Interventions targeting social isolation in older people: a systematic review.
Interventions targeting social isolation in older people: a systematic review.
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DOI：
10.1186/1471-2458-11-647
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发表时间：
2011-08-15
影响因子：
4.5
通讯作者：
Campbell JL
中科院分区：
文献类型：
--
作者：
Dickens AP;Richards SH;Greaves CJ;Campbell JL
针对老年人的社会孤立是一个日益令人关注的公共卫生问题。近几十年来，社会中老年人的比例有所增加，据估计，在未来20至40年内，约有25%的人口将达到60岁或以上。社会孤立在老年人中很普遍，有证据表明它可能对健康和福祉产生有害影响。本综述的目的是评估旨在减轻老年人社会隔离和孤独感的干预措施的有效性。相关的电子数据库（MEDLINE， EMBASE， ASSIA， IBSS, PsycINFO, PubMed， DARE, Social Care Online， Cochrane Library和CINAHL）使用广泛的搜索策略系统地检索了2009年5月之前发表的英文随机对照试验和准实验研究。通过引文跟踪确定了其他文章。如果研究与老年人有关，如果干预旨在减轻社会孤立和孤独感，如果干预参与者与不活跃的对照组进行比较，如果报告了治疗效果，则纳入研究。两名独立的审稿人使用标准化表格提取数据。采用叙事综合和计票方法总结和解释研究数据。本综述纳入了32项研究。有证据表明，所提供的干预措施存在很大的异质性，所纳入研究的总体质量表明存在中至高偏倚风险。在社会、心理和身体健康三个领域，79%的基于群体的干预措施和55%的一对一干预措施报告至少有一项参与者的结果得到改善。超过80%的参与性干预措施在相同领域产生了有益效果，而非参与性干预措施的这一比例为44%。在被归类为具有理论基础的干预措施中，87%的干预措施报告了三个领域的有益效果，而在没有明显理论基础的干预措施中，这一比例为59%。就干预类型而言，86%的提供活动和80%的提供支持的人改善了参与者的结果，相比之下，60%的家访和25%的互联网培训干预。在明确针对社会孤立或孤独老年人的干预措施中，58%的干预措施报告了积极的结果，而在没有明确目标的研究中，这一比例为80%。此外，还需要对缓解社会孤立的社会干预措施的有效性进行良好的研究，以改善证据基础。然而，有效干预措施的共同特征似乎是那些在理论基础的背景下发展起来的干预措施，以及那些在群体形式下提供社会活动和/或支持的干预措施。老年人积极参与的干预措施似乎也更有可能有效。因此，纳入所有这些特征的未来干预措施可能会更成功地解决老年人的社会孤立问题。
Targeting social isolation in older people is a growing public health concern. The proportion of older people in society has increased in recent decades, and it is estimated that approximately 25% of the population will be aged 60 or above within the next 20 to 40 years. Social isolation is prevalent amongst older people and evidence indicates the detrimental effect that it can have on health and wellbeing. The aim of this review was to assess the effectiveness of interventions designed to alleviate social isolation and loneliness in older people. Relevant electronic databases (MEDLINE, EMBASE, ASSIA, IBSS, PsycINFO, PubMed, DARE, Social Care Online, the Cochrane Library and CINAHL) were systematically searched using an extensive search strategy, for randomised controlled trials and quasi-experimental studies published in English before May 2009. Additional articles were identified through citation tracking. Studies were included if they related to older people, if the intervention aimed to alleviate social isolation and loneliness, if intervention participants were compared against inactive controls and, if treatment effects were reported. Two independent reviewers extracted data using a standardised form. Narrative synthesis and vote-counting methods were used to summarise and interpret study data. Thirty two studies were included in the review. There was evidence of substantial heterogeneity in the interventions delivered and the overall quality of included studies indicated a medium to high risk of bias. Across the three domains of social, mental and physical health, 79% of group-based interventions and 55% of one-to-one interventions reported at least one improved participant outcome. Over 80% of participatory interventions produced beneficial effects across the same domains, compared with 44% of those categorised as non-participatory. Of interventions categorised as having a theoretical basis, 87% reported beneficial effects across the three domains compared with 59% of interventions with no evident theoretical foundation. Regarding intervention type, 86% of those providing activities and 80% of those providing support resulted in improved participant outcomes, compared with 60% of home visiting and 25% of internet training interventions. Fifty eight percent of interventions that explicitly targeted socially isolated or lonely older people reported positive outcomes, compared with 80% of studies with no explicit targeting. More, well-conducted studies of the effectiveness of social interventions for alleviating social isolation are needed to improve the evidence base. However, it appeared that common characteristics of effective interventions were those developed within the context of a theoretical basis, and those offering social activity and/or support within a group format. Interventions in which older people are active participants also appeared more likely to be effective. Future interventions incorporating all of these characteristics may therefore be more successful in targeting social isolation in older people.
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DOI：
10.2190/6aqx-1tdm-del4-3t6l
发表时间：
1983-01-01
影响因子：
2
作者：
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通讯作者：
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影响因子：
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影响因子：
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