Loneliness in long-term Taiwanese expatriates and domestic residents in the COVID-19 era: A cross-sectional study.

BACKGROUND/AIM: This study aimed to assess the loneliness in long-term expatriates during the COVID-19 pandemic.

METHODS

This retrospective, cross-sectional study distributed an online structured questionnaire through the website and health education events of the New Southbound Health Center, established by Taiwan's CDC. The target population was Taiwanese employees expatriated to Southeast Asian countries and domestic employees, aged 20 years and older. From August 2022 to August 2023, the data of 22 long-term expatriates and 64 domestic employees were included. Outcomes of interest included distress, measured by the Brief Symptom Rating Scale-5 (BSRS-5), and loneliness, measured by the UCLA Three-Item Loneliness Scale (UT-ILS). Other relevant factors examined included demographic data, expatriate status, social factors, psychological factors, and pandemic-related factors. Logistic regression analysis was employed to identify predictors and protectors of loneliness and distress.

RESULTS

Loneliness (UT-ILS ≥4) was significantly higher among expatriates (77.3 %) than domestic residents (46.9 %; P = 0.014). Multivariable analysis revealed that higher psychological distress (OR = 1.19, p = 0.001), greater impact of the pandemic (OR = 3.19, p = 0.036), and fewer relatives contacted monthly (OR = 0.82, p = 0.04) predicted loneliness. Additionally, sub-analysis found that higher levels of self-esteem (OR = 5.49, p = 0.003) and less social support (OR = 0.80, p = 0.004) independently predicted psychological distress (BSRS-5 ≥ 6).

CONCLUSIONS

Psychological distress, greater impact of the pandemic, and fewer relatives contacted monthly are associated with loneliness in expatriates and residents during the COVID-19 pandemic. Social support has a protective effect against psychological distress.