| ObjectiveThis study was to explore the status and the related factors of emotional-social loneliness including emotional isolation,social isolation,emotional loneliness and social loneliness among patients with acute cerebral infraction.It would be beneficial to develop targeted interventions for preventing or relieving patients' emotional-social loneliness.MethodsThe present study recruited 186 inpatients with acute cerebral infraction in Neurology Department of five Three-A hospitals from Jan.2017 to Oct.2017.Data was collected with self-reported questionnaire for patient characteristics,Emotional-social loneliness questionnaire,Self-Esteem Scale,General Self-efficacy Scale,Coping Style Scale,Social Support Rating Scale(SSRS),Activity of Daily Living Scale,National Institute of Health stroke scale(NIHSS),Mini Mental State Examination(MMSE).Statistical analysis was conducted with SAS9.2.Results1.The incidence of emotional-social loneliness among patients with acute cerebral infractionIn 186 patients with acute cerebral infraction.the total average score for emotional isolation was(7.26±5.05);there were 62(33.3%)patients with emotional isolation,specifically,there were 33(17.7%)patients with moderate emotional isolation,and 29(15.6%)patients with severe emotional isolation.The total average score for social isolation was(7.57±5.09);there were 80(43.0%)patients with social isolation,specifically,there were 43(23.1%)patients with moderate social isolation,and 37(19.9%)patients with severe social isolation.The total average score for emotional loneliness was(6.73±5.73);there were 52(28.0%)patients with emotional loneliness,specifically,there were 29(15.6%)patients with moderate emotional loneliness,and 23(12.4%)patients with severe emotional loneliness.The total average score for social loneliness was(6.55±5.26);there were 45(24.2%)patients with social loneliness,specifically,there were 22(11.8%)patients with moderate social loneliness,and 23(12.4%)patients with severe social loneliness.2.The differences of emotional-social loneliness by demographic characteristics in patients with acute cerebral infraction(1)Emotional isolation:The score of emotional isolation for patients who were ?65 years old were higher than scores for those who were 45-65 years old(P<0.05);the score of emotional isolation for patients who had family monthly income 2000-5000 RMB were lower than scores for those who had family monthly income?5000 RMB(P<0.05);the score of emotional isolation for patients who were practitioners(farming,other physical labor and brainwork)were lower than scores for those who were non-practitioners or retired(all P<0.05);the score of emotional isolation for patients who were in asleep and angry before disease were higher than scores for those who were in other condition(all P<0.05).(2)Social isolation:The score of social isolation for patients who were>65 years old were higher than scores for those who were 45-65 years old(P<0.05);the score of social isolation for patients who had family monthly income<5000 RMB were lower than scores for those who had family monthly income>5000 RMB(all P<0.05);the score of social isolation for patients who were practitioners(farming,other physical labor and brainwork)were lower than scores for those who were non-practitioners or retired(all P<0.05);the score of social isolation for patients who had stroke history were higher than scores for those who had no stroke history(P<0.05).(3)Emotional loneliness:The score of emotional loneliness for patients who were>65 years old were higher than scores for those who were 45-65 years old(P<0.05);the score of emotional loneliness for patients who had family monthly income 2000-5000 RMB were lower than scores for those who had family monthly income>5000 RMB(P<0.05);the score of emotional loneliness for patients who were practitioners(fanning,other physical labor and brainwork)were lower than scores for those who were non-practitioners or retired(all P<0.05);the score of emotional loneliness for patients who were in asleep and angry before disease were higher than scores for those who were in other condition(all P<0.05).(4)Social loneliness:The score of social loneliness for patients who were>65 years old were higher than scores for those who were 45-65 years old(P<0.05);the score of social loneliness for patients who had family monthly income<5000 RMB were lower than scores for those who had family monthly income ?5000 RMB(all P<0.05);the score of social loneliness for patients who were practitioners(farming,other physical labor and brainwork)were lower than scores for those who were non-practitioners or retired(all P<0.05).3.Correlations between self-esteem,self-efficiency,coping styles social support,activity ability,cognitive function,neurological function and emotional-social loneliness in patients with acute cerebral infraction(1)The score for self-esteem was negatively correlated with the scores of emotional isolation,social isolation,emotional loneliness and social loneliness(r=-0.502,P<.0001;r=-0.576,P<.0001;r=-0.611,P<.0001;r=-0.602,P<0001).