Illness acceptance and community self-efficacy mediate the relationship between social isolation and loneliness among elderly people with Parkinson's Disease

Objective: In this study, we investigated the status quo of illness acceptance, community self-efficacy, and social isolation in elderly patients with Parkinson’s disease (PD). We explored the effects of illness acceptance and community self-efficacy on the relationship between social isolation and loneliness in patients with PD based on the self-regulation theory model. Methods: We selected elderly patients with PD from the outpatient department of two Grade iii-A hospitals in Guangdong Province through convenience sampling. We collected data using a general information questionnaire. We used the Lubben Social Network Scale, UCLA Loneliness Scale, Community’s Self-Efficacy Scale, and Acceptance of Illness Scale. Data were analyzed using descriptive statistics, Pearson’s correlation coefficient, and bootstrap sampling to test the multiple mediation model. Results: We recruited 142 elderly patients with PD. Their mean age was 69.30 years (standard deviation = 5.34, range from 60 to 89 years). Approximately 55.6% (n = 79) were male. The mean scores for community self-efficacy, social network, and illness acceptance were 11.03 ± 6.21, 13.29 ± 5.4, and 23.56 ± 6.871, respectively. Loneliness was negatively associated with illness acceptance (r = -0.536, p < 0.001) and community self-efficacy (r = -0.654, p < 0.001). The results of multiple mediation analysis indicated that illness acceptance (effect: -0.172, 95% confidence interval (CI) [-0.297, 0.067]) and community self-efficacy (effect: -0.271, 95% CI [-0.446, -0.115]) individually and collectively influenced the relationship between social isolation and loneliness (effect: -0.055, 95% CI [-0.105, -0.017]). The direct effect and mediating effect values accounted for 59.6% and 40.4% of the total effect value, respectively. Conclusion: Illness acceptance and community self-efficacy mediate the association between social isolation and loneliness. Interventions that help facilitate mutuality, illness acceptance, and community self-efficacy may help minimize the level of loneliness in patients with PD.