Social network features among the community-dwelling elderly
A total of 380 participants was provided with a self-administered questionnaire, and 358 of them returned the questionnaire (return rate = 94.21%). After excluding incomplete questionnaires, there were 340 valid questionnaires for further statistical analysis (valid response rate = 89.47%). The respondents’ age ranged from 65 to 98 years with mean age of 75.6 years (SD = 7.7). Other demographic and characteristic data of the participants, including gender, level of education, marital status, among others, were shown in table 1.
According to the 340 valid questionnaires, 1067 persons were listed in the social network based on the time they spent with the participant in the last three months, though 12 questionnaires left a blank as the respondents claimed to have no social connections with others. We counted the roles of each listed person from first to fifth place separately. As shown in Figure 1, spouses occupy the highest proportion in and only in the first place, adult children mainly distribute in the first and second groups, while friends and neighbors have relatively high proportions across all places.
Peer network features among community-dwelling elderly
To figure out the specific proportions of peers in the elderly’s social network, we classified the listed persons into six categories: spouses, the parental generation, generation of children, grandchildren’s generation, peers (including friends, neighbors, previous colleagues, previous schoolmate, siblings and acquaintances) and others. The proportion of each category was presented in Figure 2. Overall, 67.10% of all people listed in social networks who have the most contact with the participants are their peers, which is significantly higher than the proportion of spouses (10.31%) and children (18.46%) of the elderly. Among the 717 peers listed in the survey, neighbors accounted for the highest proportion of 32.15%, followed by friends (19.87%) and previous colleges (7.69%).
In the final part of the quantitative analysis, we analyzed the characteristic of listed peers and the relevant detailed information about peer relationship features (Table 2). It seems that older people tend to engage with same-sex peers, as the majority (87.45%) of peers listed in the network are same-sex as participants. Besides, we calculated the differences in age between peers listed in social networks and participants. Strikingly, 57.44% of the 717 listed peers have the age differences within five years of age from the corresponding participants, and 85.47% of them are within ten years of age. Further, the majority (93.31%) of peer relationships have been established for more than three years, indicating that years known may be an essential influence factor for peer relationship among older adults.
Contact frequency and interaction type are important in maintaining close social relationships(LeBlanc, 2018). Among listed peer members, the frequency of interaction was predominantly daily (66.11%) and at least once a week (18.55%). The most common means of interaction was contacting in person (84.24%), followed by communicating on the telephone (7.81%) or through WeChat (7.95%). Besides, most (70.01%) relationships with peers are claimed to be somewhat close, with 20.08% of peers to be the most intimate, 9.90% not close. It is also apparent from table 2 that 89.96% of peers with whom the participants have most contact lived within an hour’s drive.
Nineteen older adults participated in the semi-structured interview without refusal or dropout. Table 1 presented the demographic characteristics of the interviewed persons. The participants ranged in age from 65 to 92 years (mean age = 77.8, SD = 8.07). Approximately half of the participants were widowed. 31.58% of the participants lived alone. Three key overarching themes were identified from the interviews as described below: perceived motivation for peer interactions, preference and perceived barriers on peer interaction, perceived impact on health by peer interaction. Participants were coded ‘P’ + an assigned number for a quotation.
The perceived motivation for peer interactions
Internal driving forces
Motivation is the starting point for peer-to-peer socialization, which consists of two categories: internal and external driving forces. According to what the participants said, we divided the internal driving forces into three sub-categories: fear of loneliness, fear of boredom, and missing for the peers.
The primary motivation for participants seeking peer interactions was the fear of loneliness. Loneliness is common at all stages of life, but many participants described that their loneliness increases with age. “(sigh)I used to have many colleagues and friends, but now I can't walk for a long time and don't go out to play with them anymore. Everyone is saying that people are lonely when they grow old. Sure, it is. Some people about my age have passed away, some have become sick, and some moved far away to live with their children. Once people can’t walk, there would be no friends…” (Female, P4)
At the same time, participants also stated that they tend to play with peers because it helps to fill in their spare time, otherwise they would get very bored. As one interviewee said, “It seemed like time went by faster when I was hanging out with my peer friends, chatting and joking with them. Usually, if I feel bored, I would go downstairs to run into my peer friends and play with them.” (Female, P16)
Another internal driving force for the elderly’s peer interaction was that they miss their peer friends very much. Participants expected to “keep in touch” with familiar peer friends or previous colleagues and share their current life events. One of the participants stated, “I have only been to Chongqing for two years and haven’t made many new friends…I have been quite familiar with people about my age in rural areas and don't want to come here…I want to go back to my hometown for some familiar ones and play with them…” (Female, P11)
External driving forces
Apart from internal driving forces, many external environment factors could also drive the elderly to interact with peers, such as shared interactive opportunities and family support.
