Perceived Social Isolation, Self-Care Behaviors and Health Status among Community Dwelling Older Adults Living Alone

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Lithong Phatharapreeyakul, RN, MNS
Phachongchit Kraithaworn, RN, PhD
Noppawan Piaseu, RN, APN, PhD


OBJECTIVE: To study and analyze the links among basic conditioning factors, perceived social isolation, self-care behaviors and health status of community dwelling older adults living alone.

MATERIAL AND METHOD: This study was a descriptive correlational research. The samples were 212 community dwelling older adults living alone in Sa Kaeo Province, Thailand. The data were collected by structured interviews and were analyzed using descriptive statistics, Pearson’s Product Moment Correlation statistics and Chi-square test.

RESULTS: The perceived social isolation of the samples was at a moderate level (62.7%) while that of the self-care behaviors was at a fair level (55.2%). Also, both perceived physical status and mental health status were both at a high level (50.5% and 60.8%, respectively). The perceived social isolation had statistically signifi cant negative correlation with self-care behaviors (r = -0.518, p < 0.001) and the perceived physical health status (r = -0.249, p < 0.001) and the perceived mental health (r = -0.364, p < 0.001). The basic factors which were statistically signifi cant correlated with the perceived social isolation was education (χ2= 6.194, p = 0.045) and income (χ2 = 17.489, p < 0.001). Self-care behaviors were statistically signifi cant associated with age (r = -0.236, p < 0.001), gender (χ2 = 9.288, p = 0.01), education (χ2 = 10.255, p = 0.006) and income χ2 = 21.414, p < 0.001). The perceived physical health status was statistically signifi cant associated with age (r = -0.328, p < 0.001), income (χ2 = 14.584, p = 0.001) and health problems (χ2 = 9.726, p = 0.008). The perceived mental health status was statistically signifi cant associated with age (r = -0.238, p < 0.001) and income (χ2 = 23.309, p < 0.001).

CONCLUSION: It can be concluded that there were links among basic conditioning factors, the perceived social isolation, self-care behaviors and health status of the community dwelling older adults living alone. Thus, in assessing the health status and promoting self-care behaviors that are appropriate for this group of older adults, these factors should be taken into account, especially the older adults who have a low income and are poorly educated.


