Older People's Lived Perspectives of Social Isolation during the First Wave of the COVID-19 Pandemic in Italy

Sabrina Cipolletta, Francesca Gris, Sabrina Cipolletta, Francesca Gris

Abstract

The aim of the present study is to understand the experiences of isolation and strategies used to cope with it among older people living at home during the first wave of the COVID-19 pandemic. More specifically, the roles of media and online technologies were also explored. Semistructured interviews were conducted via telephone between March and April 2020 with 30 people aged 72-94 years old living in Northern Italy. The thematic analysis identified six thematic areas: changes in daily life, emotions, social networks, exploited resources and strategies, use of media, and view of the future. Older people faced the emergency in heterogeneous ways; some were able to take advantage of their own residual resources and of social support, whereas in other cases, isolation exacerbated existing weaknesses. Technology and media were useful for reducing loneliness and fostering social contacts, but people with age-related impairments or low digital literacy presented many difficulties in approaching new technologies. Moreover, the overabundance of information could also increase anxiety and feelings of threat. Given the impact of social isolation on older people's well-being, it is critical to identify and strengthen personal resources and social support strategies that may help older people cope with the restrictions imposed by the COVID-19 pandemic.

Keywords: COVID-19 pandemic; coronavirus; information and communication technologies; loneliness; older people; qualitative method; social isolation; social support.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Map of the relationships between themes.

