Foundations of Research Inquiry in Health

Question: What is social isolation like for older people? Answer: Foundations of Research Background: According to Dickens et al. (2011), social isolation is considered as a one of the most important topics in health-related researches. Recently this issue gets the lime light of the media and attracting lots of people because of its high rates of increase. According to the study of Steptoe et al. (2013), it is found that a large number of people in this society are the victims of social isolation. However, it is also found that the older people of the society are the more vulnerable group of this threat than the others (Shankar et al. 2011). Although many researchers try to define the reasons behind the isolations of this group of people through their extensive research studies it is recognized that there are so many factors played as variables as the reason of isolation of the older people, it is hard for the researchers to define, which are the important one. Therefore, the research of this article carefully developed the research question with the help of PICO format. The research question, which is developed with the help of PICO format, is as follows- What is social isolation like for older people? This research question can be considered with importance in the context of the nursing practice due to its severity and the impact of human health. According to the study of (Cacioppo, Hawkley and Thisted 2010), the health consequences of the social isolation are a matter of great concern. The majority of the research studies showed that the social isolation can lead towards several health risks even the death of the victim has been reported. According to Ahmed, and Haboubi (2010), older people are the main victim of social isolation as they are mostly overlooked by their families because of their poor health and feeble memories. According to the research study of Luo et al. (2012), it is found that the older people who are abandoned by their family are mostly suffering from health issues than those who are having the kindest attention of their families. It is also found from the research studies that the older people who have Alzheimer and dementia are mostly avoided by the society. The impact of social stigma is so heavier in their life that they catch up more health issues, mainly depression, which leads them to the deterioration of their health and eventually towards an unwelcome death. Therefore, it can be said that picking up this research question is justified to find out the impact of the social isolation on the older people, especially those who are mentally ill. Database search string: PICO is one of the most helpful to identify the search terminology and form a research question, after answering which the researcher can enlighten the truth and find the interventions. The PICO terms used to develop the questions are as follows- P=Patient, Participants, Problem, Population I= Intervention (Prognostic Factor, Exposure) C= Comparison O= Outcomes Older people Social Isolation - Wellbeing Keywords: The keywords identified with PICO are as follows- Impacts of social isolation on older people Older people and Social Isolation Truncation: In this search string ! is used as a truncation to find a root word and other terms that can be formed by using letters to the end. The is used as follows- Older people and socio!- This search terminology finds the results with- older people with social stigma, older people with social issues and older people with social isolation. Wildcards: In this search string * is used to hold space for other characters and form search terminology such as- Older people Soc*** isolation- which covered older people with socio isolation and older people with sociocultural Abbreviations: No abbreviations were used in the search strategy Boolean Operators: AND is used as one of the most important Boolean Operators in the search string in the following way- Older people and social isolation. Results List of five relevant research articles- Boulos, C., Salameh, P. Barberger-Gateau, P. 2016, "Social isolation and risk for malnutrition among older people: Social isolation and malnutrition",Geriatrics Gerontology International,, pp. n/a. Dickens, A.P., Richards, S.H., Greaves, C.J. Campbell, J.L. 2011, "Interventions targeting social isolation in older people: a systematic review",BMC public health, 11, no. 1, pp. 647-647. Kono, A., Tadaka, E., Kanaya, Y., Dai, Y., Itoi, W. Imamatsu, Y. 2012, "Development of a community commitment scale with cross-sectional survey validation for preventing social isolation in older Japanese people",BMC public health, 12, no. 1, pp. 903. VICTOR, C.R., SCAMBLER, S.J., BOWLING, A. BOND, J. 2005, "The prevalence of, and risk factors for, loneliness in later life: a survey of older people in Great Britain",Ageing and Society, 25, no. 6, pp. 357-375. Hawton, A., Green, C., Dickens, A.P., Richards, S.H., Taylor, R.S., Edwards, R., Greaves, C.J. Campbell, J.L. 2011, "The impact of social isolation on the health status and health-related quality of life of older people",Quality of Life Research, 20, no. 1, pp. 57-67. Table 1. Peer-reviewed Research Articles Article Reference (authors and publication date) Study Design (i.e., ethnography, cohort, RCT phenomenology,) Population (how many participants, age, gender, disease, etc.) Intervention OR Issue (what was being implemented or studied) Comparison If relevant (what was the intervention compared against?) Outcomes (what were the main findings of the study?) 