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AJN, American Journal of Nursing:
doi: 10.1097/01.NAJ.0000434175.17418.6e
Feature Articles

CE Test 2.5 Hours: Loneliness and Quality of Life in Chronically Ill Rural Older Adults

Contrada, Emily

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To present the details of a study done to learn more about the prevalence of loneliness in rural older adults with chronic illness and how it affects their quality of life

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After reading this article and taking this test, you will be able to

* recognize the background information provided here for context, in order to enhance understanding of the need for the authors’ study of loneliness and quality of life in chronically ill rural older adults.

* identify the characteristics of the participants in the authors’ study.

* name the authors’ recommendations for this population.

1. According to Peplau, loneliness is a condition that is

a. manageable.

b. rooted in depression.

c. unbearable.

d. a chosen state.

2. The recent health and social sciences literature recognizes loneliness as a phenomenon with two components, social and

a. emotional.

b. biochemical.

c. intellectual.

d. cognitive.

3. Because of its association with neuroimmunological stress responses and other mechanisms, it's believed that loneliness may be linked to multiple chronic illnesses. In women, these include which of the following?

a. endometriosis

b. fibrocystic breasts

c. hyperthyroidism

d. coronary heart disease

4. Lonely adults are more likely to

a. exercise obsessively.

b. use tobacco.

c. use relaxation techniques.

d. have overall obesity.

5. Molloy and colleagues found that as the frequency of loneliness increased, the odds of which of the following also increased?

a. unplanned emergency hospitalization

b. social and emotional withdrawal

c. use of mental health services

d. alcohol abuse

6. In a Swedish study of frail elderly people, Jakobsson and colleagues found that high use of inpatient services was correlated with relatively high scores on which of the following measures?

a. life satisfaction

b. cognitive function

c. social network

d. depression

7. Of the following factors, which has been linked to loneliness and, according to the U.S. Department of Agriculture, is more common among people in rural areas?

a. poverty

b. isolation

c. slower paced lifestyle

d. occupational illness

8. A study by Davis and Magilvy exploring how rural older adults experience chronic illness found that participants especially valued which of the following?

a. higher education

b. life satisfaction

c. self-reliance

d. health care access

9. The prevalence rate of loneliness nationally is about 17%. In comparison, in the authors’ study sample of rural older adults, it was

a. 58%.

b. 76%.

c. 85%.

d. 97%.

10. Among the participants in the authors’ study, which of the following diagnoses was most prevalent?

a. arthritis

b. hypertension

c. diabetes

d. hyperlipidemia

11. What percentage of the participants were obese?

a. 40%

b. 50%

c. 60%

d. 70%

12. The participants took an average of how many prescription medications?

a. 5.5

b. 6.4

c. 7.3

d. 8.2

13. Participants with which of the following diagnoses had the highest loneliness scores?

a. hypertension

b. lung disease

c. heart disease

d. mood disorder

14. Participants with which of the following diagnoses had the lowest overall quality of life scores?

a. stroke

b. obesity

c. arthritis

d. cancer

15. The authors’ study found that loneliness correlated positively with

a. a mediocre quality of life.

b. the total number of prescription medications.

c. poorer chronic illness control.

d. the total number of chronic illnesses.

16. Of the following medication types, which was found to correlate significantly with both higher loneliness scores and lower quality of life scores?

a. diuretics

b. benzodiazepines

c. β-blockers

d. bronchodilators

17. For assessing patients for loneliness, the authors recommend using the Three-Item Loneliness Scale, which includes which of the following questions?

a. “How often do you feel left out?”

b. “How often do you feel you have no one to talk to?”

c. “How often do you feel yourself waiting for people to call you?”

d. “How often do you feel as if no one understands you?”

18. With colleagues, the authors recently completed a study evaluating an intervention based on principles of cognitive restructuring and story theory. Early results show that, compared with controls, participants in the story-sharing group demonstrated significant decreases in loneliness and

a. heart rate.

b. frequency of viral illnesses.

c. systolic blood pressure.

d. use of health care services.

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