Publication: Evaluación del impacto de un programa comunitario de acompañamiento en personas mayores con riesgo de soledad en términos de mejora de la calidad de vida, resultados de salud y utilización de recursos sanitarios
Authors
Ramón Rizo, Jordi
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Escuela Internacional de Doctorado
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Abad Corpa, Eva
Publisher
Universidad de Murcia
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DOI
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info:eu-repo/semantics/doctoralThesis
Description
Abstract
La soledad no deseada se considera uno de los principales retos sociales del siglo XXI y ha sido descrita como la "pandemia silenciosa" de las sociedades contemporáneas. Es un fenómeno global vinculado a la modernidad, el desarrollo urbano, los cambios en las estructuras familiares y el incremento del individualismo. Estas transformaciones han debilitado los vínculos sociales y comunitarios, aumentando el riesgo de aislamiento, especialmente en los colectivos más vulnerables.La soledad es una experiencia subjetiva que no depende únicamente del número de relaciones, sino de la percepción de su calidad y adecuación. Puede manifestarse en distintas dimensiones: la soledad emocional, asociada a la ausencia de relaciones íntimas y significativas; la soledad relacional, vinculada a la conexión insuficiente con familiares y amistades; y la soledad social, relacionada con el sentimiento de no sentirse integrado o valorado en el entorno comunitario.La capacidad para afrontar la soledad varía entre individuos. Las personas vulnerables (como quienes presentan enfermedades físicas o mentales, discapacidad, edad avanzada, pobreza o escasas redes de apoyo) experimentan la soledad con mayor intensidad y sufren consecuencias más graves. En las personas mayores, la soledad no deseada es un problema relevante, ya que se asocia a deterioro de la salud física y mental, reducción de la calidad de vida y mayor utilización de servicios sanitarios y sociales.La evidencia indica que las intervenciones comunitarias más eficaces son las desarrolladas desde un enfoque educativo o de apoyo, preferentemente en formato grupal. Estas intervenciones facilitan la creación de vínculos sociales, refuerzan el sentimiento de pertenencia y promueven el empoderamiento y la autogestión.El objetivo de este estudio fue evaluar el impacto de un programa comunitario de acompañamiento dirigido a personas mayores con riesgo de soledad, analizando su efecto sobre la salud y el uso de recursos sanitarios.Se llevó a cabo un estudio de método mixto con dos fases. La fase cuantitativa consistió en un estudio cuasi-experimental multicéntrico, pre-post intervención no controlado. La fase cualitativa se desarrolló mediante un análisis fenomenológico de entrevistas, explorando percepciones, vivencias y necesidades asociadas a la soledad.En la fase cuantitativa se recogieron variables sociodemográficas y clínicas de las historias clínicas, incluyendo visitas a atención primaria y salud mental, participación en actividades comunitarias, peso, IMC, datos analíticos y farmacológicos, y riesgo suicida. La soledad se evaluó con la escala ESTE II. Todas las variables se registraron antes de la intervención y un año después. En la fase cualitativa participaron 12 personas seleccionadas de las 83 del estudio cuantitativo, realizando un análisis del contenido latente para identificar las categorías centrales.La muestra incluyó 83 personas, 26.19 % hombres y 73.81 % mujeres, de 55 a 92 años. Tras la intervención, se observó una mejora significativa en la percepción de soledad, un aumento de la participación comunitaria y una reducción de las visitas a atención primaria y salud mental, así como disminución del riesgo cardiovascular, suicida y del consumo de fármacos.En conclusión, una intervención comunitaria grupal basada en recuperación y autogestión en personas mayores con soledad no deseada mejora la salud, reduce la utilización de recursos sanitarios y farmacológicos, disminuye la ideación suicida y mejora la percepción subjetiva de soledad, favoreciendo el bienestar emocional y la calidad de vida.
