Association between loneliness and mental health among nurses: a cross-sectional research in China

This study explored the association between loneliness and mental health among nurses in China during the COVID-19 pandemic. This cross-sectional study was conducted from March to April 2022. We enrolled 2,811 nurses from a tertiary hospital in China. Demographic characteristics, lifestyle factors, work-related factors, and psychological characteristics were collected from participants via a self-reported questionnaire. Loneliness was measured with the three-item short form of the Revised UCLA Loneliness Scale, and the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder (GAD-7) scale were used to measure mental health. Adjusted odds ratios (ORs) and 95% confidence intervals (CI) were determined using binary logistic regression. Among participants in this study, 12.0% (337) experienced loneliness, and 7.8% (219) and 6.7% (189) reported depression and anxiety, respectively. The loneliness scores were categorized into three levels (3, 4-6, and 7-9). For depression, compared with the lowest reference, the ORs and 95% CI across the tertile were 1.31 (0.69-1.84) and 2.53 (1.11-5.76) after adjustment, respectively, and the P-value for trend was 0.045. For anxiety, compared with the lowest reference, the ORs and 95%CI across the tertile were 1.84 (1.28-2.63) and 2.52 (1.57-4.10) after adjustment, respectively; the P-value for trend was 0.004. This study showed that loneliness was significantly associated with poor mental health among nurses during the COVID-19 pandemic. These findings suggested that medical establishments should offer interventions for nurses to prevent mental health problems by targeting this modifiable risk factor.

Investigation on loneliness and negative emotional symptoms among first generation college students in the family / 中国学校卫生

Objective@#To investigate the current status and relationship between loneliness and negative emotional symptoms among first generation college students in the family, so as to provide reference for improving mental health of this population.@*Methods@#A convenience sampling method was used to select 3 017 college students from 10 colleges and universities in Guangdong Province and Yunnan Province, China, in May 2023. Questionnaires were administered to the students, and the Depression Anxiety Stress Scale (DASS-21) and the short form of the University of California at Los Angeles Loneliness Scale (ULS-6) were employed.@*Results@#The total ULS-6 score of first generation college students in the family was (12.38±4.16), while the score of non first generation college students in the family was (11.89±4.38), with a statistically significant difference ( t=2.79, P <0.05). The total DASS-21 score of first generation college students in the family was (71.13±26.97), while the score of non first generation college students in the family was (70.20±26.66), with a statistically significant difference ( t=2.69, P <0.05). Among the first generation college students in the family, male students experienced more DASS-21 score (77.55±29.36) than female students (70.43±25.03)( t =5.79, P <0.05). Urban students (12.00±4.15, 70.34±25.68) reported lower levels of loneliness score and DASS- 21 score than rural students (12.62±4.15, 74.93±27.63), and the depression subscale scores showed statistically significant differences among students with different professional achievement rankings ( t/F =-3.42, -3.94, 4.25, P <0.05). There was a positive correlation between loneliness, depression, anxiety, pressure and DASS-21 scales of first generation college students in the family ( r=0.64, 0.62, 0.64, 0.66, P <0.01). The linear regression analysis results showed a positive correlation between loneliness and all dimensions and total scores of the DASS-21, explaining 44% of the variance in negative emotional symptoms.@*Conclusions@#A positive correlation is found between loneliness and negative emotional symptoms among first generation college students in the family. Improving the loneliness of the first generation college students in the family can reduce their negative emotional symptoms and improve their mental health level.

Severity of loneliness and factors associated with social and emotional loneliness among the elderly in three districts in Shanghai / 复旦学报（医学版）

Objective To explore the severity of loneliness among the elderly in communities in Shanghai,and to identify factors associated with social and emotional loneliness respectively.Methods A cross-sectional study was conducted in older adults aged 65 years or above in Pudong New Area,Jing'an District and Huangpu District in Shanghai from Mar to Jun 2021.In Pudong New Area,multi-stage stratified random sampling was conducted based on the age and gender distribution of Shanghai,while in Huangpu District and Jing'an District convenience sampling was conducted.A total of 635 samples were included in the study.Loneliness was assessed using the De Jong Gierveld Loneliness Scale with social and emotional loneliness subscales.Logistic regression analyses were conducted to identify factors associated with social and emotional loneliness.Results Among the 635 participants,only 53 older adults(8.4%)were not lonely.Female(OR=0.46,95%CI:0.31-0.70),higher self-efficacy(OR=0.97,95%CI:0.94-1.00),more objective social support(OR=0.96,95%CI:0.93-0.99)were associated with less severe social loneliness.Meanwhile,higher level of education(secondary education,OR=0.56,95%CI:0.34-0.95;college or above,OR=0.30,95%CI:0.11-0.83)and higher self-efficacy(OR=0.96,95%CI:0.93-0.99)were associated with less severe emotional loneliness,while depression(OR=3.41,95%CI:1.76-6.60)and worse social capital(OR=2.02,95%CI:1.29-3.16)were associated with more severe emotional loneliness.Conclusion Up to 91.6%of the elderly in our study sample were moderately lonely or above.The factors associated with social loneliness include self-efficacy,gender and social support.The factors associated with emotional loneliness are self-efficacy,education level,depression,and social capital.

Advances in the study of loneliness among family caregivers of chronically ill patients / 中国实用护理杂志

A review of studies related to the loneliness of family caregivers of chronically ill patients aims to provide a basis for understanding the current situation of loneliness among family caregivers of chronically ill patients, assessing the degree of loneliness among family caregivers, and formulating individualized interventions with a view to reducing the loneliness of family caregivers and promoting their physical and mental health.

