Study On The Status Of Social Isolation And Influencing Factors In Elderly Patients With Diabetes

Objective:(1)The causes of social isolation of elderly diabetic patients were analyzed by semi-structured interview,and to analyze the influencing factors.(2)Through the cross-sectional survey,the current situation of social isolation in elderly patients with diabetes and the related demographic characteristics,disease characteristics and social psychological characteristics were understood,in order to provide reference for the development of targeted social isolation intervention measures and in-depth research for elderly patients with diabetes,so as to effectively improve the problem of social isolation in elderly patients with diabetes.Methods: This study is a mixed-type study and consists of two parts.(1)The first part is a descriptive study.Objective sampling method is adopted to select elderly diabetic patients who received social isolation(Lubben social network scale score < 12)in the endocrinology department of a Grade-III hospital in Anhui Province from November 2021 to February 2022 as research objects.based on the principle of sample size saturation and the researcher himself as the research tool,one-to-half structured interview was used for data collection.Based on the phenomenological research method,semi-structured interview was used to analyze the causes of social isolation in elderly diabetic patients.After the data were imported into Nvivo12.0,the interview data were repeatedly read and extracted,and Colaizzi seven-step data analysis was used to analyze the interview data.(2)The second part is a cross-sectional observational study.Elderly patients with diabetes admitted to a Grade-A hospital in Anhui Province from March to October 2022 are selected as subjects by convenience sampling method.The general data Questionnaire,the Ability to perform Activities of daily Living Scale,the Diabetes selfmanagement Behavior Scale,the Social Support Rating Scale,the Lubben Social Network Scale,and the Internal Strength Scale were used for the questionnaire survey.SPSS 26.0 software was used for data analysis.The univariate analysis method involved independent sample t test and Chi-square test,and the multivariate analysis method was binary logistic regression.Results:(1)A total of 11 elderly diabetic patients with social isolation were interviewed in the qualitative study.The results showed that the main causes of social isolation in elderly patients with diabetes included physical function changes(reduced activity tolerance,sensory abnormalities);Lack of inner strength(feeling of loneliness,feeling of incompetence,feeling of guilt,potential negative evaluation);Weakened social support(reduced attention,lack of new communication methods,loss of connections due to changes in living environment);And ineffective social coping(quiet withdrawal,anxious withdrawal,active withdrawal).(2)The results of descriptive analysis showed that social isolation in elderly patients with diabetes was at high risk.Among 330 elderly diabetic patients,114 elderly diabetic patients developed social isolation,the incidence of social isolation was 34.5%(114/330).(3)Univariate analysis showed that there were significant differences in age,education level,pre-retirement occupation,per capita monthly family income,personality type,residence,community type,community infrastructure improvement,family history,diabetes complications,diabetic foot,external insulin use,glycosylated hemoglobin,and self-rated health between the social isolation group and the non-social isolation group(P<0.05).There were significant differences in activities of daily living,inner strength,diabetes self-management behavior and social support between the social isolation group and the non-social isolation group(P<0.001).(4)Logistic regression analysis showed that age,per capita monthly income,personality,glycosylated hemoglobin,self-rated health status,social support and inner strength were independent factors affecting social isolation in elderly patients with diabetes(P < 0.05).Conclusions:(1)This study found that changes in physical function,insufficient internal strength,weakened social support and ineffective social coping were risk factors for social isolation in elderly patients with diabetes.Social isolation is caused by physiological,psychological and social factors,and it is particularly important to reduce risk factors in various aspects for elderly diabetic patients to prevent social isolation.(2)In this study,the incidence of social isolation in middle-aged and elderly patients with diabetes was 34.54%.As a high-risk group of social isolation,elderly patients with diabetes should be highly concerned by medical staff or relevant departments,with regular assessment and targeted help.(3)In this study,the occurrence of social isolation in middle-aged and elderly patients with diabetes was influenced by demographic data,disease-related data,and psychosocial characteristics,among which demographic data included per capita monthly family income and personality;disease-related data included glycosylated hemoglobin,external insulin use,self-rated health,etc.;and psychosocial characteristics included social support and inner strength.Medical staff should take these influencing factors into account,carry out relevant intervention measures in an all-round,multi-angle and targeted way,improve the social isolation of elderly patients with diabetes,and promote the communication and contact between individuals and society.