Assessment of multiple constructs of social integration for older adults living in nursing homes

Abstract

A variety of terms and measures have been used in the literature to denote being socially integrated, and many studies of older adults focus on only social networks or social support and often only include those living in the community. The purpose of this study was to assess multiple constructs of social integration (i.e., social networks, social capital, social support, and social engagement) for older adults in nursing homes. Data were collected from 140 older adults at 30 nursing homes in Kansas. We interviewed older adults' in-person using a survey questionnaire, and used multilevel confirmatory factor analysis to analyze the data. The final model that included the four constructs had acceptable fit (χ = 174.71; df = 112; p < .01; CFI = .93; RMSEA = .06; SRMR-W = .06; SRMR-B = .12). The results showed that the proposed model was supported at the individual level. At the between-level, social networks and social support were supported. Study results have methodological and practice/policy implications for the study of older adults in long term care settings. In particular, this study contributes to understanding how to operationally define and differentiate social integration variables in studies of older adults, particularly when study data are hierarchical.

Social Connection is Essential in Long-Term Care Homes: Considerations During COVID-19 and Beyond

“…Social connection includes a number of separate but interrelated concepts. We considered the following aspects of social connection that matter to residents, family, and care staff in LTC homes: ( 1 , 2 )…”

Social integration and loneliness among long-term care home residents: protocol for a scoping review

“…Social capital , that is, features of an organisation that facilitate coordination and communication for mutual benefit, such as interpersonal trust, reciprocity and mutual aid 12 30…”

“…Published journal articles reporting results of observational and intervention studies will be eligible for inclusion if they report a measure of social integration or loneliness (descriptive, exposure or outcome) in a population of adult residents of LTC homes,19 38 nursing homes12 39 or care homes15 40 (ie, adults living in residential facilities, whose staff provide help with most or all daily activities and 24-hour care and supervision). These terms reflect differences in terminology between countries, but were chosen for their overlap with the international consensus definition of nursing home 41.…”

“…However, research on the influence of social factors on health has noted limitations including inconsistent terminology, inattention to the multiple aspects of social factors and an incomplete understanding of the biological mechanisms underlying these relationships 7 9–12. A conceptual framework for social integration, proposed by Berkman et al , describes a process whereby macrosocial contexts (ie, cultural, socioeconomic status, politics and social change) influence the development and structure of social networks which in turn provide opportunities for specific psychosocial mechanisms (including social support and social engagement); ultimately, these ‘downstream’ psychosocial mechanisms may influence health status by buffering physiological stress responses, imparting positive psychological states and traits and reducing negative health behaviours 9.…”

“…While loneliness has generally been considered distinct from social support and social engagement,4 5 others have found that perceived isolation (eg, loneliness) may mediate the relationship between these factors and mental health 11. For consistency, we will hereafter use the term social integration9 12 to encompass concepts such as social networks, social support and social engagement, and loneliness to denote it as a distinct phenomenon.…”