Mediating effects of self-efficacy and loneliness on health promoting behavior and frailty in elderly patients with proliferative diabetic retinopathy / 沈阳医学院学报

Objective:To investigate the relationship between health promoting behavior and frailty in elderly patients with proliferative diabetic retinopathy(PDR),and the mediating effects of self-efficacy and loneliness.Methods:In an eye hospital of Anhui Province,214 elderly patients with PDR were selected from May 2021 to Nov 2022 by convenient sampling method.The Frailty Scale,Chinese Version of Health-Promoting Lifestyle Profile-Ⅱ,Self-Efficacy Scale and Simplified Loneliness Scale were used in this survey.Bootstrap method of Process software was used to analyze the mediating effect of self-efficacy on the relationship between health promoting behaviors and frailty in elderly PDR patients and the moderating effect of loneliness on the relationship between self-efficacy and frailty.Results:A total of 220 questionnaires were distributed and 214 valid questionnaires were returned,with valid response rate of 97.27% .Moderated mediation effect analysis suggested that health-promoting behaviors negatively predicted frailty(β=-0.508,P＜0.01).Health promoting behaviors and self-efficacy had significant predictive effects on frailty(β=-0.191 and-0.433,P＜0.01),and health promoting behaviors also had a significant predictive effect on self-efficacy(β=0.063,P＜0.01).Self-efficacy played a partially mediating role between health promoting behaviors and frailty,and the mediating effect accounted for 14.76% of the total effect.The product term of loneliness and self-efficacy significantly predicted frailty(β=0.255,P＜0.01),the mediating effect of self-efficacy on frailty was moderated by loneliness.Conclusions:The health-promoting behaviors of elderly patients with PDR affect frailty through self-efficacy,and loneliness moderates the relationship between self-efficacy and frailty.The moderated mediation model is established.

Relationship between mobile phone addiction and anxiety among college students： the acting path of loneliness / 四川精神卫生

BackgroundAnxiety exists as a prevalent psychological problem among college students nowadays， which brings negative influence on their normal life. Mobile phone addiction and loneliness both have an impact on college students' anxiety. However， the acting path of loneliness between mobile phone addiction and anxiety requires further exploration. ObjectiveTo analyze the relationships among mobile phone addiction， loneliness and anxiety in college students， and to explore the acting path of loneliness between mobile phone addiction and anxiety. MethodsOn December 21， 2023， 1 400 college students from a university in Henan Province were selected， in accordance with the simple random sampling method， for investigation of this study. Questionnaire survey was conducted by using several scales including Mobile Phone Addiction Tendency Scale （MPATS）， Self-rating Anxiety Scale （SAS） and University of California Los Angeles-Loneliness Scale （UCLA-LS）. Pearson correlation analysis was used to examine the correlation between the scores of each scale above， and SPSS macro program Process 3.3 was used to test the mediation effect. ResultsA total of 1 239 valid questionnaires were collected， with an effective recovery rate of 88.50%. The MPATS score of college students was positively correlated with both SAS and UCLA-LS scores （r=0.474， 0.387， P<0.01）， and UCLA-LS score was positively correlated with SAS score （r=0.541， P<0.01）. The indirect effect of loneliness between mobile phone addiction and anxiety was 0.160 （95% CI： 0.118~0.173）， accounting for 33.97% of the total effect. ConclusionMobile phone addiction can positively predict anxiety among college students， and loneliness may act as the mediation path between mobile phone addiction and anxiety among college students.

Loneliness, Social Support, and Cognitive Reserve of Older Adults in the COVID-19 Pandemic / Solidão, Apoio Social e Reserva Cognitiva em Pessoas Idosas na Pandemia da COVID-19 / Soledad, Apoyo Social y Reserva Cognitiva en Adultos Mayores en la Pandemia del COVID-19

Abstract: The COVID-19 pandemic significantly affected the quality of life of older Brazilian adults. This study aimed to investigate the level of loneliness and social support of older adults during the COVID-19 pandemic and its relation with cognitive reserve, sociodemographic data, daily habits, and perceived health. An online cross-sectional study was conducted. The final sample consisted of 116 Brazilians aged over 60 years. The following instruments were used: sociodemographic questionnaire, questionnaire on the everyday habits during the pandemic, CRIq, Revised UCLA Loneliness Scale and MOS-SSS. The results showed a significant association between loneliness and social support. The regression models demonstrate the influence of perceived health and different forms of social contact in predicting social support and loneliness. These results evince the importance of the evaluation of factors related to the quality of life of older Brazilian adults during and after the COVID-19 pandemic.

Resumo: A pandemia da COVID-19 afetou significativamente a qualidade de vida das pessoas idosas brasileiras. O objetivo deste estudo foi analisar o nível de apoio social e de solidão de pessoas idosas durante a pandemia do COVID-19 e sua relação com variáveis como a reserva cognitiva, dados sociodemográficos, hábitos diários e a saúde percebida. Foi conduzido um estudo transversal, online, com uma amostra de 116 brasileiros com mais de 60 anos. Os seguintes instrumentos foram aplicados: Questionário sociodemográfico, Questionário sobre hábitos na pandemia, CRIq, Revised UCLA Loneliness Scale e MOS-SSS . Foi observada uma associação significativa entre a solidão e o apoio social. Os modelos de regressão demonstram a influência da percepção da saúde, e de diferentes meios de comunicação na predição do apoio social e da solidão. Os resultados apresentados demonstram a importância de avaliar fatores psicossociais relacionados à qualidade de vida das pessoas idosas brasileiras durante e após a pandemia de COVID-19.

Resumen: La pandemia del COVID-19 ha afectado significativamente a la calidad de vida de los adultos mayores brasileños. El objetivo de este estudio fue investigar el nivel de apoyo social y la soledad en los adultos mayores durante la pandemia del covid-19 y su relación con las variables como reserva cognitiva, datos sociodemográficos, hábitos diarios y salud percibida. Se realizó un estudio transversal en línea con una muestra de 116 participantes con más de 60 años de edad. Se utilizaron los instrumentos: Cuestionario sociodemográfico, cuestionario sobre hábitos en la pandemia, CRIq , Revised UCLA Loneliness Scale y MOS-SSS . Se encontró una correlación significativa entre la soledad y el apoyo social. Los modelos de regresión encontrados demuestran la influencia de la percepción del estado de salud y de diferentes medios en la predicción del apoyo social y la soledad. Los resultados presentados muestran la importancia de evaluar los factores psicosociales relacionados con la calidad de vida de los adultos mayores brasileños durante y después de la pandemia del COVID-19.

