Community-based mental health and well-being interventions for older adults in low- and middle-income countries: a systematic review and meta-analysis.
Community-based mental health and well-being interventions for older adults in low- and middle-income countries: a systematic review and meta-analysis.
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DOI：
10.1186/s12877-022-03453-1
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发表时间：
2022-09-29
期刊：
影响因子：
4.1
通讯作者：
Gabbay, Mark
中科院分区：
文献类型：
--
作者：
Giebel, Clarissa;Shrestha, Nipun;Reilly, Siobhan;White, Ross G.;Zuluaga, Maria Isabel;Saldarriaga, Gabriel;Liu, Ginger;Allen, Dawn;Gabbay, Mark
低收入和中等收入国家 (LMIC) 往往缺乏心理健康支持，心理健康受到污名化。老年人是社会中最脆弱的成员之一，可能需要特定类型的心理健康支持。这项混合方法系统评价和荟萃分析的目的是探讨针对中低收入国家老年人（60岁以上）的基于社会心理社区的心理健康干预措施的类型、组成部分和功效。 2021 年 8 月检索了六个数据库。自 2000 年以来发表的研究如果收集了有关改善中低收入国家老年人心理健康的社区干预措施的主要定量或定性数据，则纳入其中，重点是改善心理健康和福祉结果。全文由两名研究人员筛选。在确定的 24,378 篇引用中，有 40 项研究符合资格标准。在 12 个国家中，干预措施分为以下几类：(1) 既定形式的心理治疗； (2)锻炼； (3) 教育； （四）社会参与； (5)多组分。大多数干预措施可以有效降低抑郁、焦虑水平并改善幸福感，包括回忆疗法、不同类型的社交以及呼吸和大笑练习。一些干预措施没有报告任何益处，而那些有时有效果的干预措施在随访中也未能报告持续的益处。鉴于干预类型和实施方式、文化和所使用的结果衡量标准的差异，很难确定干预成功或失败的支撑因素。针对中低收入国家老年人的心理社会干预措施需要根据文化和人口需求适应当地情况。现有的干预措施及其组成部分可以作为制定适应性和多组成部分干预措施的基础，以解决中低收入国家精神卫生保健服务日益增长和不足的问题。审查方案已在 PROSPERO 上注册 [CRD42021271404]。在线版本包含可在 10.1186/s12877-022-03453-1 获取的补充材料。
Mental health support is often scarce in low- and middle-income countries (LMIC), with mental health stigmatised. Older adults are some of the most vulnerable members of society and may require specific types of mental health support. The aim of this mixed-methods systematic review and meta-analysis was to explore the types, components, and efficacy of psychosocial community-based mental health interventions for older adults (aged 60 + years) residing in LMIC. Six databases were searched in August 2021. Studies published since 2000 were included if they collected primary quantitative or qualitative data on community-based interventions for improving mental health for older adults residing in LMICs, focusing on improving mental health and well-being outcomes. Full texts were screened by two researchers. From 24,378 citations identified, 40 studies met eligibility criteria. Across 12 countries, interventions were categorised into those focusing on (1) Established forms of psychological therapy; (2) Exercise; (3) Education; (4) Social engagement; (5) Multi-component. Most interventions were effective in reducing levels of depression, anxiety, and improving well-being, including reminiscence therapy, different types of socialising, and breathing and laughter exercises. Some interventions reported no benefits and those that did at times failed to report continued benefits at follow-up. Given the variations in intervention type and delivery, cultures, and outcome measures used, underpinning factors of intervention success or failure were difficult to establish. Psychosocial interventions for older adults in LMIC need to be adapted to local contexts depending on culture and population needs. Existing interventions and their components can be used as a foundation to produce adapted and multi-component interventions, to tackle growing and inadequate mental health care provision in LMIC. The review protocol was registered on PROSPERO [CRD42021271404]. The online version contains supplementary material available at 10.1186/s12877-022-03453-1.
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