References

    1. World Health Organization Coronavirus Disease (COVID-19) Advice for the Public. [(accessed on 29 April 2020)]. Available online: .
    1. Sahin A.R. 2019 Novel Coronavirus (COVID-19) Outbreak: A Review of the Current Literature. Eurasian J. Med. Oncol. 2020;4:1–7. doi: 10.14744/ejmo.2020.12220.
    1. Rossi R., Socci V., Talevi D., Mensi S., Niolu C., Pacitti F., Di Marco A., Rossi A., Siracusano A., Di Lorenzo G. COVID-19 Pandemic and Lockdown Measures Impact on Mental Health Among the General Population in Italy. Front. Psychiatry. 2020;11:790. doi: 10.3389/fpsyt.2020.00790.
    1. Cipolletta S., Ortu M.C. COVID-19: Common Constructions of the Pandemic and Their Implications. J. Constr. Psychol. 2021;34:278–294. doi: 10.1080/10720537.2020.1818653.
    1. Tomaino S.C.M., Cipolletta S., Kostova Z., Todorova I. Stories of Life during the First Wave of the COVID-19 Pandemic in Italy: A Qualitative Study. Int. J. Environ. Res. Public Health. 2020;18:7630. doi: 10.3390/ijerph18147630.
    1. Fiorillo. 2021 A., Gorwood P. The consequences of the COVID-19 pandemic on mental health and implications for clinical practice. Eur. Psychiatry. 2020;63:e32. doi: 10.1192/j.eurpsy.2020.35.
    1. Doraiswamy S., Cheema S., Mamtani R. Older people and epidemics: A call for empathy. Age Ageing. 2020;49:493. doi: 10.1093/ageing/afaa060.
    1. Landry M.D., Van den Bergh G., Hjelle K.M., Jalovcic D., Tuntland H.K. Betrayal of Trust? The Impact of the COVID-19 Global Pandemic on Older Persons. J. Appl. Gerontol. 2020;39:687–689. doi: 10.1177/0733464820924131.
    1. Tyrrell CJand Williams K.N. The paradox of social distancing: Implications for older adults in the context of COVID-19. Psychological Trauma: Theory. Res. Pract. Policy. 2020;12((Suppl. S1)):S214. doi: 10.1037/tra0000845.
    1. Baker E., Clark L.L. Biopsychopharmacosocial approach to assess impact of social distancing and isolation on mental health in older adults. Br. J. Community Nurs. 2020;25:231–238. doi: 10.12968/bjcn.2020.25.5.231.
    1. Kasar K.S., Karaman E. Life in lockdown: Social isolation loneliness and quality of life in the elderly during the COVİD-19 pandemic: A scoping review. Geriatric Nursing. 2021;42:1222–1229. doi: 10.1016/j.gerinurse.2021.03.010.
    1. Rana W., Mukhtar S., Mukhtar S., Mohiuddin G., Ehmad A. Psychological health of aging mental healthcare social workforce amidst coronavirus disease-2019 pandemic. Int. J. Geriatr. Psychiatry. 2021;46:1–462. doi: 10.1002/gps.5456.
    1. Smith M.L., Steinman L.E., Casey E.A. Combatting Social Isolation among Older Adults in a Time of Physical Distancing: The COVID-19 Social Connectivity Paradox. Front. Public Health. 2020;8:403. doi: 10.3389/fpubh.2020.00403.
    1. Armitage R., Nellums L.B. COVID-19 and the consequences of isolating the elderly. Lancet Public Health. 2020;5:e256. doi: 10.1016/S2468-2667(20)30061-X.
    1. Nitschke M., Hansen A., Bi P., Pisaniello D., Newbury J., Kitson A., Tucker G., Avery J., Dal Grande E. Risk Factors. Health Effects and Behaviour in Older People during Extreme Heat: A Survey in South Australia. Int. J. Environ. Res. Public Health. 2013;10:6721–6733. doi: 10.3390/ijerph10126721.
    1. Santini Z.I., Jose P.E., York Cornwell E., Koyanagi A., Nielsen L., Hinrichsen C., Meilstrup C., Madsen K.R., Koushede V. Social disconnectedness, perceived isolation, and symptoms of depression and anxiety among older Americans (NSHAP): A longitudinal mediation analysis. Lancet Public Health. 2020;5:e62–e70. doi: 10.1016/S2468-2667(19)30230-0.
    1. Sepúlveda-Loyola W., Rodríguez-Sánchez I., Pérez-Rodríguez P., Ganz F., Torralba R., Oliveira D.V., Rodríguez-Mañas L. Impact of Social Isolation Due to COVID-19 on Health in Older People: Mental and Physical Effects and Recommendations. J. Nutr. Health Aging. 2020;24:938–947. doi: 10.1007/s12603-020-1500-7.
    1. Liu N., Zhang F., Wei C., Jia Y., Shang Z., Sun L., Wu L., Sun Z., Zhou Y., Wang Y., et al. Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: Gender differences matter. Psychiatry Res. 2020;287:112921. doi: 10.1016/j.psychres.2020.112921.
    1. Grey I., Arora T., Thomas J., Saneh A., Tohme P., Abi-Habib R. The role of perceived social support on depression and sleep during the COVID-19 pandemic. Psychiatry Res. 2020;293:113452. doi: 10.1016/j.psychres.2020.113452.
    1. Briguglio M., Giorgino R., Dell’Osso B., Cesari M., Porta M., Lattanzio F., Banfi G., Peretti G.M. Consequences for the Elderly After COVID-19 Isolation: FEaR (Frail Elderly amid Restrictions) Front. Psychol. 2020;11:565052. doi: 10.3389/fpsyg.2020.565052.
    1. Brooke J., Clark M. Older people’s early experience of household isolation and social distancing during COVID-19. J. Clin. Nurs. 2020;29:4387–4402. doi: 10.1111/jocn.15485.