Role adoption, anxiety, depression and loneliness in family caregivers of patients with chronic diseases / Adopción del rol, ansiedad, depresión y soledad en cuidadores familiares de pacientes con enfermedades crónicas / Adoção do papel, ansiedade, depressão e solidão em cuidadores familiares de pacientes com doenças crônicas

Objective: to describe and explore the relationship of loneliness, anxiety and depression with adoption of the caregiver role among individuals caring for people with chronic diseases in Colombia. Methods: this was an exploratory and cross-sectional study involving 960 primary caregivers of individuals with chronic diseases. We applied the Caregiver Role Adoption Scale, the University of California at Los Angeles Loneliness Scale, and the Anxiety and Depression Scale. Principal component and multiple correspondence analyses were performed for clustering. Results: among the participating caregivers, 40.8% reported experiencing depression, 59% reported anxiety, 54.6% reported moderate to severe loneliness, and 88.6% reported satisfactory adoption of the caregiver role. Caregivers who presented basic or insufficient role adoption levels tended to have higher scores for anxiety, depression and loneliness. Conclusion: adoption of the caregiver role is a mediator in the anxiety, depression and loneliness levels among caregivers. Strategies aimed at supporting caregivers should include training for the caregiver role to mitigate the negative impacts of anxiety, depression and loneliness.

Objetivo: describir y explorar la relación de la soledad, la ansiedad y la depresión con la adopción del rol de cuidador entre personas que se ocupan de cuidar pacientes con enfermedades crónicas en Colombia. Métodos: se trató de un estudio exploratorio y transversal con la participación de 960 cuidadores principales de personas con enfermedades crónicas. Aplicamos la Escala de Adopción del Rol de Cuidador, la Escala de Soledad de la Universidad de California de Los Ángeles y la Escala de Ansiedad y Depresión. Se realizaron análisis de componentes principales y de correspondencia múltiple para el clustering . Resultados: el 40,8% de los cuidadores que participaron en el estudio informó padecer depresión, el 59% informó ansiedad, el 54,6% indicó soledad de moderada a grave y el 88,6% presentó adopción satisfactoria del rol de cuidador. Los cuidadores que presentaron los niveles básico o insuficiente en términos de adopción del rol tendieron a obtener puntuaciones de ansiedad, depresión y soledad más elevadas. Conclusión: adoptar el rol de cuidador es un mediador de los niveles de ansiedad, depresión y soledad entre los cuidadores. Las estrategias dirigidas a apoyar a los cuidadores deberían incluir preparación para dicho rol a fin de mitigar los efectos negativos de la ansiedad, la depresión y la soledad.

Objetivo: descrever e explorar a relação entre a solidão, a ansiedade e a depressão com a adoção do papel de cuidador entre os indivíduos que cuidam de pessoas com doenças crônicas na Colômbia. Método: trata-se de um estudo exploratório e transversal que envolveu 960 cuidadores primários de indivíduos com doenças crônicas. Foi aplicada a Escala de Adoção do Papel de Cuidador, a Escala de Solidão da Universidade da Califórnia em Los Angeles e a Escala de Ansiedade e Depressão. Foram realizadas análises de componentes principais e de correspondência múltipla para o agrupamento. Resultados: entre os cuidadores participantes, 40,8% relataram ter depressão, 59% relataram ansiedade, 54,6% relataram solidão moderada a grave e 88,6% relataram uma adoção satisfatória do papel de cuidador. Os cuidadores que apresentaram níveis básicos ou insuficientes de adoção do papel tenderam a ter pontuações mais elevadas de ansiedade, depressão e solidão. Conclusão: a adoção do papel de cuidador é um mediador nos níveis de ansiedade, depressão e solidão entre os cuidadores. As estratégias destinadas a apoiar os cuidadores devem incluir o treinamento para o papel de cuidador, a fim de atenuar os impactos negativos da ansiedade, da depressão e da solidão.

Soledad y ansiedad ante la muerte en adultos mayores

Introducción: La etapa de la vejez facilita la aparición del sentimiento de soledad, lo que puede aumentar la vulnerabilidad del adulto mayor frente a la enfermedad y el deterioro de su salud mental. Objetivo: Describir la asociación entre soledad y ansiedad ante la muerte en adultos mayores peruanos. Métodos: Estudio cuantitativo, transversal, correlacional, desarrollado en dos centros del adulto mayor de Lima Sur, Perú, en el período septiembre a noviembre del año 2022. Se utilizó un muestreo no probabilístico, y eligieron 300 participantes de ambos sexos, entre 60 y 85 años (Medad= 71,74, DE = 7,21), quienes fueron evaluados mediante la Escala de Soledad y la Escala de Ansiedad ante la muerte. Para el análisis de datos se empleó el coeficiente de correlación de Pearson. Los datos se interpretaron en función a la significancia estadística y el tamaño de efecto de las asociaciones. Resultados: El mayor porcentaje de participantes sentían moderada soledad (51 %) y un nivel de ansiedad moderado (65 %). La soledad obtuvo una asociación directa y moderada con la ansiedad ante la muerte (r = 0,275, p< 0,001). En el análisis de las dimensiones, solo la dimensión miedo a que la vida llegue a su fin se correlacionó con una magnitud moderada con la soledad (0,277, p< 0,001). Conclusiones: Los resultados respaldan que, ante una mayor percepción de soledad, mayor será la ansiedad ante la muerte en el adulto mayor.

Introduction: The stage of old age facilitates the appearance of a loneliness feeling, which can increase the vulnerability of older adults to illness and deterioration of their mental health. Objective: To describe the association between loneliness and death anxiety in Peruvian older adults. Methods: A quantitative, cross-sectional and correlational study was carried out in two centers for the elderly in Lima Sur, Peru, from September to November 2022. A nonprobabilistic sampling was used and 300 participants of both sexes, between 60 and 85 years of age (mean age = 71.74, SD = 7.21), were chosen and evaluated by means of the Loneliness Scale and the Death Anxiety Scale. Pearson's correlation coefficient was used for data analysis. The data were interpreted in terms of statistical significance and effect size of the associations. Results: The highest percentage of participants felt moderate loneliness (51%) and a moderate level of anxiety (65%). Loneliness obtained a direct and moderate association with death anxiety (r = 0.275, p < 0.001). In the dimensional analysis, only the dimension fear of life coming to an end correlated with loneliness in a moderate magnitude (0.277, p < 0.001). Conclusions: The results support that, the greater the perception of loneliness, the greater will be the anxiety about death in the older adult.

