Guidance for Research on Social Isolation, Loneliness, and Participation Among Older People: Lessons From a Mixed Methods Study

This article provides methodological guidance to researchers wishing to develop collaborative research projects with local governments and other agencies, by describing the process adopted in a mixed methods study conducted in the City of Wanneroo (the City), a local government area in Perth, Western Australia. The study explored factors related to older people’s (60+ years) participation in community-based activities and links between their participation and levels of social isolation, loneliness, and social connectedness. The research incorporated four interrelated stages: (1) an audit of existing programs in the City and program participant characteristics; (2) focus groups with program participants and interviews with nonparticipants; (3) a cross-sectional survey to assess factors associated with participation and links to social isolation, loneliness, and social connectedness; (4) face-to-face interviews with survey respondents screened at risk for loneliness. Methodological recommendations are provided to guide future collaborative research with local authorities, program developers, and administrators, aimed at minimizing social isolation and loneliness among older people. These include the need for clear communication and documentation of mutually agreed research objectives and responsibilities from project initiation to completion, identifying and working with local agencies to maximize recruitment among “hard to reach” groups, understanding the dimensions of loneliness addressed in the selected instrument used to screen for loneliness, and integrating innovative data collection techniques when working with vulnerable groups such as socially isolated older people.

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Home Alone or Not? A Mixed Methods Study of Different Perceptions of Social Isolation between Care Managers and Older Housebound Adults

Journal of Nursing & Healthcare ◽

10.33140/jnh/01/01/00002 ◽

2016 ◽

Vol 1 (1) ◽

Keyword(s):

Mixed Methods ◽

Older People ◽

Social Isolation ◽

Well Being ◽

Mixed Methods Study ◽

Assessment Process ◽

Older Person ◽

Care Needs ◽

Care Manager ◽

Care Managers

Purpose: This paper aims to discuss whether the level of social isolation and loneliness as assessed by care managers corresponds to the level of social isolation and loneliness as perceived by the older persons whose care needs are being assessed. Design/methodology/approach: This mixed methods study followed up the assessment of 40 older people by 20 care managers with a focus on the accuracy of the care manager’s assessment on the level of social isolation experienced by the service user. In order for this to be achieved structured interviews were conducted with both the older person and the care manager assessing their needs, with a specific focus on the assessment of loneliness and social isolation. Following these initial interviews two focus groups were then undertaken with the care manager to discuss the findings and unpack the assessment process. Findings: The key issues were that the true level of social isolation and loneliness was under assessed by the care manager completing the assessment. That the care manager’s assessment was predominantly focused on the physical well-being of the older person and heavily influenced by the assessment paperwork. Originality/value: This provides lessons for professionals about the lack of effectiveness of their assessment of social isolation and loneliness in older people, and the potential impact this has on the older person’s quality of life.

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Uncertainty about cellulitis and unmet patient information needs: a mixed methods study

British Journal of General Practice ◽

10.3399/bjgp18x697349 ◽

2018 ◽

Vol 68 (suppl 1) ◽

pp. bjgp18X697349

Author(s):

Anna Lalonde ◽

Emma Teasdale ◽

Ingrid Muller ◽

Joanne Chalmers ◽

Peter Smart ◽

...

Keyword(s):

Mixed Methods ◽

Information Needs ◽

Qualitative Data ◽

Information Provision ◽

Mixed Methods Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Face To Face ◽

Patient Information Needs ◽

History Of

BackgroundCellulitis is a common painful infection of the skin and underlying tissues that recurs in approximately a third of cases. Patients’ ability to recover from cellulitis or prevent recurrence is likely to be influenced by their understanding of the condition.AimTo explore patients’ perceptions of cellulitis and their information needs.MethodMixed methods study comprising semi-structured, face-to-face interviews and cross-sectional survey, recruiting through primary care, secondary care and advertising. Adults aged 18 or over with a history of cellulitis (first or recurrent) were invited to complete a survey, take part in an interview or both. Qualitative data was analysed thematically.ResultsThirty interviews were conducted between August 2016 and July 2017. Qualitative data revealed low prior awareness of cellulitis, uncertainty around diagnosis, concern/surprise at the severity of cellulitis, and perceived insufficient information provision. People were surprised they had never heard of the condition and that they had not received advice or leaflets giving self-care information. Some sought information from the internet and found this bewildering. Two hundred and forty surveys were completed (response rate 17%). These showed that, while most people received information on the treatment of cellulitis (60.0%, n = 144), they reported receiving no information about causes (60.8%, n = 146) or prevention of recurrence (73.3%, n = 176).ConclusionThere is a need for provision of basic information for people with cellulitis, particularly being informed of the name of their condition, how to manage acute episodes, and how to reduce risk of recurrence.

