Social Connectedness and Social Isolation in Nursing Home Residents

疗养院居民的社会联系和社会孤立

基本信息

批准号：
10414934
负责人：
Kate L Lapane
金额：
$ 86.07万
依托单位：
UNIV OF MASSACHUSETTS MED SCH WORCESTER
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-06-01 至 2026-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10414934
关键词：
Address Adult Affect Aggressive behavior Aging Alzheimer&apos s disease related dementia Anxiety Area Attenuated Behavioral Symptoms COVID-19 COVID-19 impact COVID-19 pandemic COVID-19 pandemic effects Caring Cessation of life Characteristics Cognitive Communication Communities Coupled Crowding Data Data Set Data Sources Dementia Development Elderly Eligibility Determination Emotional Environment Evaluation Evolution Facial Expression Funding Goals Health Healthcare Systems Heart Diseases Home Hospitalization Hypertension Impaired cognition Individual Intervention Lead Link Loneliness Long-Term Effects Longitudinal Studies Measures Medicare Mental Depression National Institute on Aging Natural experiment Nursing Homes Outcome PF4 Gene Pattern Personal Satisfaction Persons Pharmaceutical Preparations Physical Function Policies Population Posture Process Quality of Care Research Risk Social Network Social isolation Socialization Societies Strategic Planning Stroke Testing Underserved Population United States United States National Institutes of Health Work advanced analytics base contagion contextual factors design experience functional status indexing knowledge base loved ones neglect novel nursing home length of stay pandemic disease pandemic preparedness racial and ethnic segregation social social vulnerability virtual

项目摘要

This proposal is responsive to PAR-19-373 and the National Institute on Aging Strategic Plan Goals B and C. Social connectedness, the relationship people have with others, contributes to thriving in nursing homes. Loneliness is prevalent in nursing homes, and more so in residents with Alzheimer’s disease and related dementias (ADRD). In the community, loneliness spreads through a contagious process. Nursing homes provide congregate living for older adults where such spread of loneliness has not been studied. The proposed R01 explores the longitudinal evolution of lack of social connectedness throughout the nursing home stay, describes the interdependence of social isolation and lack of social connectedness within congregate living environments, and identify individual and contextual factors that exacerbate or attenuate its spread. Understanding who is at risk for lack of social connectedness and the health consequences of “being alone in a crowd” will inform interventions to address this important determinant of health and well-being in nursing home residents. The importance of this R01 is underscored by the impact of the COVID-19 pandemic on nursing home residents. Necessary policies introduced unprecedented social disruption to nursing homes (e.g., no visitors, residents restricted to their rooms), coupled with devastating COVID-19 illnesses and deaths leaving no resident, loved one, or nursing home staff unaffected. The horrific COVID-19 “natural experiment” allows the study of the downstream ripple effects of the policies to contain COVID-19 in nursing homes on social isolation and connectedness. The proposed R01 builds from our novel NIH-funded work to develop and test indices of social connectedness and social isolation using the Minimum Data Set 3.0 (MDS). We leverage an in-house longitudinal national MDS-based data source (2011-2018, extended to 2021) which includes area-based and facility characteristics, COVID-19 related data (e.g., policies, cases, deaths), and Medicare eligibility and claims data. These data enable the evaluation of deaths, hospitalizations and other validated outcomes. Our specific aims are to: 1) Extend our social connectedness/isolation MDS measure development and testing to residents without ADRD; 2) Evaluate the “natural course” of social connectedness in nursing homes and identify individual and contextual factors that modulate its spread; 3) Quantify the effect of social connectedness and isolation on health outcomes and evaluate factors that moderate its impact; 4) Estimate the impact of the pandemic on the lack of social connectedness in nursing home residents and the corresponding ripple effects of lack of social connectedness on resident health and well-being; 5) Identify characteristics of nursing homes that altered the impact of COVID-19 on the lack of social connectedness and its associated health effects among residents. The project develops a knowledge base regarding the broader impact of social isolation and COVID-19 on outcomes in nursing homes. The research will inform policies for the care of a rapidly growing segment of an aging society and guidance nursing home pandemic preparedness.

该提案响应 PAR-19-373 和国家老龄化研究所战略计划目标 B 和 C。社会联系，即人们与他人之间的关系，有助于疗养院的蓬勃发展。孤独感在疗养院中普遍存在，对于患有阿尔茨海默病和相关疾病的居民来说更是如此痴呆症（ADRD）在社区中通过传染过程传播。拟议的 R01 尚未对老年人的集体生活进行研究。探索了整个疗养院住宿过程中缺乏社交联系的纵向演变，描述了集体生活环境中社会孤立和缺乏社会联系的相互依存，并确定加剧或减弱其传播的个人和背景因素。缺乏社会联系的风险以及“独自在人群中”的健康后果将告知采取干预措施来解决疗养院居民健康和福祉的这一重要决定因素。 COVID-19 大流行对疗养院居民的影响凸显了 R01 的重要性。必要的政策给疗养院带来了前所未有的社会混乱（例如，没有访客，居民限制在自己的房间内），再加上毁灭性的 COVID-19 疾病和死亡，没有留下任何居民，受到喜爱一名或未受影响的疗养院工作人员可怕的 COVID-19“自然实验”允许对这一问题进行研究。疗养院遏制 COVID-19 的政策对社会隔离和社会隔离的下游连锁反应拟议的 R01 以我们 NIH 资助的新颖工作为基础，旨在开发和测试社交指数。我们利用最小数据集 3.0 (MDS) 来衡量连通性和社会隔离。基于国家 MDS 的纵向数据源（2011-2018 年，延长至 2021 年），其中包括基于区域和设施特征、COVID-19 相关数据（例如政策、病例、死亡）以及 Medicare 资格和索赔这些数据可以评估死亡、住院和其他经过验证的结果。目标是： 1) 将我们的社会联系/隔离 MDS 措施的开发和测试扩展到居民 2) 评估疗养院中社会联系的“自然过程”并识别个人以及调节其传播的背景因素；3）量化社会联系和孤立对其的影响；健康结果并评估减轻其影响的因素； 4) 估计大流行对健康的影响；疗养院居民缺乏社会联系以及缺乏社会联系所产生的相应连锁反应 5) 确定疗养院改变居民健康和福祉的特征； COVID-19 对居民缺乏社会联系的影响及其相关健康影响。项目开发了一个关于社会隔离和 COVID-19 对结果的更广泛影响的知识库这项研究将为老龄化社会中快速增长的群体的护理政策提供参考。并指导疗养院大流行病防范。