Social representations of loneliness in people aged at least seventy years old / Representações sociais da solidão em pessoas septuagenárias e em idosos / Representación social de la soledad en personas septuagenarias y de mayor edad

ABSTRACT Objective: to analyze the social representations of loneliness in older adults. Method: an exploratory and qualitative research study conducted in Lambayeque, Peru, by applying the Theory of Social Representations. A sociodemographic questionnaire was applied and in-depth interviews were conducted employing the semi-structured instrument with 32 older adults aged at least 70 years old, 50% belonging to each gender. Simple statistics and percentage analysis were applied to the sociodemographic data. The interviews were analyzed in the Alceste software program, subjecting them to lexicographic analysis. Results: the negative social representations refer to weak or impaired social relations with insufficient social support, thus vulnerabilizing older adults. The positive ones refer to pleasurable activities with no other people involved, assuming loneliness as adequate for intimacy, for listening to silence, for enjoying harmony and peace, for internal self-connection and for leading a pleasurable life, valuing it and strengthening the spiritual dimension. Conclusion: there is certain dialectics in the conception of loneliness: negative when it refers to the social context and to older adults' relationships with others; and positive when it represents an opportunity to embrace loneliness and perform pleasurable activities without depending on other people. It is indispensable to foster such positive aspects in the care provided to aged people.

RESUMO Objetivo: analisar as representações sociais da solidão em idosos. Método: pesquisa exploratória e qualitativa, aplicando a Teoria das Representações Sociais, realizada em Lambayeque, Peru. Aplicou-se um questionário sociodemográfico, sendo realizadas entrevistas em profundidade usando um instrumento semiestruturado, com 32 idosos com idade acima dos setenta anos, sendo 50% do sexo masculino e 50% do sexo feminino. Aplicou-se estatística simples e análise porcentual aos dados sociodemográficos. As entrevistas foram analisadas no software Alceste e submetidas à análise lexicográfica. Resultados: as representações negativas fazem referência a relações sociais fragilizadas ou diminuídas, com insuficiente apoio emocional, vulnerabilizando aos idosos. As positivas fazem referência a atividades prazerosas sem presença de outras pessoas, assumindo a solidão como adequada para a intimidade, para escutar o silencio, ter harmonia e paz, conectar-se internamente e viver uma vida agradável, valorar a vida e fortalecer a dimensão espiritual. Conclusão: há uma dialética na concepção da solidão: negativa quando se refere ao contexto social e às relações dos idosos com outras pessoas; e positiva quando representa uma oportunidade de abraçar a solidão e realizar atividades prazerosas sem depender de outros. É imprescindível fomentar esses aspectos positivos no cuidado dos idosos.

RESUMEN Objetivo: analizar las representaciones sociales de la soledad en adultos mayores. Método: investigación exploratoria, cualitativa, aplicando la Teoría de las Representaciones Sociales, realizada en Lambayeque, Perú. Se aplicó cuestionario sociodemográfico y se realizó entrevista en profundidad empleando instrumento semiestructurado, con 32 adultos mayores de 70 años o más, 50% de cada sexo. Se aplicó estadística simple y análisis porcentual a los datos sociodemográficos. Las entrevistas fueron analizadas mediante el software Alceste, practicándoseles análisis lexicográfico. Resultados: las representaciones negativas hacen referencia a relaciones sociales frágiles o disminuidas, con apoyo emocional insuficiente, vulnerabilizando a los adultos mayores. Las positivas hacen referencia a actividades placenteras sin presencia de otras personas, asumiendo la soledad como adecuada para la intimidad, para oír el silencio, tener armonía y paz, para conectarse internamente y asumir una vida agradable, valorar la vida y fortalecer la dimensión espiritual. Conclusión: hay una dialéctica en la concepción de la soledad, que es negativa cuando se refiere al contexto social, a las relaciones del anciano con los demás; y positiva cuando representa una oportunidad de abrazar la soledad y realizar actividades placenteras sin depender de terceras personas. Es imprescindible fomentar tales aspectos positivos en el cuidado de las personas ancianas.

Soledad y fragilidad en personas mayores que viven en comunidad: Una revisión integrativa / Loneliness and frailty in community-dwelling older adults: An integrative review

CONTEXTO: Se proyecta un aumento del 6% en la población mundial de personas mayores para el 2050, generando desafíos sociales significativos, especialmente el crecimiento de la soledad en la vejez. Este fenómeno está estrechamente vinculado a problemas de salud notables, incluido el síndrome de fragilidad. OBJETIVO: Esta revisión de literatura tiene como objetivo proporcionar una comprensión actualizada de la relación entre fragilidad y soledad en adultos mayores que residen en la comunidad. METODOLOGÍA: Utilizando una revisión integradora, se recopilaron sistemáticamente artículos originales de las bases de datos de PubMed, Web of Science y CINAHL. RESULTADOS: Una revisión de 475 artículos publicados entre 2018 y 2022 identificó 17 estudios que cumplían con los criterios de inclusión y exclusión especificados. CONCLUSIÓN: Los hallazgos revelan sólida evidencia científica que respalda una asociación sustancial entre la soledad y la fragilidad en adultos mayores que viven en la comunidad. A pesar de la consistencia en la evidencia, persisten variaciones en los enfoques conceptuales y las metodologías de medición en los estudios revisados.

CONTEXT: The global elderly population is projected to increase 6% by 2050, posing significant social challenges, particularly the escalating prevalence of loneliness in old age. This phenomenon is closely linked to notable health issues, including the frailty syndrome. OBJECTIVE: This literature review aims to provide an updated understanding of the relationship between frailty and loneliness among older adults residing in the community. Methodology: Employing an integrative review, original articles were systematically gathered from PubMed, Web of Science, and CINAHL databases. RESULTS: A review of 475 articles published between 2018 and 2022 identified 17 studies meeting specified inclusion and exclusion criteria. CONCLUSION: Findings reveal robust scientific evidence supporting a substantial association between loneliness and frailty among older adults in community settings. Despite consistent evidence, variations persist in conceptual approaches and measurement methodologies across reviewed studies.

