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Research ArticleOriginal Research

Social Isolation and Patient Experience in Older Adults

Takuya Aoki, Yosuke Yamamoto, Tatsuyoshi Ikenoue, Yuka Urushibara-Miyachi, Morito Kise, Yasuki Fujinuma and Shunichi Fukuhara
The Annals of Family Medicine September 2018, 16 (5) 393-398; DOI: https://doi.org/10.1370/afm.2257
Takuya Aoki
1Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
MD, MMA
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Yosuke Yamamoto
1Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
MD, PhD
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Tatsuyoshi Ikenoue
1Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
MD, MPH
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Yuka Urushibara-Miyachi
2Medical Education Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
MD, MHPE
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Morito Kise
3Centre for Family Medicine Development, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
MD
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Yasuki Fujinuma
3Centre for Family Medicine Development, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
MD
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Shunichi Fukuhara
1Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
4Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan
5Department of General Medicine, Shirakawa Satellite for Teaching And Research (STAR), Fukushima Medical University, Fukushima, Japan
MD, DMSc, MACP
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  • For correspondence: fukuhara.shunichi.6m@kyoto-u.ac.jp
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Abstract

PURPOSE Social isolation has been identified as a major health problem, particularly in the elderly. In the present study, we examine the association between social isolation and patient experience in elderly primary care patients.

METHODS This cross-sectional study was conducted in a primary care practice–based research network (28 clinics) in Japan. We assessed social isolation using an abbreviated Lubben Social Network Scale and patient experience of primary care using a Japanese version of the Primary Care Assessment Tool (JPCAT), which comprises 6 domains: first contact, longitudinality, coordination, comprehensiveness (services available), comprehensiveness (services provided), and community orientation. We used a linear mixed effects model to adjust clustering within clinics and individual covariates.

RESULTS Data were analyzed for 465 elderly primary care patients aged ≥65 years. After adjustment for possible confounders and clustering within clinics, social isolation was negatively associated with the JPCAT total score, (mean difference = −3.67; 95% CI, −7.00 to −0.38). Among the JPCAT domain scores, social isolation was significantly associated with longitudinality, comprehensiveness (service provided), and community orientation scores.

CONCLUSIONS Social isolation was associated with negative patient experience in elderly primary care patients. Raising awareness regarding patient social networks among primary care providers and targeted interventions for socially isolated elderly patients aimed at improving the experience of primary care, especially regarding longitudinality, comprehensiveness, and community orientation, may be warranted.

Key words
  • social isolation
  • social capital
  • primary care/general practice
  • patient experience
  • Received for publication November 5, 2017.
  • Revision received February 27, 2018.
  • Accepted for publication March 22, 2018.
  • © 2018 Annals of Family Medicine, Inc.
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The Annals of Family Medicine: 16 (5)
The Annals of Family Medicine: 16 (5)
Vol. 16, Issue 5
September/October 2018
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Social Isolation and Patient Experience in Older Adults
Takuya Aoki, Yosuke Yamamoto, Tatsuyoshi Ikenoue, Yuka Urushibara-Miyachi, Morito Kise, Yasuki Fujinuma, Shunichi Fukuhara
The Annals of Family Medicine Sep 2018, 16 (5) 393-398; DOI: 10.1370/afm.2257

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Social Isolation and Patient Experience in Older Adults
Takuya Aoki, Yosuke Yamamoto, Tatsuyoshi Ikenoue, Yuka Urushibara-Miyachi, Morito Kise, Yasuki Fujinuma, Shunichi Fukuhara
The Annals of Family Medicine Sep 2018, 16 (5) 393-398; DOI: 10.1370/afm.2257
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Subjects

  • Domains of illness & health:
    • Mental health
  • Person groups:
    • Older adults
    • Vulnerable populations
  • Methods:
    • Quantitative methods
  • Other research types:
    • Health services
  • Core values of primary care:
    • Continuity
    • Comprehensiveness
  • Other topics:
    • Social / cultural context

Keywords

  • social isolation
  • social capital
  • primary care/general practice
  • patient experience

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