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Older people’s news dependency and social connectedness

Media International Australia ◽

10.1177/1329878x211006497 ◽

2021 ◽

pp. 1329878X2110064

Author(s):

Caroline Fisher ◽

Sora Park ◽

Jee Young Lee ◽

Kate Holland ◽

Emma John

Keyword(s):

Older People ◽

Social Isolation ◽

News Media ◽

Digital Literacy ◽

Social Connectedness ◽

Aged Care ◽

Capital City ◽

Contributing Factors ◽

Older Citizens

Social isolation has become a growing issue, particularly among older citizens. The ‘digital divide’ has been identified as one of the contributing factors leaving many older citizens behind. While increasing digital literacy among seniors has been identified as one of the remedies, less attention has been paid to the role of news media on the wellbeing and connectedness of older people. Through the lens of the uses and gratifications theory, this article reports on the findings of a survey of 562 news consumers aged 50 years and above who live in Canberra, the capital city of Australia. The analysis highlights the important role of news in reducing feelings of social isolation, particularly for those who spend more time alone and older people with cognitive impairment. Older participants who had difficulty concentrating and learning new tasks were also more dependent on news. We suggest this is due to the habitual, predictable and concise nature of news. These findings contribute to our understanding of the role of news in the wellbeing of older people and point to the need for policymakers and those in the aged care sector to ensure access to news for older citizens to improve the quality of life.

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The ‘loneliness pandemic’: implications for gerontological nursing

British Journal of Nursing ◽

10.12968/bjon.2021.30.11.652 ◽

2021 ◽

Vol 30 (11) ◽

pp. 652-655

Author(s):

Carlos Laranjeira

Keyword(s):

Mental Health ◽

Older Adults ◽

Older People ◽

Chronic Diseases ◽

Old Age ◽

Social Isolation ◽

Social Relationships ◽

Vulnerable Groups ◽

Negative Consequences ◽

Gerontological Nursing

The COVID-19 pandemic compelled states to limit free movement, in order to protect at-risk and more vulnerable groups, particularly older adults. Due to old age or debilitating chronic diseases, this group is also more vulnerable to loneliness (perceived discrepancy between actual and desired social relationships) and social isolation (feeling that one does not belong to society). This forced isolation has negative consequences for the health of older people, particularly their mental health. This is an especially challenging time for gerontological nursing, but it is also an opportunity for professionals to combat age stereotypes reinforced with COVID-19, to urge the measurement of loneliness and social isolation, and to rethink how to further adjust interventions in times of crisis, such as considering technology-mediated interventions in these uncertain times.

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Ringing the changes: the role of telephone communication in a helpline and befriending service targeting loneliness in older people

Ageing and Society ◽

10.1017/s0144686x18000120 ◽

2018 ◽

Vol 39 (7) ◽

pp. 1528-1551 ◽

Cited By ~ 2

Author(s):

CLAIRE PRESTON ◽

STEPHEN MOORE

Keyword(s):

Mixed Methods ◽

Older People ◽

Thematic Analysis ◽

Emotional Support ◽

Mixed Methods Study ◽

Structured Interviews ◽

Voice Communication ◽

Telephone Communication ◽

The United Kingdom

ABSTRACTThe drive to deliver services addressing loneliness in older people by telephone and online makes it increasingly relevant to consider how the mode of communication affects the way people interact with services and the capacity of services to meet their needs. This paper is based on the qualitative strand of a larger mixed-methods study of a national phoneline tackling loneliness in older people in the United Kingdom. The research comprised thematic analysis of four focus groups with staff and 42 semi-structured interviews with callers. It explored the associations between telephone-delivery, how individuals used the services and how the services were able to respond. To understand these associations, it was useful to identify some constituent characteristics of telephone communication in this context: namely its availability, reach and non-visual nature. This enabled various insights and comparison with other communication media. For example, the availability of the services attracted people seeking frequent emotional support but this presented challenges to staff. More positively, the ability of the services to connect disparate individuals enabled them to form different kinds of satisfying relationships. The evolution of mixed communication forms, such as internet-based voice communication and smartphone-based visual communication, makes analysis at the level of a technology's characteristics useful. Such a cross-cutting perspective can inform both the design of interventions and assessment of their suitability for different manifestations of loneliness.