    1. Cipolletta S., Morandini B., Tomaino S.C.M. Caring for a person with dementia during the COVID-19 pandemic: A qualitative study with family caregivers. Aging Society. 2021:1–21. doi: 10.1017/S0144686X21000696.
    1. Vahia I.V. COVID-19, Aging, and Mental Health: Lessons from the First Six Months. Am. J. Geriatr. Psychiatry. 2020;28:691–694. doi: 10.1016/j.jagp.2020.05.029.
    1. Zhou X., Snoswell C.L., Harding L.E., Bambling M., Edirippulige S., Bai X., Smith A.C. The Role of Telehealth in Reducing the Mental Health Burden from COVID-19. Telemed. E-Health. 2020;26:377–379. doi: 10.1089/tmj.2020.0068.
    1. Cipolletta S., Entilli L., Bettio F., De Leo D. Live-Chat Support for People Bereaved Due to Suicide: A Thematic Analysis. Crisis J. Crisis Interv. Suicide Prev. 2020:1–7. doi: 10.1027/0227-5910/a000759.
    1. Cipolletta S., Tomaino S.C.M., Lo Magno E., Faccio E. Illness experience and attitude toward medication in online communities for people with fibromyalgia. Int. J. Environ. Res. Public Health. 2020;17:8633. doi: 10.3390/ijerph17228683.
    1. Newman M.G., Zainal N.H. The value of maintaining social connections for mental health in older people. Lancet Public Health. 2020;5:e12–e13. doi: 10.1016/S2468-2667(19)30253-1.
    1. Cipolletta S., Mocellin D. Online counseling: Psychologists’ attitudes towards new ways of interaction. Psychother. Res. 2018;28:909–924. doi: 10.1080/10503307.2016.1259533.
    1. Van Daele T., Karekla M., Kassianos A., Compare A., Haddouk L., Salgad J., Ebert D., Trebbi G., Bernaerts S., Van Assche E., et al. Recommendations for policy and practice of telepsychotherapy and e-mental health in Europe and beyond. J. Psychother. Integr. 2020;30:160–173. doi: 10.1037/int0000218.
    1. Kuwahara K., Kuroda A., Fukuda Y. COVID-19: Active measures to support community-dwelling older adults. Travel Med. Infect. Dis. 2020;36:101638. doi: 10.1016/j.tmaid.2020.101638.
    1. Colenda C.C., Reynolds C.F., Applegate W.B., Sloane P.D., Zimmerman S., Newman A.B., Meeks S., Ouslander J.G. COVID-19 Pandemic and Ageism: A Call for Humanitarian Care. Am. J. Geriatr. Psychiatry. 2020;28:805–807. doi: 10.1016/j.jagp.2020.04.005.
    1. Altena E., Baglioni C., Espie C.A., Ellis J., Gavriloff D., Holzinger B., Schlarb A., Frase L., Jernelöv S., Riemann D. Dealing with sleep problems during home confinement due to the COVID-19 outbreak: Practical recommendations from a task force of the European CBT-I Academy. J. Sleep Res. 2020;29:e13052. doi: 10.1111/jsr.13052.
    1. Gao J., Zheng P., Jia Y., Chen H., Mao Y., Chen S., Wang Y., Fu H., Dai J. Mental health problems and social media exposure during COVID-19 outbreak. PLoS ONE. 2020;15:e0231924. doi: 10.1371/journal.pone.0231924.
    1. Kelly G.A. The Psychology of Personal Constructs. Norton; New York, NY, USA: 1955.
    1. Chiari G. To live is to know, to know is to change: Change in personal construct psych- ology and psychological constructivism. J. Constr. Psychol. 2016;29:340–356. doi: 10.1080/10720537.2015.1134364.
    1. Cipolletta S., Gammino G.R., Palmieri A. Illness trajectories in patients with amyotrophic lateral sclerosis: How illness progression is related to life narratives and interpersonal relationships. J. Clin. Nurs. 2017;26:5033–5043. doi: 10.1111/jocn.14003.
    1. Winter D.A., Reed N. Unprecedented Times for Many but Not for All: Personal Construct Perspectives on the COVID-19 Pandemic. J. Constr. Psychol. 2021;34:254–263. doi: 10.1080/10720537.2020.1791291.
    1. Hurwitz B., Greenhalgh T., Skultans V. Narrative Research in Health and Illness. Blackwell Publishing; Malden, MA, USA: 2004.
    1. Goodman L.A. Snowball Sampling. Ann. Math. Stat. 1961;32:148–170. doi: 10.1214/aoms/1177705148.
    1. Flick U. An Introduction to Qualitative Research. Sage Publications; Los Angeles, CA, USA: 2009.
    1. Kvale S. Interviews: An Introduction to Qualitative Research Interviewing. Sage; Thousand Oaks, CA, USA: 1996.
    1. Braun V., Clarke V. Using thematic analysis in psychology. Qual. Res. Psychol. 2006;3:77–101. doi: 10.1191/1478088706qp063oa.
    1. Tong A., Sainsbury P., Craig J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. Int. J. Qual. Health Care. 2007;19:349–357. doi: 10.1093/intqhc/mzm042.
    1. Yardley L. Dilemmas in qualitative health research. Psychol. Health. 2000;15:215–228. doi: 10.1080/08870440008400302.
    1. WorldOMeter. [(accessed on 26 October 2021)]. Available online: .
    1. Russo F., Pitter G., Da Re F., Tonon M., Avossa F., Bellio S., Fedeli U., Gubian L., Monetti D., Saia M., et al. Epidemiology and public health response in early phase of COVID-19 pandemic, Veneto Region, Italy, 21 February to 2 April 2020. Eurosurveillance. 2020;25:2000548. doi: 10.2807/1560-7917.ES.2020.25.47.2000548.
    1. Ministero della Salute. [(accessed on 26 October 2021)]; Available online: .
