Jenkinson Caroline E, Dickens Andy P, Jones Kerry, Thompson-Coon Jo, Taylor Rod S, Rogers Morwenna, Bambra Clare L, Lang Iain, Richards Suzanne H
Primary Care, University of Exeter Medical School, Smeall Building, St Luke's Campus, Exeter EX1 2LU, UK.
BMC Public Health. 2013 Aug 23;13:773. doi: 10.1186/1471-2458-13-773.
Volunteering has been advocated by the United Nations, and American and European governments as a way to engage people in their local communities and improve social capital, with the potential for public health benefits such as improving wellbeing and decreasing health inequalities. Furthermore, the US Corporation for National and Community Service Strategic Plan for 2011-2015 focused on increasing the impact of national service on community needs, supporting volunteers' wellbeing, and prioritising recruitment and engagement of underrepresented populations. The aims of this review were to examine the effect of formal volunteering on volunteers' physical and mental health and survival, and to explore the influence of volunteering type and intensity on health outcomes.
Experimental and cohort studies comparing the physical and mental health outcomes and mortality of a volunteering group to a non-volunteering group were identified from twelve electronic databases (Cochrane Library, Medline, Embase, PsychINFO, CINAHL, ERIC, HMIC, SSCI, ASSIA, Social Care Online, Social Policy and Practice) and citation tracking in January 2013. No language, country or date restrictions were applied. Data synthesis was based on vote counting and random effects meta-analysis of mortality risk ratios.
Forty papers were selected: five randomised controlled trials (RCTs, seven papers); four non-RCTs; and 17 cohort studies (29 papers). Cohort studies showed volunteering had favourable effects on depression, life satisfaction, wellbeing but not on physical health. These findings were not confirmed by experimental studies. Meta-analysis of five cohort studies found volunteers to be at lower risk of mortality (risk ratio: 0.78; 95% CI: 0.66, 0.90). There was insufficient evidence to demonstrate a consistent influence of volunteering type or intensity on outcomes.
Observational evidence suggested that volunteering may benefit mental health and survival although the causal mechanisms remain unclear. Consequently, there was limited robustly designed research to guide the development of volunteering as a public health promotion intervention. Future studies should explicitly map intervention design to clear health outcomes as well as use pragmatic RCT methodology to test effects.
志愿服务得到了联合国以及美国和欧洲各国政府的倡导，被视为一种让人们融入当地社区并提升社会资本的方式，具有改善福祉和减少健康不平等现象等潜在的公共卫生益处。此外，美国国家与社区服务公司2011 - 2015年战略计划着重于增强国家服务对社区需求的影响、支持志愿者的福祉，并将招募和吸引代表性不足的人群作为优先事项。本综述的目的是研究正式志愿服务对志愿者身心健康及生存的影响，并探讨志愿服务类型和强度对健康结果的影响。
通过检索12个电子数据库（考克兰图书馆、医学索引数据库、荷兰医学文摘数据库、心理学文摘数据库、护理学与健康领域数据库、教育资源信息中心数据库、英国健康管理与信息数据库、社会科学引文索引数据库、亚洲社会科学索引数据库、社会关怀在线数据库、社会政策与实践数据库）以及2013年1月的引文追踪，确定了比较志愿服务组与非志愿服务组身心健康结果及死亡率的实验性研究和队列研究。未设置语言、国家或日期限制。数据综合基于对死亡风险比的点数法计数和随机效应荟萃分析。
共筛选出40篇论文：5项随机对照试验（随机对照试验，7篇论文）；4项非随机对照试验；以及l7项队列研究（29篇论文）。队列研究表明志愿服务对抑郁、生活满意度、福祉有积极影响，但对身体健康没有影响。实验性研究未证实这些发现。对5项队列研究的荟萃分析发现志愿者的死亡风险较低（风险比：0.78；95%置信区间：0.66，0.90）。没有足够的证据表明志愿服务类型或强度对结果存在一致的影响。
观察性证据表明志愿服务可能有益于心理健康和生存，尽管其因果机制尚不清楚。因此，用于指导将志愿服务发展为一种公共卫生促进干预措施的设计完善的研究有限。未来的研究应明确将干预设计与明确的健康结果相对应，并采用实用的随机对照试验方法来检验效果。
