Who often feels lonely? A cross-sectional study about loneliness and its related factors among older home-dwelling people.

To investigate the prevalence of individuals who often feel lonely among a sample of Norwegian older home-dwelling people aged ≥65 years old, as well as to identify any possible factors explaining their loneliness. Loneliness is known to be common among older people. To identify those older adults who are lonely, and to acquire knowledge about the complexity of their loneliness, is important to provide them with adequate help and support. This study employed a cross-sectional design. A questionnaire was mailed to a randomised sample of 6,033 older home-dwelling persons aged ≥65 years. A total of 2,052 persons returned the questionnaire and were included in the study. The questionnaire consisted of questions asking whether the subjects often felt lonely or not, as well as health-related and background questions and instruments to measure the participants' sense of coherence, mental problems, nutritional screening and self-care ability. The data were analysed using univariate and multivariate statistical methods. A total of 11.6% of the participants reported often feeling lonely. Six factors emerged to be independently associated with often feeling lonely among the respondents: Living alone, not being satisfied with life, having mental problems, a weak sense of coherence, not having contact with neighbours and being at risk for undernutrition. The study shows that often feeling lonely among older home-dwelling persons is a health-related problem that includes social, psychological and physical aspects. Moreover, these persons have limited resources to overcome feelings of loneliness. Lasting loneliness among older home-dwelling persons requires an overall, person-centred and time-consuming approach by nurses. Nurses with advanced knowledge on geriatric nursing may be required to offer appropriate care and support. Healthcare leaders and politicians should offer possibilities for adequate assessment, support and help.

Tomstad S ，Dale B ，Sundsli K ，Saevareid HI ，Söderhamn U ... -  《-》

The impact of depression and sense of coherence on emotional and social loneliness among nursing home residents without cognitive impairment - a questionnaire survey.

To analyse the relationships between depressive symptoms, sense of coherence and emotional and social loneliness among nursing home residents without cognitive impairment. Depression symptoms and loneliness are major health problems for older people. Sense of coherence, which is based on a salutogenic theoretical framework, is a strong determinant of positive health and successful coping and is associated with well-being and depression among older people. Few studies have explored the relationships between depression symptoms, sense of coherence and emotional and social loneliness among nursing home residents. A cross-sectional, descriptive, correlational design. Sample - 227 residents 65-102 years old from 30 nursing home residing ≥ six months. All had a Clinical Dementia Rating ≤ 0·5 and could converse. Residents were interviewed using the Social Provisions Scale, Geriatric Depression Scale and Sense of Coherence Scale (SOC-13). Possible relationships between these were analysed, controlled for sex, age, marital status, education, length of stay and comorbidity. Before adjustment, Geriatric Depression Scale was associated with attachment and social integration. After adjustment, Geriatric Depression Scale was still associated with attachment and social integration. Further adjusting for Sense of Coherence Scale reduced the association between Geriatric Depression Scale and attachment and even more so for the association between Geriatric Depression Scale and social integration. Sense of coherence and Geriatric Depression Scale did not interact, and SOC-13 was associated with attachment and social integration. Depression symptoms contribute to emotional and social loneliness. Independent of sense of coherence, depression symptoms are associated with emotional loneliness, sense of coherence influence emotional and social loneliness. Clinical nurses should observe residents closely for signs of depression and loneliness and support their sense of coherence to reduce emotional and social loneliness.

Drageset J ，Espehaug B ，Kirkevold M 《-》

Life satisfaction among older people (65+) with reduced self-care capacity: the relationship to social, health and financial aspects.

Borg C ，Hallberg IR ，Blomqvist K 《JOURNAL OF CLINICAL NURSING》

Self-care ability among home-dwelling older people in rural areas in southern Norway.

The growing number of older people is assumed to represent many challenges in the future. Self-care ability is a crucial health resource in older people and may be a decisive factor for older people managing daily life in their own homes. Studies have shown that self-care ability is closely related to perceived health, sense of coherence and nutritional risk. The aim of this study was to describe self-care ability among home-dwelling older individuals living in rural areas in southern Norway and to relate the results to general living conditions, sense of coherence, screened nutritional state, perceived health, mental health and perceived life situation. A cross-sectional survey was carried out in rural areas in five counties in 2010. A mailed questionnaire, containing background variables, health-related questions and five instruments, was sent to a randomly selected sample of 3017 older people (65+ years), and 1050 respondents were included in the study. Data were analysed with statistical methods. A total of 780 persons were found to have higher self-care ability and 240 to have lower self-care ability using the Self-care Ability Scale for the Elderly. Self-care ability was found to be closely related to health-related issues, self-care agency, sense of coherence, nutritional state and mental health, former profession, and type of dwelling. Predictors for high self-care ability were to have higher self-care agency, not receiving family help, having low risk for undernutrition, not perceiving helplessness, being able to prepare food, being active and having lower age. When self-care ability is reduced in older people, caregivers have to be aware about how this can be expressed and also be aware of their responsibility for identifying and mapping needs for appropriate support and help, and preventing unnecessary and unwanted dependency.

Dale B ，Söderhamn U ，Söderhamn O 《-》

Facing the challenge of adapting to a life 'alone' in old age: the influence of losses.

The aim of this study is to explore older people's approaches to living a life characterized by losses and 'aloneness' and how this relates to loneliness. Loneliness is closely related to social status and health condition. Older people are vulnerable to experiences of loneliness due to losses, which follow the ageing process. A qualitative interpretative design was used. Older people, aged 65 and above, living at home, in retirement villages, or in long-term care settings in Australia, Norway, and UK participated. Seventy-eight persons were included. Data were collected through open-ended interviews during autumn of 2006 and spring of 2007. The interviews were audio taped, transcribed, and analysed applying a hermeneutic, interpretative process. Analyses revealed great differences in the way participants handled their life situation. Interviewees describing themselves as 'not lonely' viewed losses as normal, and they participated in meaningful activities, connected to other people and thrived in their own company. Those describing themselves as 'lonely' on the other hand, strove to create meaning in their lives, were overwhelmed by losses, had problems finding meaningful activities and difficulty keeping up social relations. Loneliness was associated with overwhelming losses, inactivity, meaninglessness, and social isolation. The contrasting findings between 'not lonely' and 'lonely' older people have implications for nursing in that nurses must seek to identify those who need help in managing their loneliness and give guidance and support. More research is needed to develop interventions that are effective in reducing loneliness.

Kirkevold M ，Moyle W ，Wilkinson C ，Meyer J ，Hauge S ... -  《-》