Yu Chen. Supervisors: Prof. Alison While; Dr. Allan Hicks Florence Nightingale School of Nursing & Midwifery
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1 Yu Chen Supervisors: Prof. Alison While; Dr. Allan Hicks Florence Nightingale School of Nursing & Midwifery
2 China is undergoing dramatic population ageing. The number of older people living alone is increasing. Background Living alone may increase the risk of loneliness of older people. Social support may reduce loneliness. Little is known about loneliness and social support of older people living alone in China. 2
3 A B Source: Peng XZ. (2011) China s demographic history and future challenges. Science 333. doi: /science
4 - To describe the loneliness level, social support level and sources of social support of older people living alone in China. - To explore the relationships between socio-demographic characteristics and loneliness and social support. - To explore the relationship between loneliness and social support. 4
5 Sample A stratified random cluster sample of community-dwelling older people living alone in Shanghai. Excluded Under 60 years old With hearing, language and communication difficulties With moderate or severe cognitive impairment Measurements UCLA Loneliness Scale version 3 (RULS-V3) Social Support Rate Scale (SSRS) Socio-demographic information 5
6 Data collection Information sheets were given to 640 potential participants during door-to-door visits One week later Face-to-face interview (n=618) Good cognitive function Short Portable Mental Status Questionnaire Moderate or severe cognitive impairment Questionnaire (n=521) Excluded (n=97) 6
7 Results Loneliness of the participants The score for the RULS-V3 ranged from (median=45). Table 1 The loneliness level of the participants (n=521) Loneliness level Frequency (n) Percentage (%) Low Moderate Moderately high High 0 0 Perry s (1990) loneliness classification scheme: 20-34: low level 35-49: moderate level 50-64: moderately high level 64-80: high level Loneliness level of Chinese older people (Liu & Guo, 2007; Wu et al., 2010) Low: 19%-50.8% Moderate: 40.7%-56.3% Moderately high : 8.5%-24.7%
8 Results Table 2 The loneliness level of the participants by different socio-demographic characteristics Variable Low Moderate Moderately high n n % n % n % χ 2 Age (year) * Gender Male Female Education No formal education Primary school Junior high school and above Previous occupation Peasant ** Not peasant Economic level Low ** Medium-low Medium-high High Residential area Rural ** Urban * p<0.05, **p<
9 Social support of the participants Table 3 The scores for the SSRS (n=521) Range Mean SD Overall social support Objective support Subjective support Support utilization Chinese population norm:
10 Graph 1 Sources of objective support--instrumental support 10
11 Graph 2 Sources of objective support--emotional support 11
12 Results 89.8% of the participants perceived that they had at least one friend who could help or support them. Other sources of subjective support 100.0% 80.0% 60.0% 40.0% None/Little Some/A lot 20.0% 0.0% Graph 3 Subjective support from different sources 12
13 Confinding when in trouble Asking for help when in trouble Attending social activities 10 0 Never Rarely Sometimes Always Graph 4 Percentage of each item in support utilization 13
14 Results Table 4 The overall social support of the participants by different socio-demographic characteristics Variable Low Moderate High n χ 2 n % n % n % Age (year) * Gender Male Female Education No formal education ** Primary school Junior high school and above Previous occupation Peasant ** Not peasant Economic level Low ** Medium-low Medium-high High Residential area Rural ** * p<0.01, ** p<0.001 Urban
15 The relationship between loneliness and social support Loneliness was negatively correlated with overall social support (r =-0.29*), s objective support (r =-0.24*), s subjective support (r =-0.20*) s and support utilization (r =-0.26*). s * p<
16 Older people living alone in China were more likely to feel lonely and have a lower level of social support. Improving social support might be an effective strategy to reduce the experience of loneliness. Loneliness and social support differed across older people with different socio-demographic characteristics. 16
17 More frequent contacts from children One-to-one befriending programmes Group activity programmes 17
18 Friends, neighbours, volunteers, social workers... Provide companionship; help with daily activities; provide necessary skills. Nurses Provide home care services: risk assessment, physical examinations, health education thanetcommunitysupport.org/ourservices.html 18
19 Peer-led counselling or discussion groups Recreational activities Volunteering activities Lunch club Nurse-led community-building initiatives Health education lectures/courses Health promotion activities
20 Chen Y, Hick A & While AE. Loneliness and social support of older people in China: a systematic literature review. Health & Social Care in the Community (in press). Liu LJ & Guo Q. (2007) Loneliness and health-related quality of life for the empty nest elderly in the rural area of a mountainous county in China. Quality of Life Research 16, Perry GR. (1990) Loneliness and coping among tertiary-level adult cancer patients in the home. Cancer Nursing 13, Preiffer E. (1975) A Short Portable Mental Status Questionnaire for the assessment of organic brain deficit in elderly patients. Journal of American Geriatric Society 23, Russell DW. (1996) UCLA Loneliness Scale (Version 3): reliability, validity, and factor structure. Journal of Personality Assessment 66, Wu ZQ, Sun L, Sun YH, Zhang XJ, Tao FB & Cui GH. (2010). Correlation between loneliness and social relationship among empty nest elderly in Anhui rural area, China. Aging & Mental Health 14, Xiao SY. (1994) The theoretical basis and applications of Social Support Rate Scale. Journal of Clinical Psychiatry 4, Xiao SY. (1999) The social support rate scale. In Wang XD, Wang XL and Ma H. (eds), The Handbook of Mental Health Rating Scales. Chinese Mental Health Journal Press, Beijing,
21 21
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