1 Boulos, C., Salameh, P. Barberger-Gateau, P. 2016 A cohort study was performed by the researchers to find out the impact of social isolation on the older people. To perform the study, 1200 randomly selected older people (65) were included in the study from the rural areas of Lebanon. In this study the researchers interviewed the older people about their isolation and if they are deprived of the food facilities. The issue focused in this study is the malnutrition among the older people as a result of social isolation. In this study, the researchers did not compare any interventions. The result of the study reflects that the social isolation is highly related with the increasing malnutrition risks among the older people. However, they were unable to find any relationship between the risk of malnutrition and frequency of sharing of meals. 2 Dickens, A.P., Richards, S.H., Greaves, C.J. Campbell, J.L. 2011 Secondary research was performed to find out a proper intervention step for the older people who are suffering social isolation. More than 7067 papers were analysed by the researchers and evidence were collected. The following types of interventions procedures were used in this study- BCI (Bereavement crisis intervention), SAI (Social adjustment intervention). The researchers of this study compared the interventions between the randomised group and the control group From the study, it is found overall increment in social network helped to decrease the impact of social isolation 3 Kono, A., Tadaka, E., Kanaya, Y., Dai, Y., Itoi, W. Imamatsu, Y. 2012 A pilot test was performed by the researchers, which was followed by a cohort study. In this research populations of two local governments (Matsubara and Daito) were included in this study. The total number of participant of this is 859 In this paper, the researchers focused on the interventions (CCS) in a community to prevent social isolation among the older Japanese people. In this study, the researchers did not compare any interventions between the control group and study group. The result of the research study showed that the intervention (CCS) used by the researcher in this study have validity and is capable of helping the older people who are the victim of social isolation. 4 VICTOR, C.R., SCAMBLER, S.J., BOWLING, A. BOND, J. 2005 A cohort study had been performed by the researchers with the help of face to face interview to find out the risk factors of the social isolation among the older people. For this study, 999 participants were selected who are aged more than 65 years old and live in their home. In this research study, the researchers were focused on the prevalence of the risk factors, which are related with the loneliness of the older people. In this study, the researchers did not compare any interventions between the control group and study group. The result showed the risk factors related to health increases due to the loneliness and social isolation of the older people. 5 Hawton, A., Green, C., Dickens, A.P., Richards, S.H., Taylor, R.S., Edwards, R., Greaves, C.J. Campbell, J.L. 2011 A cohort study had been performed by the researchers to find out the impact of social isolation on the health status of the older people. For this study, 393 participants were selected by the researchers based on inclusion criteria. In this study, the researchers focused on the impact of social isolation on the health of older people. In this study, the researchers did not compare any interventions between the control group and study group. As the result of this study, the researchers showed the degree of clinical attendance increases among the older people with the increase of social isolation. Discussion According to Hawkley and Cacioppo (2010), the Academy of Medical-Surgical Nurses (AMSN) considers EBP (evidenced based practice) is the best way to develop best patient care. The impact of EBP is already proved as very helpful in the nursing practice. From the research study of Cacioppo et al. (2011), it is found that the patient outcomes can be improved immensely with the significant help of evidence-based practices. However, the use of evidence-based practice is a time-consuming method and needs extensive search knowledge. To perform evidence-based practices first, it is important to develop a research question, answering which the researcher can meet the target of the research or fulfil the research purpose. I found that the use of PICO format