Jersey , Newark, New Jersey, USA.,Health Care Policy and Aging Research, Rutgers Institute for Health , New Brunswick, New Jersey, USA
| | - Shou-En Lu
- School of Public Health, Rutgers, the State University of New Jersey , Piscataway, New Jersey, USA
| | - XinQi Dong
- Health Care Policy and Aging Research, Rutgers Institute for Health , New Brunswick, New Jersey, USA
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12
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Høy B, Hall EOC. "Take good care of yourself" An integrative review of older widows' self-care for health and well-being. J Women Aging 2020; 34:1-30. [PMID: 32339070 DOI: 10.1080/08952841.2020.1753484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Take good care of yourself is a regard often said to older bereaved women. However, what does it mean? Though self-care is a well-known phenomenon within health, it is not well understood in the context of late life spousal bereavement and widowhood. We undertook an integrative review to synthesize knowledge of older women's self-care challenges, resources and activities when bereaved and in a healthy transition to widowhood. Good care refers to health-promoting self-care and can be explained as the older widows' ability to access and mobilize resources and activities that are significant for a healthy transition to widowhood.
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Affiliation(s)
- Bente Høy
- Research Unit, Randers Regional Hospital, Randers, Denmark
| | - Elisabeth O C Hall
- Health, Aarhus University, Aarhus, Denmark.,Faculty of Natural and Health Sciences, University of Faroe Islands, Thorshavn, Faroe Islands
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13
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Hemberg J, Nyqvist F, Näsman M. "Homeless in life" - loneliness experienced as existential suffering by older adults living at home: a caring science perspective. Scand J Caring Sci 2018; 33:446-456. [PMID: 30566252 DOI: 10.1111/scs.12642] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 11/26/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Due to physical impairments and functional limitations, older adults receiving home care can be considered especially vulnerable to loneliness. To understand how society can provide support that enhances vulnerable individuals' quality of life, it is important to explore loneliness and its underlying causes in older adults. AIMS To contribute to a deeper understanding of caring science theory, the aim of this study was to use a caring science perspective to explore and understand experiences of suffering from loneliness in older adults receiving home care. The research questions are as follows: What phenomena are associated with the experience of suffering from loneliness in older adults receiving home care? How can this experience be understood? METHODOLOGY A hermeneutical approach was used. The material was collected through interviews with 17 older adults about their quality of life, including their experiences of loneliness. The texts were interpreted through latent content analysis. FINDINGS The findings resulted in one main category and three subcategories. The main category was as follows: Being homeless in life-loneliness expressed and primarily stemming from existential suffering. The subcategories were as follows: Loss of communion with one's partner or other loved ones, Loss of meaningful social activities due to isolation and Loss of health due to frailty and vulnerability. All categories were described and implications for practice discussed. CONCLUSION This study contributes to an understanding of experiences of suffering from loneliness in older adults receiving home care, with relevance for the healthcare context as well as for what a community or society should focus on when addressing these important issues.
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Affiliation(s)
- Jessica Hemberg
- Department of Caring Sciences and Health Sciences, Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland
| | - Fredrica Nyqvist
- Faculty of Education and Welfare Studies, Social Policy Unit, Åbo Akademi University, Vaasa, Finland
| | - Marina Näsman
- Faculty of Education and Welfare Studies, Social Policy Unit, Åbo Akademi University, Vaasa, Finland
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14
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Strategies employed by older people to manage loneliness: systematic review of qualitative studies and model development. Int Psychogeriatr 2018; 30:1767-1781. [PMID: 29798736 DOI: 10.1017/s1041610218000339] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
UNLABELLED ABSTRACTObjectives:To (i) systematically identify and review strategies employed by community dwelling lonely older people to manage their loneliness and (ii) develop a model for managing loneliness. METHODS A narrative synthesis review of English-language qualitative evidence, following Economic and Social Research Council guidance. Seven electronic databases were searched (1990-January 2017). The narrative synthesis included tabulation, thematic analysis, and conceptual model development. All co-authors assessed eligibility of final papers and reached a consensus on analytic themes. RESULTS From 3,043 records, 11 studies were eligible including a total of 502 older people. Strategies employed to manage loneliness can be described by a model with two overarching dimensions, one related to the context of coping (alone or with/in reference to others), the other related to strategy type (prevention/action or acceptance/endurance of loneliness). The dynamic and subjective nature of loneliness is reflected in the variety of coping mechanisms, drawing on individual coping styles and highlighting considerable efforts in managing time, contacting others, and keeping loneliness hidden. Cognitive strategies were used to re-frame negative feelings, to make them more manageable or to shift the focus from the present or themselves. Few unsuccessful strategies were described. CONCLUSION Strategies to manage loneliness vary from prevention/action through to acceptance and endurance. There are distinct preferences to cope alone or involve others; only those in the latter category are likely to engage with services and social activities. Older people who deal with their loneliness privately may find it difficult to articulate an inability to cope.
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