The Effect Of The Loneliness On Frailty In Empty Nesters In Rural China

Objective The purpose of this study is to understand the status quo and influencing factors of frailty and loneliness among the empty nest older adults in rural China;to explore the correlation between frailty,loneliness,and quality of life;and to explore the cut-point of loneliness score and the quality of life score to reflect frailty in empty nest older adults in the rural area in China.Suggestions and countermeasures for improving the health status of empty nesters in rural areas so as to improve the quality of life and delay the occurrence and development of frailty.Methods A cluster random sample survey was conducted to survey the elderly aged 60 and over in 8 rural villages around Changchun from June to August 2017.Survey tools are adopted: general information questionnaire,the University of California at Los Angeles(UCLA)loneliness scale,the 36-Item Short-Form Health Survey(SF-36),and Mini-Mental State Examination(MMSE).Data was entered using Epidata3.1,and the results were statistically analyzed using SPSS23.0.Use the frequency,percentage,median,and quartile to describe the general information of the study subjects,the frailty status and loneliness in rural empty nest elderly people.Using Chi-squared test and Fisher-test to analyze the general demographic difference between frailty and loneliness.Using Logistic regression to analyze the demographic influence factors of rural empty nesters.Using one-way analysis of variance and post-hoc test to explore whether there are differences between different levels of loneliness(low,moderate,and moderately high)and different frailty status(robust,prefrail,and frail).Using two-way analysis of variance to explore interactions between different frailty status and loneliness levels and to analyze their impact on quality of life.We utilized the area under the receiver operator curves to explore the cutoffs of the UCLA loneliness scale and the SF-36 for frailty.Results1.A general descriptive analysis showed that most rural empty-nests were frailty and prefrailty(n=218,71.8%),and about half of them were in the prefrail status(n=154,50.7%),while the frail elderly accounted for 21.0%.In addition,the vast majority of rural empty nesters are in moderate or moderately high loneliness(n=240,79%),and about half of them are in moderate loneliness(n=162,53.3%),about 1/4 at a level of moderately high loneliness(n=78,25.7%).2.The results of the Chi-square test showed that the general information of the research subjects,includes women,primary and lower education level,current occupation as farmer,income for daily living expenses,no living guarantee,having health insurance,no money for retirement,no need for others care,chronic diseases,other types of chronic diseases,and medications,on frailty of empty nest elderly in rural areas were statistically significant(P(27)0.05).At the same time,former and current occupations are farmers,1–4 children,income for daily living expenses,health insurance,no need for others care,never smoking or quitting smoking,never or occasional alcohol consumption,chronic illness,medication for rural were statistically significant on loneliness(P(27)0.05).3.Logistic regression analysis showed that the current occupation,requiring other people to take care of,and suffering from other types of chronic diseases,three variables enter the regression equation,and there was a predictive effect on the situation of frailty among rural empty nest elderly.The results of logistic regression analysis showed that the current occupation,medical payment,and number of children entered the regression equation,and there was a predictive effect on the situation of loneliness among rural elderly empty nesters.4.One-way analysis of variance showed that there was a significant difference between different levels of loneliness and frailty status(P(27)0.001).Two-way analysis of variance showed that there was a significant interaction between different frailty status(robust,prefrail,frail)and different levels of loneliness(low,moderate,and moderately high)on the quality of life(P=0.002).5.The Receiver Operator Curves(ROC)showed that the UCLA Loneliness Scale score can predict the frailty of the rural empty nest elderly.The cutoff of the scale score was 34.5(sensitivity: 59.4%,specificity: 66.7%).The SF-36 score also predicted the frailty of empty nest elderly in rural areas.The cutoff is 67.4(sensitivity: 90.6% and specificity: 74.6%).Conclusions 1.Rural empty nesters are frailty and loneliness.Therefore,nurses and staff in rural communities need to take timely and effective interventions to control their occurrence and development.2.The frailty and loneliness of the empty nest elderly in rural areas is affected by many factors,among which the current occupation,the need for care of other people and suffering from other types of chronic diseases(such as rheumatism,cataracts,arthritis,gastrointestinal diseases,etc.)are the main factors.The current occupation,medical payment,and number of children are the main influencing factors for the loneliness of rural empty nesters.The government,society,and family should in turn provide appropriate interventions to reduce the incidence of frailty and loneliness and improve the quality of life.3.One-way and two-way analysis of variance showed that different levels of loneliness in rural empty-nesters were significantly associated with frailty status,and that different levels of loneliness and frailty status had significant interactions with their quality of life.While paying attention to the physical condition of empty nesters,the state,society,and family should not neglect their inner needs,encourage older people to participate in more activities,provide social support,and often visit their parents as much as possible to reduce their loneliness and improve their quality of life.4.The cutoff of UCLA Loneliness Scale score is 34.5,and the SF-36 scale score is 67.4.It can be used to identify empty nests with frailty.When the UCLA Loneliness Scale scored more than 34.5 points or the SF-36 Scale scored less than 64.7 points,rural empty nesters may be at risk of frailty.Therefore,the relevant departments should promptly conduct appropriate screenings of rural empty-nests,evaluate their physical and psychological conditions as far as possible,and ensure effective intervention in advance.