Unwanted loneliness is the gap between the social relations a person has and those they want. The main objective of this research is to assess the impact of a multidimensional community-based intervention on the feeling of unwanted loneliness in the population over the age of 65 years old, who living alone, under social risk or socially isolated living in the La Palma island.
Loneliness is strongly associated with a significant impact on physical health, depression and may in fact be an independent risk factor for depression. Fur-thermore, it is negatively associated with healt problems, like higher blood pressure, poorer sleep, immune responses to stress, and poorer cognition over time in the elderly. The absence of personal connections is related to the adoption of worse life habits and to increased morbidity, with the consequent higher risk of suf-fering cardiovascular and endocrine diseases, mental health pathologies and risk of falls. The secondary objectives proposed are as follows: Increasing the number of opportunities for social interaction during the intervention; Contributing tools to improve the participants' social skills in the intervention; Fostering self-care and healthy habits in the participants; Reducing maladaptive thoughts; Educating on sleep hygiene measures and non-pharmacological treatments. The null hypothesis (H0) of this research is that in the population under study, the proposed multidimensional community intervention will not significantly impact the feeling of unwanted loneliness and the health management of these subjects.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
300
The intervention proposed (Compartiendo Salud) is a multicomponent intervention based on prevention and on promoting the health of older adults that live alone. The community-based intervention consists in five workshops that are carried out during a week (one day for each workshop). The sessions (which last 2.5 hours each) are designed in an expository and participatory way, using gaming dynamics that foster learning and social interaction. The content of the workshops is the same for all BHDs. Each workshop addresses risk factors that predispose the population to experiencing more unwanted loneliness and social isolation. The concepts corresponding to each of the five sessions that comprise the intervention are: Sleep hygiene, Healthy and sustainable eating habits, Physical activity and exercise, Memory and music therapy, Digital literacy
La Palma Health Area. Canary Islands Health Service.
Santa Cruz de La Palma, Spain
RECRUITINGNumber of Participants with Feeling of unwanted loneliness
It was measured using the "UCLA (University of California at Los Angeles) Loneliness scale" test validated in Spain. This instrument is based on three dimensions: Relational connection; Social connection; and Self-perceived isolation. It uses a 4-point scale ranging from "Never" to "Frequently" for responses 10 items. Scores above 30 correspond to "No loneliness", between 20 and 30 mean "Moderate loneliness" and less than 20 points is "Severe loneliness"
Time frame: Pre- and post- intervention (at three months)
Number of Participants with Social risk
It was measured using the Gijón Social risk detection questionnaire. It assesses family and economic situations, housing, social relations and support from social networks. It uses a 5-point scale ranging from best to worse situation, for responses 5 items. Scores: Good/Acceptable social situation: from 5 to 9 points; Social risk: from 10 to 14; and social problem: more than 15
Time frame: Pre- and post- intervention (at three months)
Number of Participants with Low Perceived social support
It was measured with Duke's questionnaire. It assesses perceived social support and consists of 11 items, each one assessed with a Likert scale from 1 to 5. Scores equal to or higher than 32 indicate "Normal support", whereas less than 32 points means "Low perceived social support"
Time frame: Pre- and post- intervention (at three months)
Number of Participants with Anxiety or depression
They were assessed using Goldberg's questionnaire with two subscales: Anxiety and Depression. Each of them is structured with 4 initial screening items to determine the probability of a mental disorder and a second group with 5 items that are only formulated if positive answers are given to the screening questions (at least 2 in the Anxiety subscale and at least 1 in the Depression subscale). The type of response of the questionnaire is dichotomous (Yes/No). The cut-off points are as follows: scores equal to or higher than 4 for the Anxiety subscale; and values equal to or higher than 2 for Depression. In the geriatric population, it has been proposed to use it as a single scale, with a cut-off point equal to or higher than 6
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Time frame: Pre- and post- intervention (at three months)
Number of Participants with Risk of loneliness
Nursing diagnosis "Risk of loneliness" (Yes/No) and presence/absence of each of its defining characteristics: Affective deprivation; Emotional Deprivation; Physical isolation; Social isolation.
Time frame: Pre- and post- intervention (at three months)
Number of Participants with Social Isolation
Nursing diagnosis "Social Isolation" (Yes/No) and presence/absence of each of its defining characteristics: Low social activity levels; Change in physical aspect; Explicit dissatisfaction with social connections; Social reclusion; Social behaviour inconsistent with cultural norms; Reporting feeling insecure in public; Reduced eye contact.
Time frame: Pre- and post- intervention (at three months)
Number of Participants with Smoking
The smoking assessment included in the habits module of the electronic clinical history of Primary Health Care of the Canary Islands Health Service Drago-AP will be used: Non-smoker/Smoker in undetermined phase/Smoker in pre-contemplation phase (consonant)/Smoker in contemplation phase (dissonant)/Smoker in preparation phase/Smoker in action phase/Smoker in maintenance phase/Former smoker since 1-10 years/Former smoker since more than 10 years/Passive smoker
Time frame: Pre- and post- intervention (at three months)
Number of Participants with alcoholism
The alcoholism assessment included in the habits module of the electronic clinical history of Primary Health Care of the Canary Islands Health Service Drago-AP will be used: Non-drinker/Moderate drinker/Risk drinker/Drinking problem
Time frame: Pre- and post- intervention (at three months)
Number of Participants without sleep problems
Sleep problem (Yes/No)
Time frame: Pre- and post- intervention (at three months)
Number of Participants with caregiver
Dichotomous variables (Yes/No)
Time frame: Pre- and post- intervention (at three months)
Number of Participants belonging to an organized group
Dichotomous variables (Yes/No)
Time frame: Pre- and post- intervention (at three months)
Number of Participants what does it feel like Integrated in the area where they live
Dichotomous variables (Yes/No)
Time frame: Pre- and post- intervention (at three months)
Number of Participants with Activities in free and/or leisure time
Dichotomous variables (Yes/No)
Time frame: Pre- and post- intervention (at three months)
Number of Participants with Home-based care; Social assistance
Dichotomous variables (Yes/No)
Time frame: Pre- and post- intervention (at three months)