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COPE_PC Vignette #2

Read Vignette #2

Lisa and Dr. Fakhoury

Lisa is a 55-year-old woman living with her husband and two young adult sons in their own home. She has hypertension and osteoporosis. Her husband works long hours, and her sons are busy with their own lives, leaving Lisa feeling disconnected. Though she loves her family, she misses the vibrant social interactions she had with friends when her sons were younger.

While she values her role as a mother and wife, and despite a stable financial situation, she often feels lonely and isolated. Navigating family life, Lisa grapples with her isolation and yearns for deeper connections and a sense of belonging.

Lisa sees her family physician, Dr. Fakhoury, very occasionally to check her blood pressure but otherwise does not share with him how isolated she feels. Lisa thinks of herself as independent and feels guilty about disclosing her loneliness when she feels she is so lucky to have a good family.

After reading Vignette # 2, use your clinical expertise to reflect on what part of patient’s situation resulted in them experiencing social isolation.

When you have finished your reflection, click on the REVEAL button. This button reveals colour coded phrases to share the research evidence suggesting why the patient might be experiencing social isolation and their family physician’s perspective.





The following colour-coded phrases reveal the research evidence suggesting why this patient might be experiencing social isolation.

Self-perceived mental health: Feeling lonely and isolated , and feeling guilty can negatively impact self-perceived mental health, leading to increased stress and poorer health outcomes.

Community belonging: Feeling disconnected, yearning for deeper connections, and sense of belonging may associate with lack of community belonging. This sense of feeling disconnected or lonely is reported sometimes by people who live alone and sometimes by those who live with family members.

Organizations and activities: No longer attending her sons’ weekly hockey practices where she socialized with the other parents has meant that Lisa engages in fewer activities which is associated with increased social isolation.

Family physician’s response: This illustrates how Dr. Fakhoury could use a routine visit to check on Lisa’s overall wellbeing. Or Dr. Fakhoury may consider creating a space where Lisa feels more comfortable sharing her emotional wellbeing perhaps by gently asking about how she is feeling?

Consider if what you see in the REVEAL supports your clinical assessment. Did you identify other factors? Did Dr. Fakhoury’s response resonate with you? Did the REVEAL suggest new factors you had not considered? Did the family physician’s reponse resonate with you?

Click on the COPE_PC TOOL Simulation button. This button provides the COPE_PC Tool questions you may discuss with the patient to facilitate a discussion about social isolation.

Instructions for Vignette COPE_PC Tool Simulation


Imagine Lisa is your patient and is visiting today for routine checkup. You have noticed changes in Lisa and are concerned that she may be experiencing social isolation. You wonder how you might help Lisa. You ask Lisa if you can try the COPE_PC Tool, saying something perhaps like:

  • If Lisa agrees, think about how you might use the COPE_PC website:
    • Consider sharing the COPE_PC website computer screen with Lisa.
    • Would you start by showing Lisa the Infographic? the Resources pages? You find these webpages on the left-side navigation bar.
  • Now consider how you will use the COPE_PC Tool (provided below):
    • Will you go through all the questions?
    • Will you ask Lisa which questions she wants to answer? Will you decide to ask only some questions?
    • Will you share the research evidence that supports asking these questions?
    • Will you use the COPE_PC Tool just today or might you follow up at Lisa’s next appointment?
  • Answer the questions as a simulation exercise, choosing the answer that you see reflected in Lisa’s vignette.
    • Questions are colour-coded to indicate answers that reflect factors that protect someone from social isolation (orange colour) to items that may put someone at risk for social isolation (purple).
    • You can use the COPE_PC Tool to see if there are patterns of one colour which might indicate a longer conversation with Lisa – perhaps over multiple visits. Or you may see just a few questions that indicate a risk that you and Lisa decide to explore.
  • Once you have used the COPE_PC Tool for this vignette, please click on the “Go to the Next Vignette” button or use the left-side navigation bar at the top of this webpage to move to another vignette. Once you have reviewed the five vignettes, please click on the “Proceed to Finish COPE_PC Family Physician Education Module button found on the left-side navigation bar at the top of this webpage.

    • COPE_PC Tool Simulation


    In general, how is your mental health?

    Research indicates those who rate their self-rated mental health as ‘excellent’, ‘very good’ or ‘good’ are less likely to report experiencing social isolation than those who rate their mental health as ‘fair’ or ‘poor’.

    To what level do you consider yourself to be spiritual?

    Research indicates those who identify as ‘very spiritual’ or ‘moderately spiritual’ are less likely to report experiencing social isolation than those who identify as ‘not spiritual’ or ‘slightly spiritual’.

    Resilience #1 – I am able to adapt when changes occur

    Research indicates that the more resilient a person is, the less likely to report experiencing social isolation.

    Resilience #2 – I tend to bounce back after illness, injury, or other hardships.

    Research indicates the more resilient a person is, the less likely to report experiencing social isolation.

    How would you describe your sense of belonging to your local community?

    Research indicates those who identify as having a ‘very strong’ or “somewhat strong’ sense of community belonging are less likely to report experiencing social isolation than those who identify as ‘somewhat weak’ or ‘very weak’.

    How many places such as organizations, activities or clubs do you participate in or visit? Examples: Health care, clubs, community or senior centres, exercise facilities, restaurants, stores, places of worship, parks

    Research indicates the more places a person participates in or visits, the less likely they are to report experiencing social isolation.

    Do you use any social networking websites (e.g. Facebook) or apps (e.g. Zoom or Face Time) to communicate with friends and family?

    Research indicates those who use social networking websites are less likely to report experiencing social isolation than those who do not use social networking websites.