Social isolation is a major and prevalent health problem among community-dwelling older adults, leading to numerous detrimental health conditions. With a high prevalence, and an increasing number of older persons, social isolation will impact the health, well-being, and quality of life of numerous older adults now and in the foreseeable future. For this review, a series of literature searches of the CINAHL, PsycINFO, and Medline databases were conducted, using the key words "social isolation," "social networks," "older adults," "elderly," "belonging," "perceived isolation," "social engagement," "social contacts," and "social integration," for the period of 1995-2010. The results show that there is an overabundance of evidence demonstrating numerous negative health outcomes and potential risk factors related to social isolation. However, there is scarce evidence that public health professionals are assessing social isolation in older persons, despite their unique access to very socially isolated, homebound older adults. Additionally, few viable interventions were found; therefore, it is advisable to focus on the prevention of social isolation in older adults. Public health professionals can take steps toward increasing the early assessment of social isolation and referring at-risk individuals to available community resources in order to prevent social isolation or further isolation, which would serve to reduce the numerous negative health outcomes associated with this condition.
Numerous definitions are used to describe social isolation, but they lack uniformity, consistency and clarity; this impairs the further development and refinement of the concept. This concept analysis can offer additional understanding and a starting point for future research related to social isolation.
Purpose/Objectives To describe experiences of self-management and transitioning among women with ovarian cancer. Research Approach Interpretive description. Setting Participants’ homes. Participants Purposive sample of 10 women with ovarian cancer. Methodologic Approach Individual interviews about women’s self-management and transition experiences. Main Research Variables Self-management, transitions, and ovarian cancer. Findings Participants self-managed to increase their sense of control and to self-advocate. They managed their care one step at a time to prevent becoming overwhelmed. Common transitions were diagnosis, surgery and recovery, starting chemotherapy, managing symptoms, and recurrence. Transitions were challenging, even if previously experienced, and influenced the ability and willingness of women to self-manage. Barriers and facilitators to self-management were identified. Conclusions The approach to self-management of one step at a time is somewhat illusory, as women face multiple transitions simultaneously. The short trajectory of ovarian cancer leaves little time between transitions and an awareness of mortality. Women are forced to confront goals of care quickly, which may affect their ability to self-manage. Interpretation Women with ovarian cancer need clinical and social support to prioritize and manage transitions. Introducing palliative care shortly after diagnosis could facilitate women’s anticipation of and adjustment to transitions.
Background and Objectives Social isolation is known to be detrimental to the health of older adults, yet there is no brief instrument to measure it. The objective was to describe the psychometric testing of a brief instrument constructed from theoretical underpinnings to measure social isolation in older adults. Research Design and Methods A sample of 9,245 participants, all aged 60 years and older, was obtained from 44 states in the United States. Summary descriptive statistics were calculated, followed by exploratory factor analysis using Geomin rotation and subsequently confirmatory factor analysis (CFA). After finding the best model, differential item functioning (DIF) was conducted using a multiple indicator multiple cause structural equation model to determine if item responses differed by gender or race after controlling for level of social isolation. Internal consistency was calculated and validity was assessed by correlating factor scores with 2 external measures. Results Exploratory factor analysis resulted in all items having statistically significant loadings. CFA showed the 2-factor model demonstrated excellent fit (CFI = 0.997, RMSEA = .038). The 2 factors were labeled connectedness and belongingness. After adjusting for demographic variables, no evidence suggested DIF. Internal consistency was good (alpha = .77) and the scale moderately correlated with the Social Network Index (r = .47). Discussion and Implications The Social Isolation Scale has been shown to be an effective measure of social isolation in older adults. Using this concise instrument to quickly measure social isolation in a fast-paced health care environment would be beneficial to health care providers and patients.
Older adults reporting social isolation are at increased risk for numerous negative health outcomes, including depressive symptoms, decreased quality of life, and cardiovascular disease. The purpose of this study was to test the effects of a university student model of care intervention offered through the CARELINK program on social isolation in a sample of community-dwelling older adults (N = 56). Older adults in the comparison group, who had not yet received the CARELINK program, were nearly 12 times more likely to be socially isolated. Results indicate the empowerment intervention offered through the CARELINK program had positive effects on reducing social isolation in older adults. The CARELINK program has important implications for nursing as it provides an uncomplicated and inexpensive intervention to decrease social isolation for older adults in the community. Given the sample selection limitation in this study, a randomized controlled trial is warranted. Future research should examine specific aspects of the CARELINK program and the amount each aspect affects social isolation.
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