Soledad en cuidadores informales de personas con demencia durante la pandemia de COVID-19 / Loneliness in informal caregivers of people with dementia during the COVID-19 pandemic

ANTECEDENTES Y OBJETIVO: La soledad es un factor de riesgo para el desarrollo de enfermedades físicas y mentales, causando disminución en la calidad de vida y un aumento de la mortalidad. El objetivo de este artículo fue determinar los factores predictores de soledad en personas cuidadoras informales de personas con demencia dentro de un contexto de crisis como fue la pandemia por COVID-19 con el fin de identificar e intervenir en dichos factores desde la atención primaria de salud. DISEÑO Y METODOLOGÍA: Este es un estudio cuantitativo de carácter transversal para el cual se realizó un muestreo de conveniencia no probabilístico. Ciento noventa y cinco personas cuidadores informales, por medio de una encuesta en línea, respondieron preguntas sociodemográficas y clínicas sobre ellos mismos (soledad, síntomas ansiosos y depresivos, actividades físicas y mentales, sobrecarga y apoyo psicosocial) y sobre la persona con demencia (cambios en la memoria y en los síntomas conductuales y psicológicos). Los datos fueron recolectados durante 6 meses y se hicieron análisis descriptivos, de correlación y de regresión. RESULTADOS: La baja escolaridad, disminución del ingreso económico, no mantener durante la pandemia las actividades físicas y mentales y la sobrecarga en el cuidador se relacionaron significativamente con mayor soledad, mientras que los factores predictores de la misma fueron la presencia de sintomatología ansiosa depresiva, la baja percepción de apoyo psicosocial y la convivencia de la persona cuidadora con la persona con demencia. CONCLUSIÓN: El riesgo de desarrollar soledad en los cuidadores informales de personas con demencia es alto. Los profesionales de enfermería, particularmente en atención primaria, deben estar alertas a identificar a aquellos cuidadores que conviven con la persona con demencia, que presentan síntomas ansiosos y depresivos y que reportan una baja percepción de apoyo psicosocial dado que son más vulnerables de experimentar soledad percibida.

BACKGROUND AND OBJECTIVE: Loneliness is a risk factor for the development of physical and mental illness, causing decreased quality of life and increased mortality. The aim of this article was to recognise predictors of loneliness in informal caregivers of people with dementia in the context of a crisis such as the COVID-19 pandemic. DESIGN AND METHODOLOGY: 195 informal caregivers, through an online survey, answered sociodemographic and clinical questions about themselves (loneliness, anxious and depressive symptoms, physical and mental activities, overload and psychosocial support) and about the person with dementia (changes in memory and behavioural and psychological symptoms). RESULTS: Low schooling, decreased income, failure to maintain physical and mental activities during the pandemic and caregiver overload were significantly related to increased loneliness, while predictors of loneliness were the presence of depressive anxiety symptoms, low perception of psychosocial support and the caregiver living with the person with dementia. CONCLUSION: The risk of developing loneliness in caregivers of people with dementia is high. Nursing professionals, particularly in primary care, should be on the alert for those caregivers within this group who live with the person with dementia, who present anxious and depressive symptoms and who report a low perception of psychosocial support, as they are more vulnerable to experiencing perceived loneliness.

Soledad, ansiedad, depresión y adopción del rol del cuidador de personas con enfermedad crónica en San Gil, Colombia

Introducción: Los cuidadores de personas con enfermedad crónica adoptan un nuevo rol que puede implicar respuestas como ansiedad, depresión y soledad. Objetivo: Describir y correlacionar las variables de adopción del rol del cuidador, depresión, ansiedad y soledad en cuidadores familiares de personas con enfermedad crónica en la provincia de Guanentina, en San Gil, Santander (Colombia), durante el año 2021. Método: Estudio descriptivo, analítico de corte transversal realizado con 112 cuidadores familiares de personas con enfermedades crónicas. Se utilizó una ficha de caracterización y los instrumentos: Escala adopción del rol del cuidador ROL, escala de soledad de UCLA (University of California at Los Ángeles) y Escala Hospitalaria de Ansiedad y Depresión HADS. Resultados: El perfil de los cuidadores fue predominantemente mujer; de 49 años en promedio; casadas, solteras o en unión libre; grado máximo de escolaridad bachiller; de ocupación hogar y nivel socioeconómico medio bajo y bajo. Se encontraron niveles altos de ansiedad en el 18,3 % de ellas, depresión en el 4,3 % y soledad en el 0,9 %, además, se evidenciaron niveles de adopción del rol del cuidador satisfactorios en el 100 %. Se encontró una correlación débil entre ansiedad, depresión y soledad y una correlación inversa entre estas variables con la adopción del rol del cuidador. De igual manera, se encontró una correlación directa entre la edad del paciente y los meses de diagnóstico con las horas de cuidado al día. Por último, se halló carácter predictivo de la ansiedad y la depresión sobre la adopción del rol, de la ansiedad y la adopción del rol sobre la depresión, y de la soledad y la depresión sobre la ansiedad. Conclusiones: los cuidadores tenían niveles de ansiedad, depresión y soledad normales que, al correlacionarse entre sí y con la adopción del rol del cuidador, validan la idea de que, si se interviene a los cuidadores en su trayectoria con orientaciones sobre su rol en cuanto a las labores, la organización y las respuestas se puede contribuir en la disminución de la ansiedad, depresión y soledad. Discusión: la correlación directa observada entre la soledad, depresión y ansiedad es coherente con lo reportado en estudios previos con cuidadores. Acorde con lo reportado por la literatura el desempeño satisfactorio del rol facilita los desenlaces en los cuidadores, en este caso, la moderación de la ansiedad, depresión y soledad.

