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Riley C, Venkatesh S, Dhand A, Doshi N, Kavak K, Levit E, Perrone C, Weinstock-Guttman B, Longbrake E, De Jager P, Xia Z. Impact of the COVID-19 Pandemic on the Personal Networks and Neurological Outcomes of People With Multiple Sclerosis: Cross-Sectional and Longitudinal Case-Control Study. JMIR Public Health Surveill 2024; 10:e45429. [PMID: 38319703 PMCID: PMC10879979 DOI: 10.2196/45429] [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: 12/30/2022] [Revised: 08/05/2023] [Accepted: 08/31/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has negatively affected the social fabric. OBJECTIVE We evaluated the associations between personal social networks and neurological function in people with multiple sclerosis (pwMS) and controls in the prepandemic and pandemic periods. METHODS During the early pandemic (March-December 2020), 8 cohorts of pwMS and controls completed a questionnaire quantifying the structure and composition of their personal social networks, including the health behaviors of network members. Participants from 3 of the 8 cohorts had additionally completed the questionnaire before the pandemic (2017-2019). We assessed neurological function using 3 interrelated patient-reported outcomes: Patient Determined Disease Steps (PDDS), Multiple Sclerosis Rating Scale-Revised (MSRS-R), and Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function. We identified the network features associated with neurological function using paired 2-tailed t tests and covariate-adjusted regressions. RESULTS In the cross-sectional analysis of the pandemic data from 1130 pwMS and 1250 controls during the pandemic, having a higher percentage of network members with a perceived negative health influence was associated with worse disability in pwMS (MSRS-R: β=2.181, 95% CI 1.082-3.279; P<.001) and poor physical function in controls (PROMIS Physical Function: β=-5.707, 95% CI -7.405 to -4.010; P<.001). In the longitudinal analysis of 230 pwMS and 136 controls, the networks of all participants contracted, given an increase in constraint (pwMS-prepandemic: mean 52.24, SD 15.81; pwMS-pandemic: mean 56.77, SD 18.91; P=.006. Controls-prepandemic: mean 48.07, SD 13.36; controls-pandemic: mean 53.99, SD 16.31; P=.001) and a decrease in network size (pwMS-prepandemic: mean 8.02, SD 5.70; pwMS-pandemic: mean 6.63, SD 4.16; P=.003. Controls-prepandemic: mean 8.18, SD 4.05; controls-pandemic: mean 6.44, SD 3.92; P<.001), effective size (pwMS-prepandemic: mean 3.30, SD 1.59; pwMS-pandemic: mean 2.90, SD 1.50; P=.007. Controls-prepandemic: mean 3.85, SD 1.56; controls-pandemic: mean 3.40, SD 1.55; P=.01), and maximum degree (pwMS-prepandemic: mean 4.78, SD 1.86; pwMS-pandemic: mean 4.32, SD 1.92; P=.01. Controls-prepandemic: mean 5.38, SD 1.94; controls-pandemic: mean 4.55, SD 2.06; P<.001). These network changes were not associated with worsening function. The percentage of kin in the networks of pwMS increased (mean 46.06%, SD 29.34% to mean 54.36%, SD 30.16%; P=.003) during the pandemic, a change that was not seen in controls. CONCLUSIONS Our findings suggest that high perceived negative health influence in the network was associated with worse function in all participants during the pandemic. The networks of all participants became tighter knit, and the percentage of kin in the networks of pwMS increased during the pandemic. Despite these perturbations in social connections, network changes from the prepandemic to the pandemic period were not associated with worsening function in all participants, suggesting possible resilience.
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Affiliation(s)
- Claire Riley
- Columbia University Irving Medical Center, New York, NY, United States
| | | | - Amar Dhand
- Brigham and Women's Hospital, Boston, MA, United States
| | - Nandini Doshi
- University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Elle Levit
- Yale University, New Haven, CT, United States
| | | | | | | | - Philip De Jager
- Columbia University Irving Medical Center, New York, NY, United States
| | - Zongqi Xia
- University of Pittsburgh, Pittsburgh, PA, United States
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Lim MH, Eres R, Vasan S. Understanding loneliness in the twenty-first century: an update on correlates, risk factors, and potential solutions. Soc Psychiatry Psychiatr Epidemiol 2020; 55:793-810. [PMID: 32524169 DOI: 10.1007/s00127-020-01889-7] [Citation(s) in RCA: 130] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 05/18/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE Loneliness is increasingly recognised as the next critical public health issue. A plausible reason for this concern may be related to emerging societal trends affecting the way we relate, communicate, and function in our social environment. In 2006, a prominent review of the clinical significance of loneliness was published. However, there has not been a comprehensive update on known and emerging risk factors and correlates of loneliness since then. Furthermore, there is no conceptual model that has been developed to better account for the complexity of loneliness and to inform the development of evidence-based solutions as we challenge the issues of the twenty-first century. METHODS We reviewed the current literature to identify either known or emerging risk factors and correlates of loneliness since 2006. This includes new or known evidence on: (1) demography; (2) health, including physical health; mental health; cognitive health; brain, biology, and genetics; and (3) socio-environmental factors including digital communication and the workplace. RESULTS We synthesized the literature according to a new proposed conceptual model of loneliness which showed the interplay between known and emerging correlates and risk factors from demography, health, to socio-environmental factors. In the conceptual model of loneliness, we illustrated how solutions can be delivered and tailored to an individual based on their life circumstances and preferences. CONCLUSION We concluded by making specific recommendations in advancing our scientific understanding of loneliness. Our knowledge can only be deepened if we increase scientific rigour via accounting for confounding variables and using longitudinal, multi-disciplinary, and multiple methodologies in research. We also call for the rigorous evaluation of programs targeting loneliness.