    1. Ayalon L., Chasteen A., Diehl M., Levy B.R., Neupert S.D., Rothermund K., Tesch-Römer C., Wahl H.W. Aging in Times of the COVID-19 Pandemic: Avoiding Ageism and Fostering Intergenerational Solidarity. J. Gerontol. Ser. B. 2020;76:e49–e52. doi: 10.1093/geronb/gbaa051.
    1. Feng L.S., Dong Z.J., Yan R.Y., Wu X.Q., Zhang L., Ma J., Zeng Y. Psychological distress in the shadow of the COVID-19 pandemic: Preliminary development of an assessment scale. Psychiatry Res. 2020;291:113202. doi: 10.1016/j.psychres.2020.113202.
    1. Karmakar A., Chattopadhyay C. The Manifestation of superstition in terms of COVID-19. PalArchs J. Archaeol. Egypt/Egyptol. 2021;18:4054–4060.
    1. Brown L., Mossabir R., Harrison N., Brundle C., Smith J., Clegg A. Life in lockdown: A telephone survey to investigate the impact of COVID-19 lockdown measures on the lives of older people (≥75 years) Age Ageing. 2021;50:341–346. doi: 10.1093/ageing/afaa255.
    1. Sewell K.W. An Approach to Post-Traumatic Stress. In: Fransella F., editor. International Handbook of Personal Construct Psychology. John Wiley Sons Ltd.; Chichester, UK: 2003. pp. 223–233.
    1. Momtaz Y.A., Hamid T.A., Haron S.A., Bagat M.F. Flourishing in later life. Arch. Gerontol. Geriatr. 2016;63:85–91. doi: 10.1016/j.archger.2015.11.001.
    1. Viney L.L., Benjamin Y.N., Preston C. Mourning and reminiscence: Parallel psychotherapeutic processes for elderly people. Int. J. Aging Hum. Dev. 1989;28:239–249. doi: 10.2190/27D3-VWD6-5RKQ-DCG7.
    1. Yu H., Li M., Li Z., Xiang W., Yuan Y., Liu Y., Li Z., Xiong Z. Coping style. social support and psychological distress in the general Chinese population in the early stages of the COVID-19 epidemic. BMC Psychiatry. 2020;20:426. doi: 10.1186/s12888-020-02826-3.
    1. Losada-Baltar A., Jiménez-Gonzalo L., Gallego-Alberto L., Pedroso-Chaparro M.S., Fernandes-Pires J., Márquez-González M. “We Are Staying at Home.” Association of Self-perceptions of Aging. 2020, Personal and Family Resources, and Loneliness With Psychological Distress During the Lock-Down Period of COVID-19. J. Gerontol. Ser. B. 2021;76:e10–e16. doi: 10.1093/geronb/gbaa048.
    1. Carstensen L.L., Fung H.H., Charles S.T. Socioemotional Selectivity Theory and the Regulation of Emotion in the Second Half of Life. Motiv. Emot. 2003;27:103–123. doi: 10.1023/A:1024569803230.
    1. Bailey L., Ward M., DiCosimo A., Baunta S., Cunningham C., Romero-Ortuno R., Briggs R. Physical and mental health of older people while cocooning during the COVID-19 pandemic. QJM Int. J. Med. 2021:hcab015. doi: 10.1093/qjmed/hcab015.
    1. Ongun E., Guder F.Z., Demirag A. Elderly people’s choice of media and their perceived state of loneliness. Online J. Commun. Media Technol. 2016;6:35–47. doi: 10.29333/ojcmt/2536.
    1. Motta Zanin G., Gentile E., Parisi A., Spasiano D. A preliminary evaluation of the public risk perception related to the COVID-19 health emergency in Italy. Int. J. Environ. Res. Public Health. 2020;17:3024. doi: 10.3390/ijerph17093024.
    1. Chipidza W., Akbaripourdibazar E., Gwanzura T., Gatto N.M. Topic analysis of traditional and social media news coverage of the early COVID-19 pandemic and implications for public health communication. Disaster Med Public Health. 2021:1–23. doi: 10.1017/dmp.2021.65.
    1. Tejedor S., Cervi L., Tusa F., Portales M., Zabotina M. Information on the COVID-19 pandemic in daily newspapers’ front pages: Case study of Spain and Italy. Int. J. Environ. Res. Public Health. 2020;17:6330. doi: 10.3390/ijerph17176330.
    1. Tangcharoensathien V., Calleja N., Nguyen T., Purnat T., Garcia-Saiso S., Landry M., Rashidian A., Hamilton C., AbdAllah A., Ghiga I., et al. Framework for Managing the COVID-19 Infodemic: Methods and Results of an Online. 2020, Crowdsourced WHO Technical Consultation. J. Med Internet Res. 2020;22:e19659. doi: 10.2196/19659.
    1. Paakkari L., Okan O. COVID-19: Health literacy is an underestimated problem. Lancet Public Health. 2020;5:e249–e250. doi: 10.1016/S2468-2667(20)30086-4.
    1. Nguyen H.C., Nguyen M.H., Do B.N., Tran C.Q., Nguyen T.T.P., Pham K.M., Pham L.V., Tran K.V., Duong T.T., Tran T.V., et al. People with Suspected COVID-19 Symptoms Were More Likely Depressed and Had Lower Health-Related Quality of Life: The Potential Benefit of Health Literacy. J. Clin. Med. 2020;9:965. doi: 10.3390/jcm9040965.
    1. Abel T., McQueen D. Critical health literacy and the COVID-19 crisis. Health Promot. Int. 2020;35:1612–1613. doi: 10.1093/heapro/daaa040.
    1. Eghtesadi M. Breaking social isolation amidst COVID-19: A viewpoint on improving access to technology in long-term care facilities. J. Am. Geriatr. Soc. 2020;68:949. doi: 10.1111/jgs.16478.
    1. Cornwell E.Y., Waite L.J. Social Disconnectedness. Perceived Isolation, and Health among Older Adults. J. Health Soc. Behav. 2009;50:31–48. doi: 10.1177/002214650905000103.

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner