Loneliness Across the Life Span Qualter, Pamela; Vanhalst, Janne; Harris, Rebecca ...
Perspectives on psychological science,
03/2015, Letnik:
10, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Most people have experienced loneliness and have been able to overcome it to reconnect with other people. In the current review, we provide a life-span perspective on one component of the ...evolutionary theory of loneliness—a component we refer to as the reaffiliation motive (RAM). The RAM represents the motivation to reconnect with others that is triggered by perceived social isolation. Loneliness is often a transient experience because the RAM leads to reconnection, but sometimes this motivation can fail, leading to prolonged loneliness. We review evidence of how aspects of the RAM change across development and how these aspects can fail for different reasons across the life span. We conclude with a discussion of age-appropriate interventions that may help to alleviate prolonged loneliness.
Prior research has shown that loneliness is associated with hypervigilance to social threats, with eye‐tracking research showing lonely people display a specific attentional bias when viewing social ...rejection and social exclusion video footage (Bangee, Harris, Bridges, Rotenberg & Qualter, 2014; Qualter, Rotenberg, Barrett et al., 2013). The current study uses eye‐tracker methodology to examine whether that attentional bias extends to negative emotional faces and negative social non‐rejecting stimuli, or whether it could be explained only as a specific bias to social rejection/exclusion. It is important to establish whether loneliness relates to a specific or general attention bias because it may explain the maintenance of loneliness. Participants (N = 43, F = 35, Mage = 20 years and 2 months, SD = 3 months) took part in three tasks, where they viewed different social information: Task 1 – slides displaying four faces each with different emotions (anger, afraid, happy and neutral), Task 2 – slides displaying sixteen faces with varying ratios expressing happiness and anger, and Task 3 – slides displaying four visual scenes (socially rejecting, physically threatening, socially positive, neutral). For all three tasks, eye movements were recorded in real time with an eye‐tracker. Results showed no association between loneliness and viewing patterns of facial expressions, but an association between loneliness and hypervigilant viewing of social rejecting stimuli. The findings indicate that lonely adults do not have a generalised hypervigilance to social threat, but have, instead, a specific attentional bias to rejection information in social contexts. Implications of the findings for interventions are discussed.
Purpose
Personalised information and support can be provided to cancer survivors using a structured approach. Needs assessment tools such as the Holistic Needs Assessment (HNA) in the UK and the ...Comprehensive Problem and Symptom Screening (COMPASS) questionnaire in Canada are recommended for use in practice; however, they are not widely embedded into practice. The study aimed to determine the extent to which nurses working in cancer care in the UK and Manitoba value NA and identify any barriers and facilitators they experience.
Method
Oncology nurses involved in the care of cancer patients in the UK (
n
= 110) and Manitoba (
n
= 221) were emailed a link to an online survey by lead cancer nurses in the participating institutions. A snowball technique was used to increase participation across the UK resulting in 306 oncology nurses completing the survey in the UK and 116 in Canada.
Results
Participants expressed concerns that these assessments were becoming bureaucratic “tick-box exercises” which did not meet patients’ needs. Barriers to completion were time, staff shortages, lack of confidence, privacy, and resources. Facilitators were privacy for confidential discussions, training, confidence in knowledge and skills, and referral to resources.
Conclusion
Many busy oncology nurses completed this survey demonstrating the importance they attach to HNAs and COMPASS. The challenges faced with implementing these assessments into everyday practice require training, time, support services, and an appropriate environment. It is vital that the HNA and COMPASS are conducted at optimum times for patients to fully utilise time and resources.
•We examined whether loneliness was associated with hyper-vigilance to social threat.•Real-life footage and eye-tracker methodology was used.•Lonely people showed a different visual attention pattern ...to non-lonely people.•Lonely people fixed their attention on the social threat stimuli and later avoided it.
Cacioppo and Hawkley (2009) have hypothesized that lonely people are hyper-vigilant to social threat, with earlier work (Jones & Carver, 1991) linking this bias specifically to threats of social rejection or social exclusion. The current study examined this hypothesis in eighty-five young adults (mean age=18.22; SD=0.46; 17–19years in age) using eye-tracking methodology, which entailed recording their visual attention to social rejecting information. We found a quadratic relation between the participants’ loneliness, as assessed by the revised UCLA loneliness scale, and their visual attention to social threat immediately after presentation (2s). In support of Cacioppo and Hawkley’s (2009) hypothesis, it was found that young adults in the upper quartile range of loneliness exhibited visual vigilance of socially threatening stimuli compared to other participants. There was no relation between loneliness and visual attention to socially threatening stimuli across an extended subsequent period of time. Implications for intervention are considered.
Prior research has suggested that loneliness is associated with an implicit hypervigilance to social threats-an assumption in line with the evolutionary model of loneliness that indicates feeling ...socially isolated (or on the social perimeter) leads to increased attention and surveillance of the social world and an unwitting focus on self-preservation. Little is known, however, about the temporal dynamics for social threat (vs. nonsocial threat) in the lonely brains. We used high-density electrical neuroimaging and a behavioral task including social and nonsocial threat (and neutral) pictures to investigate the brain dynamics of implicit processing for social threat vs. nonsocial threat stimuli in lonely participants (N = 10), compared to nonlonely individuals (N = 9). The present study provides evidence that social threat images are differentiated from nonsocial threat stimuli more quickly in the lonely (~116 ms after stimulus onset) than nonlonely (~252 ms after stimulus onset) brains. That speed of threat processing in lonely individuals is in accord with the evolutionary model of loneliness. Brain source estimates expanded these results by suggesting that lonely (but not nonlonely) individuals showed early recruitment of brain areas involved in attention and self-representation.
Abstract
Background
Dehydration and malnutrition are common in hospitalised patients following stroke leading to poor outcomes including increased mortality. Little is known about hydration and ...nutrition care practices in hospital to avoid dehydration or malnutrition, and how these practices vary in different countries. This study sought to capture how the hydration and nutrition needs of patients’ post-stroke are assessed and managed in the United Kingdom (UK) and Australia (AUS).
Aim
To examine and compare current in-hospital hydration and nutrition care practice for patients with stroke in the UK and Australia.
Methods
A cross-sectional survey was conducted between April and November 2019. Questionnaires were mailed to stroke specialist nurses in UK and Australian hospitals providing post-stroke inpatient acute care or rehabilitation. Non-respondents were contacted up to five times.
Results
We received 150/174 (86%) completed surveys from hospitals in the UK, and 120/162 (74%) in Australia. Of the 270 responding hospitals, 96% reported undertaking assessment of hydration status during an admission, with nurses most likely to complete assessments (85%). The most common methods of admission assessment were visual assessment of the patient (UK 62%; AUS 58%), weight (UK 52%; AUS 52%), and body mass index (UK 47%; AUS 42%). Almost all (99%) sites reported that nutrition status was assessed at some point during admission, and these were mainly completed by nurses (91%). Use of standardised nutrition screening tools were more common in the UK (91%) than Australia (60%). Similar proportions of hydration management decisions were made by physicians (UK 84%; AUS 83%), and nutrition management decisions by dietitians (UK 98%; AUS 97%).
Conclusion
Despite broadly similar hydration and nutrition care practices after stroke in the UK and Australia, some variability was identified. Although nutrition assessment was more often informed by structured screening tools, the routine assessment of hydration was generally not. Nurses were responsible for assessment and monitoring, while dietitians and physicians undertook decision-making regarding management. Hydration care could be improved through the development of standardised assessment tools. This study highlights the need for increased implementation and use of evidence-based protocols in stroke hydration and nutrition care to improve patient outcomes.
The aim of this study was to identify key indicator symptoms and patient factors associated with correct out of hospital cardiac arrest (OHCA) dispatch allocation. In previous studies, from 3% to 62% ...of OHCAs are not recognised by Emergency Medical Service call handlers, resulting in delayed arrival at scene.
Retrospective, mixed methods study including all suspected or confirmed OHCA patients transferred to one acute hospital from its associated regional Emergency Medical Service in England from 1/7/2013 to 30/6/2014. Emergency Medical Service and hospital data, including voice recordings of EMS calls, were analysed to identify predictors of recognition of OHCA by call handlers. Logistic regression was used to explore the role of the most frequently occurring (key) indicator symptoms and characteristics in predicting a correct dispatch for patients with OHCA.
A total of 39,136 dispatches were made which resulted in transfer to the hospital within the study period, including 184 patients with OHCA. The use of the term 'Unconscious' plus one or more of symptoms 'Not breathing/Ineffective breathing/Noisy breathing' occurred in 79.8% of all OHCAs, but only 72.8% of OHCAs were correctly dispatched as such. 'Not breathing' was associated with recognition of OHCA by call handlers (Odds Ratio (OR) 3.76). The presence of key indicator symptoms 'Breathing' (OR 0.29), 'Reduced or fluctuating level of consciousness' (OR 0.24), abnormal pulse/heart rate (OR 0.26) and the characteristic 'Female patient' (OR 0.40) were associated with lack of recognition of OHCA by call handlers (p-values < 0.05).
There is a small proportion of calls in which cardiac arrest indicators are described but the call is not dispatched as such. Stricter adherence to dispatch protocols may improve call handlers' OHCA recognition. The existing dispatch protocol would not be improved by the addition of further terms as this would be at the expense of dispatch specificity.