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Affiliation(s)
- Michelle H Lim
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, 3122, Australia. .,Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia.
| | - Robert Eres
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, 3122, Australia.,Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
| | - Shradha Vasan
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, 3122, Australia
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Leavitt VM, Riley CS, De Jager PL, Bloom S. eSupport: Feasibility trial of telehealth support group participation to reduce loneliness in multiple sclerosis. Mult Scler 2019; 26:1797-1800. [PMID: 31668134 DOI: 10.1177/1352458519884241] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Loneliness is a risk factor for increased morbidity and mortality. Persons with multiple sclerosis (pwMS) are at increased risk for loneliness. Support groups facilitate meaningful social connections. OBJECTIVE To conduct a feasibility trial of eSupport: online support groups. METHODS Participants engaged in 1 hour/week eSupport or eJournal (active control). Primary outcome was feasibility (completion and adherence). We evaluated loneliness and depressive symptoms for preliminary efficacy. RESULTS Feasibility outcomes were met: completion rate was 96.4%; 88.9% were adherent. Loneliness and depression showed trend-level decreases in both conditions. CONCLUSION Feasibility of telehealth support group participation for pwMS was supported. eSupport is accessible, affordable, acceptable, and scalable. Results warrant a randomized controlled trial to support efficacy.
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Affiliation(s)
- Victoria M Leavitt
- Translational Cognitive Neuroscience Laboratory, Cognitive Neuroscience Division, Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Claire S Riley
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Philip L De Jager
- Multiple Sclerosis Center and Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Sharonna Bloom
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
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Koutsogeorgou E, Chiesi AM, Leonardi M. Social capital components and social support of persons with multiple sclerosis: a systematic review of the literature from 2000 to 2018. Disabil Rehabil 2019; 42:3437-3449. [DOI: 10.1080/09638288.2019.1597182] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Eleni Koutsogeorgou
- Department of Social and Political Sciences (SPS), Università degli Studi di Milano, Milan, Italy
- Department of Cultures, Politics and Society (CPS), Università degli Studi di Torino, Turin, Italy
| | - Antonio M. Chiesi
- Department of Social and Political Sciences (SPS), Università degli Studi di Milano, Milan, Italy
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit and Coma Research Centre, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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Rokach A, Rosenstreich E, Brill S, Goor Aryeh I. People with Chronic Pain and Caregivers: Experiencing Loneliness and Coping with It. CURRENT PSYCHOLOGY 2018. [DOI: 10.1007/s12144-017-9571-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Theeke LA, Mallow JA, Moore J, McBurney A, VanGilder R, Barr T, Theeke E, Rellick S, Petrone A. Using Gene Expression Analysis to Examine Changes in Loneliness, Depression and Systemic Inflammation in Lonely Chronically Ill Older Adults. ACTA ACUST UNITED AC 2016; 6:620-631. [PMID: 29082106 PMCID: PMC5656289 DOI: 10.4236/ojn.2016.68066] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose The purpose of this study was to evaluate the effectiveness of LISTEN (Loneliness Intervention) on loneliness, depression, physical health, systemic inflammation, and genomic expression in a sample of lonely, chronically ill, older adults. Methods This was a prospective, longitudinal randomized trial of LISTEN, a novel intervention based on theories of narrative and cognitive restructuring to target specific aspects of loneliness. Twenty-three older, lonely, chronically ill adults were recruited from a family medicine clinic in West Virginia. Participants were randomized to two groups, 13 in LISTEN group (Loneliness Intervention) and 10 in attention control (healthy aging education). Participants attended an enrollment session where they completed consent, survey data (including sociodemographics and chronic illness diagnoses), baseline physical measures, and blood sampling for gene expression analysis. After completing the 5 weekly sessions, all participants attended a 12 week post data collection meeting (17 weeks post-baseline) for survey completion, physical measures and blood sampling. Results The results of this study show that the LISTEN intervention improves measures of physical and psychosocial health. Specifically, subjects enrolled in LISTEN showed reductions in systolic blood pressure, as well as decreased feelings of loneliness and depression. These changes may be due, in part, to a reduction in systemic inflammation, as measured by interleukin-2. Conclusion This study provides support for the use of LISTEN in reducing loneliness in chronically ill, older adults. Further, while some of our results are inconclusive, it provides rationale to expand our study population to evaluate the relationship between loneliness and systemic inflammation. In the future, enhancing knowledge about the relationships among loneliness, chronic illness, systemic inflammation, and gene expression of these particular targets, and how these relationships may change over time with intervention will inform translation of findings to clinical settings.