(2)The score for self-efficiency was negatively correlated with the scores for emotional isolation,social isolation,emotional loneliness and social loneliness(r=-0.495.P<.0001;r=-0.637,P<.0001;r=-0,522,P<.0001;r=-0.535,P<.0001).(3)The score for positive copying style was negatively correlated with the scores for emotional isolation,social isolation,emotional loneliness and social loneliness(r=-0.424,P<.0001;r=-0.539.P<.0001:r=-0.330,P<.0001;r=-0.371,P<.0001).(4)The score for total social support was negatively correlated with the scores for emotional isolation,social isolation,emotional loneliness and social loneliness(r=-0,340,P<.0001;r=-0.470,P<.0001;r=-0.380,P<-0001;r=-0.410,P<.0001);the score of objective support was negatively correlated with the scores of emotional isolation,social isolation,emotional loneliness and social loneliness(r=-0.199,P<0.05;r=-0.282,P<0.01;r=-0.169,P<0.05;r=-0.203,P<0.01);the score of subjective support was negatively correlated with the scores of emotional isolation,social isolation,emotional loneliness and social loneliness(r=-0.322,P<.0001;r=-0.469,P<.0001;r=-0.307,P<.0001;r=-0.372,P<.0001);the score of support utilization was negatively correlated with the scores of emotional isolation,social isolation,emotional loneliness and social loneliness(r=-0.455,P<.0001;r=-0.494,P<.0001;r=-0.479,P<.0001;r=-0.497,P<.0001).(5)The score for activity ability was negatively correlated with the scores of social loneliness(r=-0.149,P<0.05).(6)The score for NIHSS was positively correlated with the scores of emotional loneliness and social loneliness(r=0.159,P<0.05;r=0.182,P<0.05).4.Factors associated with emotional-social loneliness among patients with acute cerebral infarction(1)Emotional isolation:in multiple regression analysis,factors associated with emotional isolation were self-esteem(?=-0.398,P<.0001),total social support(?=-0.196,P=0.011)and work(non-practitioners or retired)(?=0.232,P=0.0007).The regression model was statistically significant(F=31.233,P<.0001,adjusted R2=0.366),these four variables explained 36.6%of the variance in emotional isolation.(2)Social isolation:in multiple regression analysis,factors associated with social isolation were self-esteem(?=-0.192,P=0.015),self-efficiency(?=-0.346,P<.0001),total social support(P=-0.273,P<.0001)and work(non-practitioners or retired)((3=0.139,P=0.018).The regression model was statistically significant(F=46.42,P<.0001,adjusted R2=0.0.538),these four variables explained 53.8%of the variance in social isolation.(3)Emotional loneliness:in multiple regression analysis,factors associated with emotional loneliness were self-esteem(?=-0.426,P<.0001),support utilization(?=-0.210,P=0.005),worse neurological function((3=0.164,P=0.009),work(non-practitioners or retired)(?=0.190,P=0.003)and the condition before disease(labor)(?=0.131,P=0.032).The regression model was statistically significant(F=26.09,P<.0001.adjusted R2=0.447),these five variables explained 44.7%of the variance in emotional loneliness.(4)Social loneliness:in multiple regression analysis,factors associated with social loneliness were self-esteem(?=-0.386,P<.0001),support utilization(?=-0.217,P=0.004),worse neurological function(?=0.128,P=0.041)and work(non-practitioners or retired)(?=0.254,P<.0001).The regression model was statistically significant(F=30.48,P<.0001,adjusted R2=0.434),these four variables explained 44.2%of the variance in social loneliness.Conclusions1.The incidence of emotional isolation,social isolation,emotional loneliness and social loneliness are high in patients with acute cerebral infraction.The clinical nurses should pay more attentions on patients with acute cerebral infraction,especially on the patients who are>65 years,from family with monthly income>5000 RMB,non-practitioners or retired,in asleep and angry before acute cerebral infraction and who have stroke history before.2.Factors associated with emotional isolation among patients with acute cerebral infraction are self-esteem,total social support and work condition(non-practitioners or retired).3.Factors associated with social isolation among patients with acute cerebral infraction are self-esteem,self-efficiency,total social support and work condition(non-practitioners or retired).4.Factors associated with emotional loneliness among patients with acute cerebral infraction are self-esteem,support utilization,neurological function,work condition(non-practitioners or retired)and the condition before acute cerebral infraction(labor).5.Factors associated with social loneliness among patients with acute cerebral infraction are self-esteem,support utilization,neurological function and work condition(non-practitioners or retired).6.The clinical nurses should protect patients with acute cerebral infraction against emotional-social loneliness by improving their self-esteem,self-efficiency,and social support. |
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