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Try out PMC Labs and tell us what you think. Learn More. This qualitative study aims to investigate the cultural understandings of loneliness, identify the contexts of loneliness, and to examine its effect on the health and well-being of U. Chinese older adults. Despite loneliness is one of the main indicators of well-being, little attention has been paid to understanding loneliness among immigrant older adults.
This study utilizes both survey questionnaires and semi-structured focus group methods to investigate the feelings of loneliness among U. Based on interviews with 78 community-dwelling Chinese older adults in Chicago Chinatown, this community-based participatory research study CBPR shows loneliness is common among U. It was frequently identified through emotional isolation and social isolation. Social, psychological and physical health factors could contribute to the experience of loneliness.
In addition, the health of older adults with loneliness may be associated with worsening overall health, elder mistreatment, health behavior changes and increased health care utilizations. This study has implications for healthcare professionals, social services agencies and policy makers. Our findings point to the needs for healthcare professionals to be more alert of the association of loneliness and adverse health outcomes. Communities and social services agencies should collectively take a lead in reducing social isolation, improving intergenerational relationships, and increasing social networks and companionship for this group of vulnerable older adults.
Loneliness is one of the main indicators of well-being.
It is manifested by intense feelings of emptiness, abandonment, and forlornness Meis M. Older adults are particularly vulnerable to loneliness due to the increase of multiple losses, changes, and transitions in later life Donaldson J. The feelings of loneliness have serious consequences on the health of older adults.
Studies show that loneliness predicts depressive symptoms Cacioppo J. B, More importantly, loneliness has been associated with increases in mortality and suicidal ideation Ryan M. Despite its impact on the health of aging population, loneliness has not been systematically studied among immigrant older adults. As one of the fastest growing minorities in the U. Social isolation, stressful life events, recency of immigration, poor perceived health, dissatisfaction with family, are among the unique psychosocial stressors concerning older Asian Americans Iwamasa G.
However, with more than twenty heterogeneous ethnic groups that make up the Asian population, studies have pointed the need to examine specific Asian subgroups to accurately reflect health disparities Kim G. Among Asian American population, Chinese is the oldest and largest subgroup with an estimate of 3.
Compared to the general population, Chinese population is older in average age Shinagawa L. The rapid demographic growth of Chinese older adults necessitates a deeper understanding of their health and psychosocial well-being. Some studies suggest older Chinese immigrants have poorer quality of life than the national norms Mui A. Others argue the prevalence of depressive symptoms among Chinese older adults is higher than that of general aging population in North America Lai D.
In addition, Chinese older adults were found to have the highest suicide rate than any other racial groups nationwide. Specifically, suicide rate among older Chinese women is a higher leading cause of death compared with the general population Centers for Disease Control and Prevention, b ; Centers for Disease Control and Prevention, a ; Foo L, However, research on loneliness among U.
Chinese older adults remains limited. Existing studies of loneliness in P. In addition, loneliness may be a ificant risk factor to be mistreated by family members Dong X. However, Asian adult lonely or 50 the course of immigration, traditional social relationships may be disrupted due to the vast cultural, social, and economic changes. Chinese older adults may find it increasingly difficult to maintain desired social relationships.
We speculate that these structural, social and emotional challenges in the context of immigration may provide fertile ground for the feelings of loneliness among U. A of research barriers among U. Chinese older adults may render this critical health data relatively unexplored Dai Y. Evidence indicates that Chinese community have posed mistrust toward government and federal-sponsored activities because of anti-Chinese sentiment in the past Lee I.
In addition to recruitment difficulties, vast subgroup diversity in Asian adult lonely or 50 and languages has further presented challenges Chang D. Chinese population in the U. As a result, their diverse experience of aging in different social, political and historical contexts calls for culturally and linguistically sensitive research de Guo Z. In order to bridge the knowledge gap, the purpose of this study is to: 1 Examine U.
The conceptual and theoretical perspectives on loneliness are considerably diverse. It can be defined as a subjectively experienced emotional state, which is commonly related to the unfulfilled needs in intimate and social relationships Peplau L. There exists the distinction between emotional and social loneliness which is particularly relevant for studies among older adults. Whereas emotional loneliness from the absence or lost of a close, intimate attachment, social loneliness is a response to the absence of an accessible social network which may be experienced following relocation Weiss R.
The strength of community-based participatory research CBPR approach has been noted as a paradigm shift in epidemiological research Leung M. CBPR approach enhances the quality and quantity of research by equitably engaging community and university partners in an action- driven investigation.
This study was conducted in Chicago Chinatown community, a geographically-defined community on the near south side of Chicago. The greater Chicago area has one of the largest Chinese communities in the country, with an estimate of over 67, Chinese persons Simon M.
Currently, the Chinatown community is one of the fastest-growing ethnic communities in Chicago Goldsworthy T. During the initial phase of the study, the study team and investigators invited community members through civic, health, social groups, advocacy, community centers, community physician and residents.
These stakeholders constituted the Community Advisory Board CABwhich served a pivotal role to foster community support and to guide the overall examination of health issues in the community. One of the pressing health issues identified by board members was the issues of loneliness.
Loneliness was first assessed using a validated three-question survey derived from the Revised University of California at Los Angeles Loneliness Scale. Questions were asked regarding feelings of lacking companionship, feeling left out of life, and feeling isolated from others. The alpha coefficient of reliability for this three-question survey has been shown to be 0. Participants were then invited to participate in semi-structured focus group discussions. The from focus group interviews often offer valuable insights on the health of understudied population Krueger R.
This technique is well-suited to explore relatively unexplored community health issues Morse J. In addition, the definition, experience as well as the strategies to cope of loneliness is highly related to perceptions informed by cultural backgrounds Rokach A.
People can be alone but not lonely, or they can have many social relationships but nonetheless feel lonely Hawkley L. Our focus group recruitment process benefited from the collaborative community-academic partnership. We approached participants after their attendance in CASL-sponsored cultural classes, such as calligraphy and Tai-Chi, according to the following eligibility criteria: 1 aged sixty years or older; 2 self-identified as Chinese; and 3 reside in Chicago.
Of the 80 participants approached, 78 Chinese older adults aged sixty and older gave consent to the study. Prior to Asian adult lonely or 50 questionnaires and focus group interviews, study participants gave written consents. All materials were prepared in simplified Chinese, traditional Chinese, and English. In order to ensure cultural sensitivity of the study, participants were then divided into focus groups according to their dialect of preference Mandarin or Cantonese Suh E.
This preference reflects the linguistic diversity among U. S Chinese community Norman J. For analysis purpose, we performed descriptive statistical analysis based on survey .
Regarding qualitative data, a bilingual research assistant first transcribed audio recordings into Chinese transcripts different dialects use the same Chinese charactersand then translated the transcripts into English. Another assistant subsequently back translated the English transcript into Chinese. Texts were further examined by bilingual principal investigator to ensure the accuracy of meaning.
The English transcripts, imported into NVivo software NVivo, version 8 for analysis, were scrutinized for discussion on the descriptions, perceived determinants and health consequences of loneliness. Two independent coders followed grounded theory to analyze data iteratively Glaser B. Each coder first independently labeled the texts with key words and phrases. The key words were coded and analyzed for emerging representing filial piety values and examples expressed by participants.
Two coders then compared and discussed their sets of collectively to evolve dominant themes.
The categorization of each response was not finalized until two coders reached consensus. Each category was reviewed and a short summary was written for each category. A total of 78 participants enrolled in the study. Participants with loneliness were more likely to be older. The majority of participants with loneliness understood or spoke little English. With regards to health status, 28 participants with loneliness Most of the participants with loneliness described quality of life as fair For detailed symptoms of loneliness among participants, please see Table 2. Participants most often described the embodiment of emotional loneliness in terms of the absence of intimate partnership, lack of satisfying children-parent relationship, and absence of close friendship.
At the same time, loneliness was also regarded as a negative experience. Note: Table presents a summary of findings from focus group discussions among participants. In addition, Asian adult lonely or 50 identified loneliness with respect to the absence of social integrations. Limited or lack of social contacts as well as the lack of participation in social activities were two main themes that emerged from the discussions. In most cases, participants described their daily lives in comparison with lives in their country of origin.
Then there is dancing and picnic with your friends. Here in Chicago you cannot go anywhere and have nothing to do. This study asked participants to provide contextual factors in which the feelings of loneliness may occur. We found that social, psychological and physical health correlates were three contributing factors to loneliness Table 4.
Among all vignettes given by participants, social correlates were most commonly mentioned. Participants described the poor quality of relationships as a major determinant of loneliness; in particular, their sometimes frustrating relationships with adult children and spouses. I think it is the odds and ends at home with their kids that make them unhappy. They have nowhere to go. It is reported that except co-residing family members, older adults did not have social contacts in Chicago.
Furthermore, the feelings of loneliness may be intensified by the broader social stress, such as language and cultural barriers. A of participants described elder mistreatment as a potential reason that triggers the feeling of loneliness. But her daughter-in-law did not accept her and kicked her out of the house. That is why she is sad and lonely.
Psychological correlates, including migration grief, depression, perceived stress and anxiety were also described as precursors of loneliness. During the course of immigration, a variety of losses, such as status or money, may have impacted individual immigrants differently. It is literally nothing. That is from the bottom of my heart.
If our mindset is stressed, then every negative feeling intensifies. Eventually your health suffers. Last, due to physical changes and declining health in aging, participants expressed the need for more support and care. Conversely, unmet needs may lead to the feelings of loneliness. Last, this study investigates the potential impact of loneliness on the health and well-being of older adults. For many participants, the feelings of loneliness were related to depressive symptomatology.
Other participants described the impact of loneliness in light of cognitive impairment. Our findings suggest that participants in our study were likely to perceive loneliness symptoms associated with elder mistreatment. The father lives in a nursing home and does not speak English.
He is always by himself. This daughter ignores his needs … and this girl even told me that she got all of his food stamps. Poor soul. Furthermore, participants articulated instances in terms of health behavior changes and changes in health care utilization.Asian adult lonely or 50
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