Loneliness is considered one of the main social challenges of the 21st century and has been described as the "silent pandemic" of contemporary societies. It is a global phenomenon linked to modernity, urban development, changes in family structures, and increasing individualism. These transformations have weakened social and community bonds, increasing the risk of isolation, particularly among the most vulnerable groups.Loneliness is a subjective experience that does not depend solely on the number of social relationships, but on the perceived quality and adequacy of those relationships. It can manifest in different dimensions: emotional loneliness, associated with the absence of intimate and meaningful relationships; relational loneliness, linked to insufficient connection with family and friends; and social loneliness, related to the feeling of not being integrated or valued within the community.The ability to cope with loneliness varies between individuals. Vulnerable people (such as those with physical or mental illnesses, disabilities, advanced age, poverty, or limited social support) experience loneliness more intensely and suffer more severe consequences. Among older adults, loneliness is a particularly relevant problem, as it is associated with deterioration in physical and mental health, reduced quality of life, and increased use of healthcare and social services.Evidence indicates that the most effective community interventions are those developed with an educational or supportive approach, preferably in group format. These interventions facilitate the creation of social bonds, strengthen the sense of belonging, and promote empowerment and self-management.The main objective of this study was to evaluate the impact of a community-based accompaniment program for older adults at risk of loneliness, analyzing its effects on health and healthcare resource use.A mixed-methods study was conducted in two phases. The quantitative phase consisted of a multicenter quasi-experimental pre-post intervention study without a control group. The qualitative phase involved a phenomenological analysis of in-depth interviews, exploring perceptions, experiences, and needs related to loneliness.In the quantitative phase, sociodemographic and clinical variables were collected from medical records, including visits to primary care and mental health services, participation in community activities, weight, BMI, analytical and pharmacological data, and suicide risk. Loneliness was assessed using the ESTE II scale. All variables were recorded before the intervention and one year after. In the qualitative phase, 12 participants were selected from the 83 included in the quantitative study, and a latent content analysis was conducted to identify the central categories.The sample included 83 participants, 26.19% men and 73.81% women, aged 55 to 92 years. Following the intervention, there was a significant improvement in perceived loneliness, increased community participation, and a reduction in visits to primary care and mental health services, along with decreases in cardiovascular risk, suicide risk, and medication use.In conclusion, a community-based group intervention focused on recovery and self-management in older adults experiencing loneliness improves health outcomes, reduces the use of healthcare and pharmacological resources, decreases suicidal ideation, and enhances subjective perceptions of loneliness, promoting emotional well-being and quality of life.
Loneliness is considered one of the main social challenges of the 21st century and has been described as the "silent pandemic" of contemporary societies. It is a global phenomenon linked to modernity, urban development, changes in family structures, and increasing individualism. These transformations have weakened social and community bonds, increasing the risk of isolation, particularly among the most vulnerable groups.Loneliness is a subjective experience that does not depend solely on the number of social relationships, but on the perceived quality and adequacy of those relationships. It can manifest in different dimensions: emotional loneliness, associated with the absence of intimate and meaningful relationships; relational loneliness, linked to insufficient connection with family and friends; and social loneliness, related to the feeling of not being integrated or valued within the community.The ability to cope with loneliness varies between individuals. Vulnerable people (such as those with physical or mental illnesses, disabilities, advanced age, poverty, or limited social support) experience loneliness more intensely and suffer more severe consequences. Among older adults, loneliness is a particularly relevant problem, as it is associated with deterioration in physical and mental health, reduced quality of life, and increased use of healthcare and social services.Evidence indicates that the most effective community interventions are those developed with an educational or supportive approach, preferably in group format. These interventions facilitate the creation of social bonds, strengthen the sense of belonging, and promote empowerment and self-management.The main objective of this study was to evaluate the impact of a community-based accompaniment program for older adults at risk of loneliness, analyzing its effects on health and healthcare resource use.A mixed-methods study was conducted in two phases. The quantitative phase consisted of a multicenter quasi-experimental pre-post intervention study without a control group. The qualitative phase involved a phenomenological analysis of in-depth interviews, exploring perceptions, experiences, and needs related to loneliness.In the quantitative phase, sociodemographic and clinical variables were collected from medical records, including visits to primary care and mental health services, participation in community activities, weight, BMI, analytical and pharmacological data, and suicide risk. Loneliness was assessed using the ESTE II scale. All variables were recorded before the intervention and one year after. In the qualitative phase, 12 participants were selected from the 83 included in the quantitative study, and a latent content analysis was conducted to identify the central categories.The sample included 83 participants, 26.19% men and 73.81% women, aged 55 to 92 years. Following the intervention, there was a significant improvement in perceived loneliness, increased community participation, and a reduction in visits to primary care and mental health services, along with decreases in cardiovascular risk, suicide risk, and medication use.In conclusion, a community-based group intervention focused on recovery and self-management in older adults experiencing loneliness improves health outcomes, reduces the use of healthcare and pharmacological resources, decreases suicidal ideation, and enhances subjective perceptions of loneliness, promoting emotional well-being and quality of life.
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