La soledad en la vejezanálisis y evaluación de un programa de intervención en personas mayores que viven solas

Résumé

ABSTRACT: People who age alone are more likely to suffer loneliness, and this psychological experience compromises their quality of life and active and healthy ageing. The latest advances in the study of loneliness in this population have shown that psychosocial factors such as causal attributions, perceived control, and social participation determine the development and maintenance of loneliness in old age and, therefore, they have indicated that interventions to combat loneliness must be oriented to intervene in these factors. These findings demonstrate the influence that the individual's way of processing information has on the development of loneliness, as defended by Peplau and Perlman's (1979) model of cognitive discrepancy. Considering this scientific evidence and the traditional way of addressing loneliness in our country from the viewpoint of volunteerism, the “Acompaña-Té” (Accompany-You) Program was designed. This is a university volunteerism program in which volunteers, duly trained through a theoretical and practical course, applied a 3-component psychosocial accompaniment intervention (conversational, attributional retraining, and behavioral activation). The intervention is aimed at improving perceived control to deal with loneliness and increase the social participation of older people living alone in Elche, in order to reduce and/or prevent their loneliness and promote active and healthy aging. The main objective of this thesis study is to determine the impact on the participants’ loneliness, perceived control, and social participation of the psychosocial accompaniment intervention applied through the Acompaña-Té Program (n = 20) and to analyze, also, how the meaning and causal attributions of loneliness influence the outcomes obtained in loneliness from a mixed methodological approach. A mixed, nested design was conducted, with a primary quasi-experimental design, quantitative study, with pre-post measurements without a control group, to determine the changes in the study variables after the intervention. For this purpose, pre-post mean scores were compared with t-tests for related samples, estimating the effect size in the variables with significant changes. On another hand, two secondary qualitative studies were nested, one carried out before the intervention to determine the meaning and experience of loneliness for the participants, and subsequently a second study to determine the benefits after participation in the program, the data of which were examined through thematic analysis. The results showed that the participants' loneliness remained stable after the accompaniment intervention, but from the integration of quantitative and qualitative results, it was observed that the meaning and causal attributions of loneliness seemed to influence the results. Thus, people who interpreted loneliness positively or neutrally benefited from the intervention, improving their loneliness and/or perceived control to cope with this feeling. People who attributed their loneliness to internal and to self-controllable factors also improved their loneliness and perceived control after the intervention. Through comparison of means, significant and important changes in perceived control were found because, after the intervention, self-efficacy for aging, self-efficacy to deal with various areas of aging (health, cognitive, physical-functional and socio-emotional areas), and self-efficacy to cope with loneliness in old age all improved. However, we found no changes in social participation. Participants stated that the intervention had provided multiple benefits, grouped into four thematic areas: 1) learning and personal development, 2) psychological and emotional benefits, 3) social participation and 4) a link with the volunteer and, therefore, they were highly satisfied with the Acompaña-Té Program. Thus, supporting the model of Peplau and Perlman (1979), the results of this study suggested that cognitive aspects such as the interpretation of loneliness, causal attributions, and perceived control were variables that influenced the participants' experience of loneliness and the results of the Program on this experience. On another hand, the difficulties to assess the outcomes of intervention programs with older people in real contexts are discussed, and future lines of research with the program are proposed. Drawing on the studies integrated in this research, it is concluded that the psychosocial accompaniment intervention of the Acompaña-Té Program was effective to improve the participants' control beliefs to cope with loneliness in old age and to deal with aging in an active and healthy way. Control beliefs should be therefore a target of interventions on loneliness in old age. It is also concluded that the stability of loneliness is related to the participants' unique experience of loneliness, so their assessment is recommended to understand the results of future intervention programs and the trajectories of loneliness in this population.