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Social Isolation and Loneliness Among Older Asian Immigrants Through the Lens of Sense of Coherence: Systematic Review of Qualitative Studies

ABSTRACT

Aim

To explore the meaning older Asian immigrants attribute to social isolation and loneliness, their management strategies, utilisation of resources and impact on health.

Design

Systematic review of qualitative studies.

Data Sources

AgeLine, CINAHL, MEDLINE, ProQuest, PsycINFO, Scopus, and Web of Science databases were searched in September 2024.

Methods

Inclusion criteria: participants were Asian immigrants to Western countries aged 65 and over, community-living and experiencing social isolation and loneliness. Antonovsky's Sense of Coherence was used to frame the thematic analysis.

Results

Ten papers were included and analysed deductively using elements of the sense of coherence framework: • Comprehensibility: Social isolation and loneliness are viewed as multifaceted, influenced by cultural and environmental dislocation, language barriers, intergenerational conflicts, deteriorating health and mobility, and socioeconomic challenges. • Manageability: included engaging in culture-specific community programs, family and ethnic community support and living within ethnic enclaves mitigated isolation and loneliness. • Meaningfulness: Strong family ties, active community involvement, spirituality, volunteerism, and cultural practices fostered resilience. However, accepting the changing values of their new world, living independently, and carving their own niche provided meaning to their transformed reality.

Conclusion

Older Asian immigrants experience social isolation and loneliness through a cultural lens, shaped by migration experiences, language barriers, and shifting family dynamics. Cultural roots, family ties, spirituality, community, acceptance, and independence enhance sense of coherence. Recognising the dynamic interplay between cultural identity, resilience, and adaptation is key to understanding their lived experience.

Implications for the Profession and Patient Care

This review informs culturally sensitive interventions, guiding healthcare, community services, and policy to support social participation, mitigate loneliness through ethno-specific activities, and improve the quality of life for aging immigrant populations in Western countries.

Reporting Method

The review was undertaken and reported using the PRISMA guidelines.

Patient or Public Involvement

None.

Protocol Registration

PROSPERO (CRD42023425752)

Impacts of Financial Stress on Mental Health and Wellbeing of Nursing Students: A Systematic Integrative Review

ABSTRACT

Aim

To explore the direct relationship between financial stress and mental health and wellbeing of nursing students and characterise the effectiveness of available support mechanisms.

Design

Systematic integrative review.

Data Sources

Academic Search Complete, CINAHL, Education Research Complete, MEDLINE, ProQuest Central, PsycNET, Scopus and Web of Science were searched in January and October 2024.

Methods

Studies reporting a direct relationship between financial stress and mental health and wellbeing in nursing students were included. Data related to sources of financial stress, mental health impacts, and support mechanisms were extracted, synthesised narratively, and reported thematically.

Results

Findings from nine studies reveal that financial stress significantly affects nursing students' mental health and wellbeing, contributing to emotional distress and reduced quality of life. Financial stress arises from personal, academic and clinical sources, with the intensity varying based on individual demographic profiles and fluctuating throughout their educational journeys. Marginalised and underserved groups experience greater impacts due to pre-existing disadvantages. Current support mechanisms are largely reactive, providing only short-term relief and failing to address root causes. Additionally, students' efforts to alleviate financial stress in one domain often exacerbated it in another.

Conclusion

This review highlights the multifaceted and compounding effects of financial stress on nursing students' mental health and wellbeing. Proactive strategies, including structured employment programs, embedded financial literacy education, and transparent pre-enrolment information offer promising solutions.

Implications for the Profession

While financial stress cannot be fully eradicated, targeted support for at-risk students can mitigate its impacts, improving their mental health and educational outcomes.

Impact

This review addresses the critical issue of financial stress among nursing students, highlighting its disproportionate impact on marginalised and underserved groups. It underscores the need for proactive interventions and systemic reform to improve educational experiences globally.

Reporting Method

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Statement.

Patient or Public Contribution

No patient or public contribution.

Trial Registration: PROSPERO: CRD42024514262

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