The nexus or linkages between loneliness, stigma, health complaints, and primary medical care in older New Zealanders was explored from a social constructionist perspective. The intent of the studies was the support and explanation of the underlying arguments of the thesis. For this age group loneliness is a clinical condition which merits greater recognition, diagnosis, and treatment from general practitioners than it presently receives. As a society we silence and stigmatise loneliness in our senior citizens making it likely that they will present indirectly to their doctors when experiencing severe effects of the condition. This behaviour will increase their risk of inappropriate medical intervention at possible cost to themselves and to society. A cross sectional, randomly selected survey of 300 New Zealanders over 60 years old, aimed to establish the patterns of loneliness in the sample using quantitative analysis. The second qualitative study used the methodology of discourse analysis to identify the themes concerning loneliness and medical care in the accounts of older adults, and how these were used. Fourteen people, deemed by their doctors to be lonely and to need frequent medical care, were interviewed in order to further knowledge of the dynamics of loneliness and the medical encounter. Fifteen percent of the sample of 300 had moderate to severe loneliness scores. The sociodemographic indicators of loneliness were extremely easy for a practitioner to recognize. Less than 2% of the total of self reported doctor visits were explicitly for loneliness. According to Barsky's (1981) model, the most likely pathways to the doctor were through symptom amplification and lowered self ratings of health, with a less likely pathway through focusing on and worrying about symptoms, leading to perceived need for medical care. The predictive variances in regressions of loneliness on all health outcomes, except for self reported visiting of more than one doctor for symptoms, were lower for chronic than for situational loneliness. The most important conclusions from the second study were the identification of three rhetorical strategies or "etcetera clauses" which provided a social prescription for the indirect presentation of loneliness by older people. Loneliness may be discussed with the doctor; if it affects your physical health; if you are consulting for another reason; and if the doctor picks it up. Also, the individual doctor defines loneliness as a worthy, or non-worthy, condition for consultation.
| Identifer | oai:union.ndltd.org:ADTP/275478 |
| Date | January 1997 |
| Creators | Hector-Taylor, Loma Helen |
| Publisher | ResearchSpace@Auckland |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
| Rights | Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated., http://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm, Copyright: The author |
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