Loneliness before and during the COVID-19 pandemic: A systematic review with meta-analysis.
Loneliness before and during the COVID-19 pandemic: A systematic review with meta-analysis.
复制标题
DOI：
10.1037/amp0001005
复制
发表时间：
2022-07
影响因子：
16.4
通讯作者：
Beutel, Manfred E
中科院分区：
文献类型：
--
作者：
Ernst, Mareike;Niederer, Daniel;Werner, Antonia M;Czaja, Sara J;Mikton, Christopher;Ong, Anthony D;Rosen, Tony;Brahler, Elmar;Beutel, Manfred E
COVID-19大流行和旨在缓解其影响的措施（如物理距离）已被讨论为孤独的风险因素，这增加了过早死亡和身心健康状况的风险。为了确定自大流行开始以来孤独感是否有所增加，本研究旨在以叙事和统计方式综合相关的高质量初步研究。该系统性综述和荟萃分析已在PROSPERO注册（ID CRD 42021246771）。检索的数据库包括PubMed、PsycINFO、科克伦图书馆/对照试验中心注册库/EMBASE/CINAHL、Web of Science、WHO COVID-19数据库，并辅以Google Scholar和引文检索（系统检索的截止日期为2021年5月12日）。从前瞻性研究中提取了总结数据，包括大流行之前和期间的孤独感评估。在检索到的6，850条记录中，纳入了34项研究（23项纵向研究，9项伪纵向研究，2项报告了两种设计），涉及215，026名受试者。使用ROBINS-I工具估计偏倚风险（RoB）。在随机效应荟萃分析中，计算连续孤独值的标准化均值差（SMD，Hedges' g）和孤独患病率的logOR作为合并效应量估计值。仅采用纵向设计的合并研究（总体N= 45，734），孤独评分（19项研究，SMD=0.27 [95%置信区间=0.14-0.40]，Z=4.02，p<0.001，I2=98%）和患病率（8项研究，logOR=0.33 [0.04-0.62]，Z=2.25，p= 0.02，I2=96%）相对于大流行前时期增加，效应量较小。研究的总体RoB、伪纵向设计、大流行前评估的时间和临床人群方面的结果是稳健的。影响的异质性表明，随着大流行的发展，有必要进一步调查风险和保护因素，以便为有针对性的干预措施提供信息。
The COVID-19 pandemic and measures aimed at its mitigation, such as physical distancing, have been discussed as risk factors for loneliness, which increases the risk of premature mortality and mental and physical health conditions. To ascertain whether loneliness has increased since the start of the pandemic, this study aimed to narratively and statistically synthesize relevant high-quality primary studies. This systematic review with meta-analysis was registered at PROSPERO (ID CRD42021246771). Searched databases were PubMed, PsycINFO, Cochrane Library/Central Register of Controlled Trials/EMBASE/CINAHL, Web of Science, the WHO COVID-19 Database, supplemented by Google Scholar and citation searching (cutoff date of the systematic search 05/12/2021). Summary data from prospective research including loneliness assessments before and during the pandemic were extracted. Of 6,850 retrieved records, 34 studies (23 longitudinal, 9 pseudo-longitudinal, 2 reporting both designs) on 215,026 participants were included. Risk of bias (RoB) was estimated using the ROBINS-I tool. Standardized mean differences (SMD, Hedges’ g) for continuous loneliness values and logOR for loneliness prevalence rates were calculated as pooled effect size estimators in random-effects meta-analyses. Pooling studies with longitudinal designs only (overall N=45,734), loneliness scores (19 studies, SMD=0.27 [95% confidence interval=0.14–0.40], Z=4.02, p<.001, I2=98%) and prevalence rates (8 studies, logOR=0.33 [0.04–0.62], Z=2.25, p=.02, I2=96%) increased relative to pre-pandemic times with small effect sizes. Results were robust with respect to studies’ overall RoB, pseudo-longitudinal designs, timing of pre-pandemic assessments, and clinical populations. The heterogeneity of effects indicates a need to further investigate risk and protective factors as the pandemic progresses to inform targeted interventions.