Stroke is a leading cause of death and disability worldwide. Identifying the aetiology of ischaemic stroke is essential in order to initiate appropriate and timely secondary prevention measures to ...reduce the risk of recurrence. For the majority of ischaemic strokes, the aetiology can be readily identified, but in at least 30% of cases, the exact aetiology cannot be determined using existing investigative protocols. Such strokes are classed as 'cryptogenic' or as a stroke of unknown origin. However, there exists substantial variation in clinical practice when investigating cases of seemingly cryptogenic stroke, often reflecting local service availability and the preferences of treating clinicians. This variation in practice is compounded by the lack of international consensus as to the optimum level and timing of investigations required following a stroke. To address this gap, we aim to systematically review and compare recommendations in evidence-based clinical practice guidelines (CPGs) that relate to the assessment and investigation of the aetiology of ischaemic stroke, and any subsequent diagnosis of cryptogenic stroke.
We will search for CPGs using electronic databases (MEDLINE, Health Management Information Consortium (HMIC), EMBASE, and CINAHL), relevant websites and search engines (e.g. guideline specific websites, governmental, charitable, and professional practice organisations) and hand-searching of bibliographies and reference lists. Two reviewers will independently screen titles, abstracts and CPGs using a pre-defined relevance criteria form. From each included CPG, we will extract definitions and terms for cryptogenic stroke; recommendations related to assessment and investigation of the aetiology of stroke, including the grade of recommendations and underpinning evidence. The quality of the included CPGs will be assessed using the AGREE II (Appraisal of Guidelines for Research and Evaluation) tool. Recommendations across the CPGs will be summarised descriptively highlighting areas of convergence and divergence between CPGs.
To our knowledge, this will be the first review to systematically compare recommendations of international CPGs on investigating the aetiology of ischaemic stroke. The findings will allow for a better understanding of international perspectives on the optimum level of investigations required following a stroke and thus contribute to achieving greater international consensus on best practice in this important and complex area.
PROSPERO CRD42019127822.
Emotional intelligence (EI) may promote wellbeing through facilitation of adaptive attentional processing patterns. In the current study, a total of 54 adults (43 females, mean age = 25 years, ...SD = 10 years) completed a Trait Emotional Intelligence (TEI) scale and took part in three eye-tracking tasks, where they viewed (1) faces with different emotions (happy, angry, fearful, neutral), (2) 16-face crowds with varying ratios of happy to angry faces, and (3) 4 visual scenes (physical threat, social threat, positive social, neutral). Findings showed that higher TEI was associated with more attention to positive emotional stimuli (happy faces, positive social scenes), relative to negative and neutral stimuli. An attentional preference for positive rather than negative emotional stimuli may be one way that TEI affords protection from stressors to promote mental health.
•We need to understand how trait Emotional Intelligence (TEI) relates to attention.•The association between TEI and viewing patterns was tested using eye-tracking.•Higher TEI predicted greater fixation on positive emotional stimuli.•Results help explain why high TEI predicts higher levels of wellbeing and happiness.
A current theoretical model (Cacioppo & Hawkley, 2009) proposes that lonely people are hypervigilant (i.e. on high alert) to social threats in the social environment. This leads to attention, memory, ...and confirmatory biases, which undermine the opportunity to develop positive social relationships. This thesis outlines a series of six studies that systematically examine the hypervigilance to social threat hypothesis in loneliness using adult samples. The studies described in this thesis make an original contribution to the loneliness literature and uses different experimental paradigms to examine whether lonely adults are hypervigilant to social threats that are visually presented. Studies 1 and 5 bridge the gap in the current knowledge to examine the visual attention processing of lonely adults to social threat depicted as social rejection stimuli using eye-tracker methodology. Study 2 investigates whether loneliness is associated to eye-gaze and emotion processing utilising a cognitive paradigm. Studies 3 and 4 extend the literature on visual attention processing of lonely adults to investigate the processing of emotional information depicted as facial expressions using eye-tracker methodology. Specifically, study 3 uses a paradigm of four different emotional expressions (i.e. anger, afraid, happy and neutral), and study 4 utilises a face in a crowd paradigm for which different ratios of happy to angry faces were presented. Study 6 extends the work on hypervigilance to social threats depicted as social rejection stimuli to examine how these stimuli are processed by lonely adults in the brain using EEG methodology. Findings from study 1 and 5 suggest that lonely adults show visual attentional biases to social threat stimuli linked to social rejection. Specifically, study 1 findings indicate that lonely adults show a hypervigilance-avoidance pattern of processing towards social rejection stimuli, whilst study 5 findings indicate that lonely adults show disengagement difficulties when processing social rejection stimuli. Study 2 indicates that loneliness is not associated to eye-gaze and emotion processing. Study 3 and 4 provide support that lonely adults are more attentive to angry facial expressions presented as static images. Findings from study 6 indicate that lonely adults detect and process social threats quickly compared to non-social threats in the brain. As outlined in Cacioppo and Hawkley’s theoretical model, the findings of this thesis support the idea that loneliness is related to initial cognitive processes. Specifically, lonely adults are hypervigilant to social threats depicted as angry facial expressions and social rejection stimuli. Thus, the thesis examines an important process within the model. The findings of the thesis can be used to inform ideas for future academic and intervention work in the loneliness field.
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