Introduction: Caregivers of people with chronic disease adopt a new role that may involve responses such as anxiety, depression, and loneliness. Objective: To describe and correlate the variables of adoption of the role of caregiver, depression, anxiety and loneliness in family caregivers of people with chronic disease in the Guanentina province in San Gil, Santander (Colombia), during the year 2021. Methods: Descriptive study, cross-sectional analysis carried out with 112 family caregivers of people with chronic diseases. A characterization sheet and the ROL, UCLA and HADS instruments were used. Results: the profile of the caregivers was predominantly female and average age of 49 years; married, single or in civil union; maximum degree of high school education; of household occupation and low and low-middle socioeconomic level. High levels of anxiety were found in 18,3% of them, depression in 4,3% and loneliness in 0,9%, in addition, satisfactory levels of adoption of the caregiver role were evidenced in 100%. A weak correlation was found between anxiety, depression and loneliness and an inverse correlation between these variables with the adoption of the caregiver role. Similarly, a direct correlation was found between the patient's age and the months of diagnosis with the hours of care per day. Finally, anxiety and depression were found to be predictive of role adoption, of anxiety and role adoption on depression, and of loneliness and depression on anxiety. Conclusions: the caregivers had normal levels of anxiety, depression and loneliness that, when correlated with each other and with the adoption of the caregiver role, validate the idea that, if caregivers are intervened in their trajectory with guidance on their role in terms of the tasks, the organization and the answers can contribute in the reduction of anxiety, depression and loneliness. Discussion: The direct connection observed between loneliness, depression and anxiety is consistent with what has been reported in previous studies with caregivers. In accordance with what has been reported in the literature, satisfactory performance of the role facilitates the outcomes in caregivers, in this case, the moderation of anxiety, depression and loneliness.

Prevalencia de la soledad en las personas mayores que viven en zonas rurales. Diferencias por grupos étnicos y variables predictivas / Prevalence of loneliness among older people living in rural areas. Differences by ethnic group and predictor variables

ANTECEDENTES: La soledad es uno de los problemas de salud pública más recurrentes en las personas mayores, sin embargo, en Chile se disponen de escasos datos sobre su prevalencia en personas mayores a 60 años que viven en zonas rurales y que pertenecen a pueblos originarios o al tribal afrodescendiente. OBJETIVO: Examinar la prevalencia de la soledad entre personas mayores que viven en zonas rurales por grupo étnico; y analizar las variables sociodemográficas, familiares y de salud que se relaciona con soledad. MATERIAL Y MÉTODOS: Se aplicó la escala de soledad DJGLS-6, APGAR-familiar, cuestionario de 13 problemas de salud más frecuentes en personas mayores chilenas, e índice de Barthel a 1.692 personas mayores que residen en zonas rurales de las regiones de Arica y Parinacota, Tarapacá, Antofagasta, Atacama, Coquimbo, Valparaíso, Los Lagos, Aisén y Magallanes. RESULTADOS: Se observa una alta prevalencia de la soledad (sobre el 55%) en personas de los pueblos: Afrodescendiente, Quechua, Atacameño, Colla, Chango, Huilliche, Kawesqar y no indígenas. Siendo la soledad emocional la más prevalente entre personas mayores indígenas y no indígenas que viven en zonas rurales (≥ 71%). Las variables que se asocian con soledad son: ser mujer, edad, no tener pareja, vivir solo(a), disfuncionalidad familiar y tener problemas de salud. CONCLUSIONES: La soledad en zonas rurales es más alta en las personas mayores y esta situación se complejiza en el cruce de diversidad étnico cultural, es necesario seguir abordando este problema que afecta el bienestar biopsicosocial en la vejez.

BACKGROUND: Loneliness is one of the most recurrent public health problems in older people. However, there is little data available in Chile on its prevalence in people over 60 years of age living in rural areas and belonging to native or Afro-descendant groups. AIM: To examine the prevalence of loneliness among older people living in rural areas by ethnic group and to analyze the socio-demographic, family, and health variables related to loneliness. METHODS: We interviewed 1,692 elderly people living in Chilean rural areas of the regions of Arica and Parinacota, Tarapacá, Antofagasta, Atacama, Coquimbo, Valparaíso, Los Lagos, Aisén and Magallanes. The instruments applied were the DJGLS-6 loneliness scale, Family-APGAR, questionnaire of 13 most frequent health problems in Chilean older people, and Barthel index. RESULTS: We found a high prevalence of loneliness (over 55%) among Afro-descendants, Quechua, Atacameño, Colla, Chango, Huilliche, Kawesqar and non-indigenous people. Emotional loneliness is the most prevalent among indigenous and non-indigenous older people living in rural areas (≥ 71%). Variables associated with loneliness were being female, age, not having a partner, living alone, family dysfunctionality, and having health problems. CONCLUSIONS: Loneliness in rural areas is higher in older people, and this situation becomes more complex at the crossroads of ethnic-cultural diversity; it is necessary to continue to address this problem that affects biopsychosocial well-being in old age.

Factores asociados a la percepción de soledad entre personas mayores que viven en la comunidad / Factors associated with the perception of loneliness among older people living in the community

ANTECEDENTES: Las personas mayores chilenas que viven en la comunidad son una población vulnerable y con alto riesgo de auto percibirse como solitarios. OBJETIVO: Examinar los factores asociados a la percepción de soledad de un grupo de personas mayores chilenas que viven en la comunidad. MATERIAL Y MÉTODO: Diseño transversal con 540 participantes de 65 años y más (72,20 ± 6,22). Se evaluaron medidas sociodemográficas, estado de salud y valoración geriátrica integral. Se realizaron correlaciones y modelos de regresión lineal múltiple. RESULTADOS: Factores como baja percepción de apoyo social en situaciones cotidianas o casos de emergencia, experimentar alta sintomatología depresiva y percibir una mala calidad de vida se asociaron significativamente con una mayor autopercepción de soledad. DISCUSIÓN: Las estrategias preventivas y las intervenciones psicosociales adecuadas a la edad para mitigar o revertir el impacto de estos factores pueden ser fundamentales para reducir la autopercepción de soledad y, en consecuencia, mejorar el bienestar de las personas mayores.