was extensively helpful to develop an ideal research question. An ideal research question should be consists of four parts such as the participants/ patients, Interventions/ issues, Comparison and outcomes. While developing the research ques tion, I found PICO format is efficient as it helped to identify each of the elements of the research question, such as older people, social isolation and the wellbeing of the older people. Therefore, I can say that the formation of research question helped me to enrich my knowledge about the current health care issues and find out proper interventions for the patients. On the other hand, while developing the research string, I gathered knowledge how to use the Keywords, Truncation, Abbreviations, Wildcards and Boolean operators. With the help of proper search terminology, I managed to find five most relevant papers that helped me to find out the answers to the research question. To analyse those papers, I have used a table format, which helped me to analyse each of the important sections of the research paper in a proper way. The identification of related research not only helped me to find out the answer to the research question but also helped me to enrich my knowledge about the s elected health-related issue. From the articles, I found that the social isolation has a deep impact on the health of the victims. I also found recognized that the older people are the most vulnerable towards social isolation. The associated research articles enriched my knowledge about the interventions that can be taken by the community members to help the older people who are the victim of social isolation. In addition, with evidence now I know the severity of the social isolation among the old people. The evidence I have gathered after reviewing the associated current journals are indeed helpful to take or promote proper interventions to help the older people who are vulnerable towards the social isolation (Perissinotto, Cenzer and Covinsky 2012). While searching the relevant papers with the help of appropriate search terminology I found a handful of papers where the researchers compared the impact of social isolation with the loneliness of the older people, which in turn enrich ed my knowledge about the topic and encouraged me to perform EBP in an extensive way. Reference Ahmed, T. and Haboubi, N., 2010. Assessment and management of nutrition in older people and its importance to health.Clin Interv Aging,5(1), pp.207-16. Boulos, C., Salameh, P. Barberger-Gateau, P. 2016, "Social isolation and risk for malnutrition among older people: Social isolation and malnutrition",Geriatrics Gerontology International,, pp. n/a. Cacioppo, J.T., Hawkley, L.C. and Thisted, R.A., 2010. Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study.Psychology and aging,25(2), p.453. Cacioppo, J.T., Hawkley, L.C., Norman, G.J. and Berntson, G.G., 2011. Social isolation.Annals of the New York Academy of Sciences,1231(1), pp.17-22. Dickens, A.P., Richards, S.H., Greaves, C.J. and Campbell, J.L., 2011. Interventions targeting social isolation in older people: a systematic review.BMC public health,11(1), p.1. Dickens, A.P., Richards, S.H., Greaves, C.J. Campbell, J.L. 2011, "Interventions targeting social isolation in older people: a systematic review",BMC public health,vol. 11, no. 1, pp. 647-647. Hawkley, L.C. and Cacioppo, J.T., 2010. Loneliness matters: A theoretical and empirical review of consequences and mechanisms.Annals of Behavioral Medicine,40(2), pp.218-227. Hawton, A., Green, C., Dickens, A.P., Richards, S.H., Taylor, R.S., Edwards, R., Greaves, C.J. Campbell, J.L. 2011, "The impact of social isolation on the health status and health-related quality of life of older people",Quality of Life Research,vol. 20, no. 1, pp. 57-67. Kono, A., Tadaka, E., Kanaya, Y., Dai, Y., Itoi, W. Imamatsu, Y. 2012, "Development of a community commitment scale with cross-sectional survey validation for preventing social isolation in older Japanese people",BMC public health,vol. 12, no. 1, pp. 903. Luo, Y., Hawkley, L.C., Waite, L.J. and Cacioppo, J.T., 2012. Loneliness, health, and mortality in old age: A national longitudinal study.Social science medicine,74(6), pp.907-914. Perissinotto, C.M., Cenzer, I.S. and Covinsky, K.E., 2012. Loneliness in older persons: a predictor of functional decline and death.Archives of internal medicine,172(14), pp.1078-1084. Shankar, A., McMunn, A., Banks, J. and Steptoe, A., 2011. Loneliness, social isolation, and behavioral and biological health indicators in older adults.Health Psychology,30(4), p.377. Steptoe, A., Shankar, A., Demakakos, P. and Wardle, J., 2013. Social isolation, loneliness, and all-cause mortality in older men and women.Proceedings of the National Academy of Sciences,110(15), pp.5797-5801. VICTOR, C.R., SCAMBLER, S.J., BOWLING, A. BOND, J. 2005, "The prevalence of, and risk factors for, loneliness in later life: a survey of older people in Great Britain",Ageing and Society,vol. 25, no. 6, pp. 357-375.