Most interviewees started their relationships with peers because they frequently have opportunities to interact with each other due to their shared hobbies and interests, co-working experience, and geopolitical proximity. “I didn’t know these peers at first. I simply want to stay healthy and stay intact. When I routinely do tai-chi exercises with these peers, I gradually get familiar with them and make friends with them.” (Male, P6)
Another external factor that may drive older adults to interact with peers was family support. The supportive attitude and behavior of important family members will serve as the elderly’s motivation for peer interactions. “I now play mahjong with peers every day… Because my spouse passed away in May this year. My child has to work and has no time to accompany me. Therefore, they asked me to go outside to make a few peer friends and take part in some activities with them, such as mahjong or something else.” (Male, P19)
Preference and perceived barriers to peer interaction
Preference for interactions with peers
All participants stated that peer interaction is essential for them, and nearly three-fourth (14/19) of them showed a preference to get involved with peers rather than their adult children. “Generally speaking, I don’t like playing with people who are much younger or older than me. I’d like to play with people who are basically about my age. Whenever I meet with my peer friends, we have a lot to talk about, for instance, talking about going somewhere to play together next time. However, I don’t have much to talk with my child, and if I call him out to play together, he will simply refuse.” (Female, P2)
Some individuals even denied their children’s invitation to relocate to their children's community or city and live together because that may sacrifice their peer interactions with familiar peers. “I know they (adult children) worry about me, but I don’t want to leave here to live with them. Their living environment is better, and the house is bigger than mine, but I know no people around their house. Instead, I’m familiar with all the friends of the same age here and have been with them for many years.” (Female, P16)
Perceived barriers of peer interaction
Despite the importance of peer interaction for the elderly, there are still a lot of perceived barriers in reality. “It hard to build a new friendship with peers in old age” was frequently cited as the main barriers to the older people. “A lot of peers like to play cards, but I don't like it. It makes me uncomfortable sitting all the time. I used to go out for walks with Chen XX and Ma XX, but now Chen XX has a disease and was too thin and frail to go out. Ma XX moved to another place, and I was unable to see him. Also, there are still some people of my age who like to go out and sit on the side of the road to sunbathe, sit and drink tea, but I know very few of them.” (Male, P1)
Besides, “It’s hard to build solid peer friendship in old age” was also a commonly reported constraint on peer interaction. For many, there was a perception that most peers’ relationship was not as deep as they want. “I feel like I have a deeper and more intimate relationship with my former peer friends. For example, although I left my hometown for Chongqing, my friends in my hometown will still try their best to help me, and some of them even spend their own money to do things for me. I don’t think my current peer friends have that deep relationship with me. They are all ok on the surface, and there are no conflicts in getting along. However, few friends are willing to help and close to me as friends in my hometown.” (Male, P19)
The impact of peer interaction on the individual’ health
Perceived promotion of psychological health
The perceived impact of peer interaction on health includes improved psychological health and improved physical condition. The participants frequently mentioned that they feel pleasure and comfortable with diminished negative emotions after having a good time with their peers. “After my spouse passed away, I always walked with my peer downstairs in the community. They persuaded me and comforted me—Don’t be so sad, please! You have cared for him for so long, and there was no pity. Each time they persuaded me, I felt much better and not that sad anymore.” (Female, P18) The interaction with peers was regarded as a leading source of happiness and subjective well-being, which will promote their psychological health, “Everyone sits and chats together every day, and there is no contradiction between us. If you want to say anything, just say that without the necessity to worry about something else. Of course, we feel happy.” (Male, P17)
Perceived promotion of physical health
What’s more, participants stated that peer interaction provides essential benefits to their physical health. The elderly mentioned that through communicating with peers, they exchanged information about health problems and healthy life style, resulting in improved health-related awareness and behaviors. “Peer interaction is very important, and communication is good for us to keep healthy. For example, we usually talk about diseases everyone has and how to treat and prevent it. Sometimes we discuss how to stay healthy and live a happy life in old age.” (Male, P13) “After the square dance with peers every day, I feel extremely relaxed and get my body stretched. Then I go home and take a bath. It makes me sleep soundly.” (Female, P9)