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Phatharapreeyakul L, Kraithaworn P, Piaseu N. Perceived Social Isolation, Self-Care Behaviors and Health Status among Community Dwelling Older Adults Living Alone. BKK Med J [Internet]. 2016Feb.19 [cited 2020Jul.15];11(1):17. Available from:
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1. Sasipat Yodpet. Long - term care system for older persons in family. Bangkok: Mister Copy; 2006. (in Thai).
2. National Statistical Office. Executive summary for administrator 2013.(Accessed October 25, 2014 at https://
3. National Statistical Office. Health care behaviors 2011. (Accessed October 30, 2011 at nso/daata/02/woe_article47.html)
4. Martsut R. Health status and self-care behavior of the elderly living alone at Kalasin Municipalty, Kalasin Province (Thesis Master of Nursing Science). Chonburi: Burapha University;2011.
5. Faulkner KA, Cauley JA, Zmuda JM, et al. Is social isolation integration associated with the risk of falling in older community-dwelling women? J Gerontol A Biol Sci Med Sci 2003;58:954-9.
6. Gurley RJ, Lum N, Sande M, et al. Persons found in their homes helpless or dead. N Eng J Med 2001;334:1710-6.
7. Routasalo PE, Savikko N, Tilvis RS, et al. Social contacts and the relationship to loneliness among aged people-A population-based study. Gerontology 2006;52:181-7.
8. Chou KL, Chi I. Comparison between Chinese living alone and those living with others. J Gerontol Soc 2000;33:51-6.
9. Fratiglioni L, Paillard-Borg S, Winblad, B. An active and socially integrated lifestyle in late life might protect against dementia: A community-based longitudinal study. Lancet Neurol 2004;35:343-53.
10. Cacioppo JT, Hughes ME, Waite LJ, et al. Loneliness as a specific risk factor for depressive symptoms: cross-sec- tional and longitudinal analyses. Psychol Aging 2006; 21:140 -51.
11. Alpass, FM, Neville S. Loneliness, health and depression in older males. Aging Ment Health 2003;7:212-6.
12. Prakotwong W. Factors predicting feeling of loneliness among living alone (Thesis Master of Nursing Science). Phitsanulok: Naresuan University; 2009.
13. Berkman LF, Glass T, Brissette I, et al. From social integration to health: Durkheim in the new millennium. Soc Sci Med 2000;51:843-57.
14. Cornwell EY, Waite LJ. Social disconnectedness, per- ceived isolation, and health among older adults. J Health Soc Behav 2009;50;31-48.
15. Yeh SL, Lo SK. Living alone, social support, and feeling among the elderly. Soc Behav and Personality 2004; 32:129-38.
16. Iliffe S, Kharicha KR, Harari D, et al. Health risk appraisal in older people2: The implications for clinicians and commissioners of social isolation risk in older people. Br J Gen Prac 2007;57:277-82.
17. Mui AC, Burnette JD. A comparative profile of frail elderly persons living alone and those living with others. J Gerontol Soc Wor 1994;21:5-26.
18. Jitapunkul S, Lailert C. Mini-Mental Status Examination: is it appropriate for screening in Thai elderly? J Med Assoc Thai 1997 ;80:116-20.
19. Thinkerd W. Effects of self-care behavior promotion program for the elderly (Thesis Master of Education). Chonburi: Burapha University; 2002.
20. Ware JE, Sherbourne CD. The MOS 36-item short form health survey(SF-36): I. conceptual framework and item selection. Med Care 1992;30:473-83.
21. Jirarattanaphochai K, Jung S, Sumananont C, et al. Reliability of the medical outcomes study short-form survey version 2.0 (Thai version) for evaluation of low back pain patients. J Med Assoc Thai 2005;88:1355-61.
22. Orem DE. Nursing: Concept of Practice. 5th ed. St. Louis: Mosby; 1995.
23. Orem DE. Nursing: Concept of Practice. 6th ed. St. Louis: Mosby; 2001.
24. Zhou Y, Zhou L, Fu C, et al. Socio- economic factors related with the subjective well-being of the rural elderly people living indepently in China. Int J Equity Health 2015;14:5.
25. House JS. Work stress and social support. MA: Addison- Welsley; 1981.
26. Bai YL, Chiou CP, Chang YY. Self- care behavior and related factors in older people with type2 diabetes. J Clinical Nurs 2009;18:3308-15.
27. Smith KV, Goldman N. Socioeconomic differences in health among older adults in Mexico. Soc Sci Med 2007;65:1372-85.
28. Hawthorne G. Perceived social isolation in a community sample: its prevalence and correlates with aspects people’s lives. Soc psychiatr and psychiatr epidemiol 2008;43:140-50.
29. Burnette D, Mui AC, Zodikoff BD. Gender, self-care and functional status among older persons with coronary heart disease: A national perspective. Women Health 2004; 39:65-84.
30. Klamrat K. Casual factors of health behavior of elderly in Western region of Thailand (Thesis of Doctoral of Education). Bangkok: Silapakorn University; 2011.
31. Dale B, Soderhamn U, Soderhamn O. Self- care ability among home- dwelling older people in rural area in southern Norway. Scand J Car Sci 2012;26:113-22.
32. Caetano SC, Silva CM, Vettore MV. Gender differences in the association of perceived social support and social network with self- rated health status older adults: a popu- lation- based study in Brazil, BMC Geriatr 2013;13:122-36.
33. Sundsli K, Soderhamn U, Espnes GA, et al. Ability for self- care in urban living older people in southern Norway. J Multidiscip Healthc 2012;5:85-95.