The impact of depression and sense of coherence on emotional and social loneliness among nursing home residents without cognitive impairment – a questionnaire survey

AIMS AND OBJECTIVES: To analyse the relationships between depressive symptoms, sense of coherence and emotional and social loneliness among nursing home residents without cognitive impairment. BACKGROUND: Depression symptoms and loneliness are major health problems for older people. Sense of coherence, which is based on a salutogenic theoretical framework, is a strong determinant of positive health and successful coping and is associated with well-being and depression among older people. Few studies have explored the relationships between depression symptoms, sense of coherence and emotional and social loneliness among nursing home residents. DESIGN: A cross-sectional, descriptive, correlational design. METHODS: Sample - 227 residents 65-102 years old from 30 nursing home residing ≥ six months. All had a Clinical Dementia Rating ≤ 0·5 and could converse. Residents were interviewed using the Social Provisions Scale, Geriatric Depression Scale and Sense of Coherence Scale (SOC-13). Possible relationships between these were analysed, controlled for sex, age, marital status, education, length of stay and comorbidity. RESULTS: Before adjustment, Geriatric Depression Scale was associated with attachment and social integration. After adjustment, Geriatric Depression Scale was still associated with attachment and social integration. Further adjusting for Sense of Coherence Scale reduced the association between Geriatric Depression Scale and attachment and even more so for the association between Geriatric Depression Scale and social integration. Sense of coherence and Geriatric Depression Scale did not interact, and SOC-13 was associated with attachment and social integration. CONCLUSIONS: Depression symptoms contribute to emotional and social loneliness. Independent of sense of coherence, depression symptoms are associated with emotional loneliness, sense of coherence influence emotional and social loneliness. RELEVANCE TO CLINICAL PRACTICE: Clinical nurses should observe residents closely for signs of depression and loneliness and support their sense of coherence to reduce emotional and social loneliness.