Social isolation and loneliness in later life: A parallel convergent mixed methods case study of older adults and their residential contexts in the Minneapolis metropolitan area, USA
Social isolation and loneliness in later life: A parallel convergent mixed methods case study of older adults and their residential contexts in the Minneapolis metropolitan area, USA
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DOI：
10.1016/j.socscimed.2018.05.010
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发表时间：
2018-07-01
影响因子：
5.4
通讯作者：
Kobayashi, Lindsay C.
中科院分区：
文献类型：
--
作者：
Finlay, Jessica M.;Kobayashi, Lindsay C.
社会孤立和孤独感在美国老年人中越来越普遍，这对发病率和死亡率风险都有影响。迄今为止，很少有研究调查复杂的人地交易对晚年社会福祉的影响。本研究旨在描述个人和社区环境对老年人社会孤立和孤独的影响。于2015年6月至10月在美国明尼阿波利斯市区对独立居住的男性和女性（n = 124，平均年龄71岁）进行了访谈。采用融合混合方法设计，定量和定性方法并行使用，同时获得对统计关联和深入个人观点的见解。Logistic回归模型预测了自我报告的社会隔离和孤独，调整了年龄、性别、过去的职业、种族/民族、独居、街道类型、居住地点和居住密度。访谈记录的定性专题分析探讨了社会孤立和孤独的个人经历。定量结果表明，非裔美国成年人、社会经济地位较高的人、不独居的人以及住在离市中心较近的人不太可能感到社会孤立或孤独。定性结果确定并解释了这些因素中每个结果的变化。他们提供了对那些独自生活但没有感到孤独的人的见解，发现一部分参与者追求并享受孤独。身心健康状况不佳往往导致报告的社会孤立，特别是在天气恶劣或社区密度低的情况下。与此同时，健康状况不佳有时为与照顾者、家人和朋友进行有价值的社会交往提供了机会。这种混合方法结合了群体层面的风险因素和深入的个人见解，可能有助于制定解决老年社区社会孤立和孤独问题的战略。
Social isolation and loneliness are increasingly prevalent among older adults in the United States, with implications for morbidity and mortality risk. Little research to date has examined the complex person-place transactions that contribute to social well-being in later life. This study aimed to characterize personal and neighborhood contextual influences on social isolation and loneliness among older adults. Interviews were conducted with independent-dwelling men and women (n = 124; mean age 71 years) in the Minneapolis metropolitan area (USA) from June to October, 2015. A convergent mixed-methods design was applied, whereby quantitative and qualitative approaches were used in parallel to gain simultaneous insights into statistical associations and in-depth individual perspectives. Logistic regression models predicted self-reported social isolation and loneliness, adjusted for age, gender, past occupation, race/ethnicity, living alone, street type, residential location, and residential density. Qualitative thematic analyses of interview transcripts probed individual experiences with social isolation and loneliness. The quantitative results suggested that African American adults, those with a higher socioeconomic status, those who did not live alone, and those who lived closer to the city center were less likely to report feeling socially isolated or lonely. The qualitative results identified and explained variation in outcomes within each of these factors. They provided insight on those who lived alone but did not report feeling lonely, finding that solitude was sought after and enjoyed by a portion of participants. Poor physical and mental health often resulted in reporting social isolation, particularly when coupled with poor weather or low-density neighborhoods. At the same time, poor health sometimes provided opportunities for valued social engagement with caregivers, family, and friends. The combination of group-level risk factors and in-depth personal insights provided by this mixed-methodology may be useful to develop strategies that address social isolation and loneliness in older communities.