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THE COMPASS OF OLDER PEOPLE LEARNING: A MIXED METHODS STUDY OF HEALTH PROMOTION FOR OLDER PEOPLE

Innovation in Aging ◽

10.1093/geroni/igx004.2989 ◽

2017 ◽

Vol 1 (suppl_1) ◽

pp. 829-829

Author(s):

T. Keinwong ◽

S. Hunter ◽

J. Lynehame

Keyword(s):

Health Promotion ◽

Mixed Methods ◽

Older People ◽

Mixed Methods Study

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Methods of identifying and recruiting older people at risk of social isolation and loneliness: a mixed methods review

BMC Medical Research Methodology ◽

10.1186/s12874-019-0825-6 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 4

Author(s):

Janet Ige ◽

Lynn Gibbons ◽

Issy Bray ◽

Selena Gray

Keyword(s):

At Risk ◽

Mixed Methods ◽

Older People ◽

Social Isolation

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Comparing perspectives of family caregivers and healthcare professionals regarding caregiver burden in dementia care: results of a mixed methods study in a rural setting

Age and Ageing ◽

10.1093/ageing/afz165 ◽

2019 ◽

Vol 49 (2) ◽

pp. 199-207

Author(s):

Simon Krutter ◽

Dagmar Schaffler-Schaden ◽

Roland Essl-Maurer ◽

Laura Wurm ◽

Alexander Seymer ◽

...

Keyword(s):

Mixed Methods ◽

Family Caregivers ◽

Caregiver Burden ◽

Rural Areas ◽

Healthcare Professionals ◽

Mixed Methods Study ◽

Rural Setting ◽

Disruptive Behaviour ◽

Cross Sectional Survey ◽

Psychosocial Burden

Abstract Background Persons with dementia (PwD) need support to remain in their own homes as long as possible. Family caregivers, homecare nurses and general practitioners (GPs) play an important role in providing this support, particularly in rural settings. Assessing caregiver burden is important to prevent adverse health effects among this population. This study analysed perceived burden and needs of family caregivers of PwD in rural areas from the perspectives of healthcare professionals and family caregivers. Methods This was a sequential explanatory mixed methods study that used both questionnaires and semi-structured interviews. Questionnaires measuring caregiver burden, quality of life and nursing needs were distributed to the caregivers; health professionals received questionnaires with adjusted items for each group. Additionally, in-depth qualitative interviews were carried out with eight family caregivers. Results The cross-sectional survey population included GPs (n = 50), homecare nurses (n = 140) and family caregivers (n = 113). Healthcare professionals similarly assessed the psychosocial burden and stress caused by behavioural disturbances as most relevant. Psychological stress, social burden and disruptive behaviour (in that order) were regarded as the most important factors from the caregivers’ perspective. It was found that 31% of caregivers reported permanent or frequent caregiver overload. Eight themes related to caregiver burden emerged from the subsequent interviews with caregivers. Conclusions Professional support at home on an hourly basis was found to be highly relevant to prevent social isolation and compensate for lack of leisure among caregivers of PwD. Improvement of interprofessional dementia-related education is needed to ensure high-quality primary care.

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Parental concerns and uptake of childhood vaccines in rural Tanzania – a mixed methods study

BMC Public Health ◽

10.1186/s12889-020-09598-1 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Lavanya Vasudevan ◽

Joy Noel Baumgartner ◽

Sara Moses ◽

Esther Ngadaya ◽

Sayoki Godfrey Mfinanga ◽

...

Keyword(s):

Mixed Methods ◽

Vaccine Coverage ◽

Mitigation Strategies ◽

Mixed Methods Study ◽

Sub Saharan Africa ◽

Vaccine Hesitancy ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Parental Concerns ◽

Childhood Vaccines

Abstract Background Vaccine hesitancy has been recognized as an important barrier to timely vaccinations around the world, including in sub-Saharan Africa. In Tanzania, 1 in 4 children is not fully vaccinated. The objective of this mixed methods study was to describe and contextualize parental concerns towards vaccines in Tanzania. Methods Between 2016 and 2017, we conducted a cross-sectional survey (n = 134) and four focus group discussions (FGDs, n = 38) with mothers of children under 2 years of age residing in Mtwara region in Southern Tanzania. The survey and FGDs assessed vaccination knowledge and concerns and barriers to timely vaccinations. Vaccination information was obtained from government-issued vaccination cards. Results In the cross-sectional survey, 72% of mothers reported missed or delayed receipt of vaccines for their child. Although vaccine coverage was high, timeliness of vaccinations was lower and varied by vaccine. Rural mothers reported more vaccine-related concerns compared to urban mothers; literacy and access to information were identified as key drivers of the difference. Mothers participating in FGDs indicated high perceived risk of vaccine-preventable illnesses, but expressed concerns related to poor geographic accessibility, unreliability of services, and missed opportunities for vaccinations resulting from provider efforts to minimize vaccine wastage. Conclusions Findings from our cross-sectional survey indicate the presence of vaccination delays and maternal concerns related to childhood vaccines in Tanzania. In FGDs, mothers raised issues related to convenience more often than issues related to vaccine confidence or complacency. Further research is necessary to understand how these issues may contribute to the emergence and persistence of vaccine hesitancy and to identify effective mitigation strategies.

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