BAKCGROUND: Chilean community-dwelling older people are a vulnerable population with a high risk of being self-perceived as lonely. AIM: To examine the factors associated with the self-perception of loneliness in a group of Chilean community-dwelling older people. MATERIAL AND METHODS: Cross-sectional study design with 540 participants aged 65 years and above (72.20 ± 6.22). Measures for sociodemographic, health status, and integral geriatric assessment were assessed. Correlations and multiple linear regression models were conducted. RESULTS: Factors such as low perception of social support in everyday situations or cases of emergency, experiencing high depressive symptoms, and perceiving a poor quality of life were significantly associated with a higher self-perception of loneliness. DISCUSSION: Preventive strategies and age-appropriate psychosocial interventions to mitigate or reverse the impact of these factors may be essential to reduce the self-perception of loneliness and consequently improve older people's well-being.

Social-emotional issues among children with strabismus higher than among non-strabismus children in Western India

Purpose: Data on social?emotional aspects among children with strabismus in India are scanty. We compared the emotional symptoms (ES), loneliness and social dissatisfaction (LSD), and self?esteem (SE) and their associated risk factors among children with and without strabismus in India. Methods: A cross?sectional case–control study design was used to recruit 101 children with strabismus aged 8 to 18 years and a control group of 101 children that were age? and gender?matched. Interviews were performed using standardized scales to assess ES, LSD, and SE. Variations in the intensity of ES, LSD, and SE were assessed using multiple classification analysis (MCA). Results: A total of 202 children participated in the study. The mean ES, LSD, and SE scores were 3.4 (standard deviation [SD] 1.9), 48.4 (SD 3.2), and 22.1 (SD 3.8) for the strabismus group and 1.8 (SD 1.5), 33.3 (SD 3), and 31.3 (SD 2) for the non?strabismus group, respectively. Among the strabismus group, the highest levels of mean ES, LSD, and SE scores were observed among children facing problems in performing daily tasks. Amongst the non?strabismus group, children studying at the primary level and those facing neglect had the highest mean scores. In MCA, being affected with strabismus had the highest effect on the intensity of ES, LSD, and SE with a beta (?) value of 0.223 (P = 0.016), 0.922 (P < 0.001), and 0.853 (P < 0.001). Conclusion: A significantly high proportion of children with strabismus deal with elevated levels of ES, LSD problems, and low SE as compared with non?strabismus children, highlighting the need to address the poor social?emotional health of children

El sentimiento de soledad en la población adulta mayor participante en centros de día en Bogotá, Colombia

Objetivo: Identificar los factores asociados a las categorías de soledad en población adulta mayor en centros de día en Bogotá, Colombia. Materiales y métodos: Se realizó un estudio cuantitativo, transversal y analítico para medir la soledad en personas mayores que participan en un centro de día de la ciudad de Bogotá, mediante la escala ESTE en personas mayores, entre noviembre de 2020 y junio de 2021. Para cumplir con el objetivo, se realizó un análisis estadístico descriptivo univariado, de tal forma que, para las variables cuantitativas, se empleó media con desviación estándar o mediana con rangos intercuartílicos, de acuerdo con los criterios de normalidad utilizando la prueba Shapiro Wilk, y para las variables categóricas, frecuencias absolutas y proporciones. El análisis bivariado se realizó con las pruebas t de Student y chi cuadrado (p < 0,05), lo cual contribuyó a la construcción de un modelo de regresión logística, con las variables con significancia estadística. Resultados: Se incluyeron 215 personas adultas mayores con promedio de edad de 70,5 años; 72 % correspondían al sexo femenino, 56,5 % tenían educación primaria, 38,6 % eran solteros y 67,4 % presentaban antecedente de enfermedad crónica no transmisible. Según la escala ESTE, en soledad familiar registraron nivel bajo (67 %); en soledad conyugal, entre nivel alto y medio (79 %); en soledad social, nivel alto y medio (51 %); en crisis de adaptación, nivel alto y medio (43 %). Se encontraron asociaciones en soledad conyugal con sexo femenino (p = 0,001), en soledad social con clase baja (p = 0,027) y en crisis de adaptación con clase baja (p = 0,024). Conclusiones: Los factores que se asocian al sentimiento de soledad en población adulta mayor participante en centros de día son, en la categoría de soledad conyugal, ser mujer, y, en soledad social y crisis de adaptación, pertenecer a clase baja.

Objective: To identify the factors associated with the categories of loneliness among the elderly population attending day care centers in Bogotá, Colombia. Materials and methods: An analytical, cross-sectional and quantitative study was carried out to measure the loneliness among older people attending a day care center in the city of Bogotá between November 2020 and June 2021 using the ESTE scale. To meet the objective, a univariate descriptive statistical analysis was performed, such that, for the quantitative variables, the mean with standard deviation or median with interquartile ranges were used, in accordance with the Shapiro-Wilk test for normality, and for the categorical variables, absolute frequencies and proportions were used. The bivariate analysis was conducted using Student's t-test and chi-square test (p < 0.05), which contributed to build a logistic regression model with statistically significant variables. Results: A total of 215 elderly people with a mean age of 70.5 years were included in the study: 72 % were females, 56.5 % had primary education, 38.6 % were single and 67.4 % had a history of chronic non-communicable disease. According to the ESTE scale, the study subjects showed a low level of family loneliness (67 %), a high and medium level of marital loneliness (79 %), a high and medium level of social loneliness (51 %) and a high and medium level of adaptation crisis (43 %). It was found that marital loneliness was associated with females (p = 0.001), social loneliness with lower class (p = 0.027) and adaptation crisis with lower class (p = 0.024). Conclusions: The factors associated with the feeling of loneliness among the elderly population attending day care centers are, in the marital loneliness category, being a woman and, in the social loneliness and adaptation crisis categories, belonging to the lower class.

