Prevalence and predictors of social isolation, explaining of older adults’ experiences in Tabriz city and providing preventive strategies: An Explanatory Sequential Mixed study

Abstract

Introduction: Social isolation is a common phenomenon among the older population and a neglected phenomenon in Iran. Focusing on social isolation while identifying high-risk individuals makes it possible to design reducing interventions. This study aimed to determine the prevalence and predictors of social isolation in older adults, explain the older adults’ experiences of social isolation, and provide preventive strategies for social isolation. Methods: The present study was a mixed-method with a Sequential Explanatory Model approach. It was conducted from 2020 to 2022 in two quantitative and qualitative stages. The first stage was a descriptive-analytical cross-sectional method. The quantitative stage included two sub-stages of psychometric evaluation of the Persian version of the used scales and determining the prevalence of social isolation among older adults in Tabriz. The sample size was 390 people. The used instruments included the social disconnectedness Scale and the Perceived Isolation Scale. The second stage included a qualitative study with a conventional content analysis approach. Participants in the qualitative phase included 11 older people who were socially isolated based on the quantitative phase of the study. Collected data through semi-structured interviews were analyzed using inductive qualitative content analysis. In the final stage, strategies to prevent social isolation per the characteristics of the study community were presented using the expert panel technique. Results: The Cronbach's alpha (.64 and .76) showed that the internal consistency and reliability were acceptable for all items on the scales. The CVR and CVI were calculated for the Persian version of the Social Disconnectedness (CVR = 0.98 and CVI = 0.91) and Perceived Isolation (CVR = 0.91 and CVI = 0.96). The overall prevalence of objective social isolation was 40.6% and perceived isolation was 14.7%. The prevalence of both objective and perceived social isolation was higher in women than men. (P <0.001). Based on the regression analysis results, the variables of marital status, education, gender, and depression status were predictors of objective social isolation. Also, based on the regression analysis results, the variables of marital status, gender, and depressive status were predictors of perceived isolation. Analysis of qualitative findings leads to the extraction of 4 themes related to describing the experience of social isolation of older adults. The extracted themes were 1- Physical and mental erosion, 2- Critical interaction gap, 3- Helplessness and forced living, and 4- Living under fear and regret. Conclusion: Designing interventions to reduce the social isolation of Iranian older adults is necessary. Older women, especially unmarried older women, should be given priority in support programs and interventions to reduce social isolation. Also, interventions related to reducing depression can effectively improve the state of objective and mental social isolation of older adults.