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Affiliation(s)
- Laurie A Theeke
- School of Nursing, West Virginia University, Morgantown, WV, USA
| | | | - Julie Moore
- School of Nursing, West Virginia University, Morgantown, WV, USA
| | - Ann McBurney
- School of Nursing, West Virginia University, Morgantown, WV, USA
| | - Reyna VanGilder
- School of Nursing, West Virginia University, Morgantown, WV, USA
| | - Taura Barr
- School of Nursing, West Virginia University, Morgantown, WV, USA
| | - Elliott Theeke
- School of Nursing, West Virginia University, Morgantown, WV, USA
| | | | - Ashley Petrone
- School of Nursing, West Virginia University, Morgantown, WV, USA.,Department of Family Medicine, West Virginia University, Morgantown, WV, USA
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Drageset J, Eide GE, Dysvik E, Furnes B, Hauge S. Loneliness, loss, and social support among cognitively intact older people with cancer, living in nursing homes--a mixed-methods study. Clin Interv Aging 2015; 10:1529-36. [PMID: 26451093 PMCID: PMC4590337 DOI: 10.2147/cia.s88404] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Loneliness is a significant psychosocial effect following a cancer diagnosis and may prevent people from engaging in social activities, thus creating difficulties in interpersonal relationships. This study investigated loneliness and social support among cognitively intact nursing home residents with cancer by using a quantitatively driven mixed-methods design with sequential supplementary qualitative components. METHODS The quantitative component consisted of face-to-face interviews of 60 nursing home residents (≥65 years) using the one-item Loneliness Scale and the Social Provisions Scale. The supplementary psychosocial component consisted of qualitative research interviews about experiences related to loneliness with nine respondents. RESULTS The quantitative results indicated that reassurance of worth was associated with loneliness. The experience of loneliness was identified by the following: loneliness that was dominated by a feeling of inner pain, feeling of loss, and feeling small. Loneliness was alleviated by the following: being engaged in activities, being in contact with other people, and occupying oneself. CONCLUSION Enhancing the lives of nursing home residents with cancer requires attending to the residents' experience of loneliness and social relationships in a targeted and individualized manner. This might require screening all nursing home residents for early detection of loneliness. Revealing factors that may contribute to or reduce loneliness improves the ability to enhance people's lives.
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Affiliation(s)
- Jorunn Drageset
- Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Geir Egil Eide
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Elin Dysvik
- Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
| | - Bodil Furnes
- Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
| | - Solveig Hauge
- Faculty of Health and Social Studies and Centre for Caring Research – Southern Norway, Telemark University College, Porsgrunn, Norway
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Rokach A, Findler L, Chin J, Lev S, Kollender Y. Cancer patients, their caregivers and coping with loneliness. PSYCHOL HEALTH MED 2013; 18:135-44. [DOI: 10.1080/13548506.2012.689839] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Drageset J, Eide GE, Kirkevold M, Ranhoff AH. Emotional loneliness is associated with mortality among mentally intact nursing home residents with and without cancer: a five-year follow-up study. J Clin Nurs 2012; 22:106-14. [DOI: 10.1111/j.1365-2702.2012.04209.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Rokach A. Caring for those who care for the dying: Coping with the demands on palliative care workers. Palliat Support Care 2006; 3:325-32. [PMID: 17039988 DOI: 10.1017/s1478951505050492] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The article reviews the complex and demanding field of palliative care, noting the sources of the stresses and strains that the health care workers often encounter. It illustrates the multidimensional needs of patients, the reasons why they and/or their families may hamper palliative care, and, mostly, what can be done to deal with and—better yet—prevent palliative workers' burnout.
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Affiliation(s)
- Ami Rokach
- The Institute for the Study and Treatment of Psychosocial Stress, Toronto, Ontario, Canada.
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