Association of loneliness, social isolation, and daily cognitive function in Mexican older adults living in community during the first wave of COVID-19 pandemic / Asociación del aislamiento social, soledad y la función cognitiva cotidiana en adultos mayores mexicanos de la comunidad durante la primera ola del COVID-19

Abstract Introduction Loneliness and social isolation are known risk factors for cognitive decline; their effect in older adults (OA) after COVID-19 lockdown is emerging. Objective To establish an association between loneliness and social isolation, with daily cognitive function in Mexican OA during the first wave of the COVID-19 pandemic. Method Cross-sectional study, derived from the cohort "The impact of COVID 19 on well-being, cognition, and discrimination among older adults in the United States and Latin America", which included 308 OA recruited between March-August 2020 whose daily cognitive function were determined with the Everyday Cognition Scale (E-Cog) as dichotomized score (cut point: 1.31 for normal cognition). Loneliness and social isolation were binomial variables. Results The mean age was 65.4 ± 7.9 years, 75.7% were women. The mean continuous E-Cog score was 57.4 (SD = ± 19.1), 49.1% had a score < 1.31 (normal cognition), while 50.9% had a higher score (cognitive impairment). Eighty four percent of participants reported loneliness, 79.9% reported social isolation. Multivariate regression model showed a negative and statistically significant association between social isolation and loneliness and E-Cog, adjusted by age, sex and education level (β = -.046, 95% CI = [-.8, -.013], p = .007; β = -.16, 95% CI = [-.08, -.018], p = .003), and a positive association with subjective memory complaint (β = .81, 95% CI = [-.16, -.11], p = < .001). Discussion and conclusion These data suggest the need for increased vigilance of those who have loneliness and social isolation due to its potential deleterious effect on cognitive function.

Resumen Introducción La soledad y el aislamiento social son factores de riesgo conocidos para el deterioro cognitivo; su efecto en las personas mayores (PM) después del confinamiento por COVID-19 está emergiendo. Objetivo Establecer una asociación entre la soledad y el aislamiento social, con la función cognitiva diaria en PM mexicanas durante la primera ola de la pandemia por COVID-19. Método Estudio transversal derivado de la cohorte "The impact of COVID 19 on well-being, cognition, and discrimination among older adults in the United States and Latin America", incluyó 308 AM reclutados de marzo-agosto 2020, la función cognitiva diaria fue evaluada con Everyday Cognition Scale (E-Cog) con un punto de corte 1.31 (cognición normal); la soledad y el aislamiento social fueron variables binomiales. Resultados La media de edad fue 65.4 ± 7.9 años, 75.7% mujeres. E-Cog promedio fue 57.4 (DE = ± 19.1), 49.1 % tenía una puntuación < 1.31 (cognición normal), 50.9% > 1.31 (deterioro cognitivo). Ochenta y cuatro por ciento de los participantes reportaron soledad, 79.9% aislamiento social. El modelo de regresión multivariado mostró una asociación negativa y estadísticamente significativa entre aislamiento social y soledad con E-Cog (β = -.046, IC 95% = [-.8, -.013], p = .007; β = -.16, IC 95% = [-.08, -.018], p = .003), y una asociación positiva con queja de memoria subjetiva (β = .81, IC 95% = [-.16, -.11], p = < .001) ajustado a edad, sexo y escolaridad. Discusión y conclusión Estos datos sugieren la necesidad de una mayor vigilancia de quienes presentan soledad y aislamiento social debido a su potencial efecto deletéreo sobre la función cognitiva.

Translation, adaptation, and reliability of a Social Frailty Scale for the Brazilian context: a methodological study

ABSTRACT BACKGROUND: Frailty comprises three dimensions: physical, psychological, and social. It is established that social frailty is correlated with several variables, such as quality of life, depression, and loneliness. These findings reinforce the need to investigate and define predictors of social frailty. OBJECTIVE: To translate, culturally adapt, and assess the reliability of the HALFT scale for Brazil. DESIGN AND SETTING: Methodological study conducted at Universidade Federal de São Carlos. METHODS: This study aimed to translate and culturally adapt the HALFT scale from English to Brazilian Portuguese, for which the steps of translation, synthesis of translations, back translation, evaluation by an expert committee, pre-test, and test-retest were followed. RESULTS: Two independent translators translated the HALFT. The consensual version was established by merging the translations, which were back translated into English by a third translator. The expert committee comprised seven health professionals working in frailty and/or social fields of study. Only one item on the scale had a content validity index of less than one (0.85). The instrument was pre-tested with 35 older adults who considered it clear and understandable, with no suggestion of changes. The reliability analysis (reproducibility) of the adapted version of the HALFT with test-retest of the scale with 23 participants showed a Kappa index of 0.62, showing good agreement. CONCLUSION: The HALFT scale is translated and adapted for Brazil, and shows good reliability. However, it is necessary to conduct psychometric analysis of the instrument to provide normative data for this population.

Loneliness and associated factors among adolescents with mixed anxiety and depressive disorder / 中国学校卫生

Objective@#To investigate loneliness and associated factors among adolescents with mixed anxiety and depressive disorder(MADD), and to provide reference for drawing up effective and targeted interventions.@*Methods@#Using convenience sampling method, 265 adolescents with MADD in Daqing Third Hospital were selected from September 2020 to June 2021. General information questionnaire, Pittsburgh sleep quality index(PSQI), Resilience Scale for Chinese Adolescents(RSCA), Child and Adolescent Peer Relationship Scale and UCLA Loneliness Scale were used to investigate the status and influencing factors of loneliness among adolescents with MADD.@*Results@#The average score of UCLA among 265 adolescents with MADD was (56.49±10.83). The results of univariate analysis showed that age, gender, burden of medical expenses, drinking behavior and parents migrant work had statistically significant differences in the UCLA scores. The results of Pearson correlation analysis showed that loneliness in MADD adolescents was negatively correlated with psychological resilience( F/t=57.65, -60.62, 21.92, 8.52, 16.22, P <0.01), and positively correlated with sleep quality and interpersonal distress( F/t=-0.69, 0.76, 0.50, P <0.01). The results of multiple stepwise regression analysis showed that phase of study, sex, burden of medical expenses, interpersonal distress, sleep quality and resilience were the influencing factors of loneliness among adolescents with MADD( B=0.11, 0.13, 0.09, 0.46, 0.10,-0.24, P <0.01).@*Conclusion@#Adolescents with MADD have moderate loneliness, which needs to be improved. Nursing staff should pay attention to the negative emotional experience such as loneliness among adolescents with MADD, and reduce their loneliness by improving sleep quality and resilience, reducing interpersonal distress.