Coll-Planas Laura, Del Valle Gómez Gabriela, Bonilla Petra, Masat Teresa, Puig Teresa, Monteserin Rosa
Fundació Salut i Envelliment (Foundation on Health and Ageing), Universitat Autònoma de Barcelona, Barcelona, Spain.
IIB Sant Pau, Barcelona, Spain.
Health Soc Care Community. 2017 Jan;25(1):145-157. doi: 10.1111/hsc.12284. Epub 2015 Oct 1.
Loneliness is especially frequent among older people in Southern Europe. Furthermore, promoting social capital to tackle loneliness and its health effects is an understudied intervention strategy. Therefore, a complex intervention was piloted in Spain in a pre-post study with a 2-year follow-up. Its aims were to explore the feasibility of the intervention and its short- and long-term effects. It was conducted in one mixed rural-urban and two urban areas of diverse socioeconomic levels from 2011 to 2012. The intervention framework was based on social capital theory applying a behaviour change model and care co-ordination. The intervention comprised: (i) a co-ordinated action aimed at building a network between primary healthcare centres and community assets in the neighbourhood and (ii) a group-based programme, which promoted social capital among lonely older people, especially social support and participation. Older people active in senior centres volunteered as gatekeepers. The main outcome domain was loneliness. Secondary outcome domains were participation, social support, self-perceived health, quality of life, depressive symptoms and use of health resources. Pre-post changes were assessed with t-test, Wilcoxon signed-rank test and McNemar's test. Differences between the three time points were assessed with a one-way ANOVA with repeated measures. Social workers and nurses were successfully involved as group leaders, 10 volunteers took part and 38 participants were included. After the intervention, loneliness decreased while social participation and support significantly increased. Furthermore, the number of visits to nurses increased. Exactly 65.8% of the participants built social contacts within the group and 47.4% became engaged in new activities. Two years later, social effects were maintained and depressive symptoms had decreased. Exactly 44.7% of the participants continued to be in contact with at least one person from the group and 39.5% continued participating. The intervention contributes a novel and feasible social capital-based approach for alleviating loneliness among older adults while prompting meaningful changes in their lives.
孤独在南欧老年人中尤为常见。此外，促进社会资本以应对孤独及其对健康的影响是一种研究不足的干预策略。因此，在西班牙进行了一项前后对照研究，并进行了为期两年的随访，以试点一项复杂干预措施。其目的是探讨该干预措施的可行性及其短期和长期效果。该研究于2011年至2012年在一个城乡混合地区和两个社会经济水平不同的城市地区进行。干预框架基于社会资本理论，应用行为改变模型和护理协调。干预措施包括：（i）一项旨在在初级医疗保健中心与社区邻里资产之间建立网络的协调行动；（ii）一个基于群体的项目，该项目促进孤独老年人之间的社会资本，特别是社会支持和参与。活跃在老年中心的老年人自愿担任守门人。主要结果领域是孤独感。次要结果领域包括参与度、社会支持、自我感知健康、生活质量、抑郁症状和卫生资源使用情况。前后变化采用t检验、Wilcoxon符号秩检验和McNemar检验进行评估。三个时间点之间的差异采用重复测量的单因素方差分析进行评估。社会工作者和护士成功参与担任组长，10名志愿者参与其中，共纳入38名参与者。干预后，孤独感降低，而社会参与和支持显著增加。此外，看护士的次数增加了。确切地说，65.8%的参与者在小组内建立了社会联系，47.4%的参与者参与了新的活动。两年后，社会效果得以维持，抑郁症状有所减轻。确切地说，44.7%的参与者继续与小组中的至少一人保持联系，39.5%的参与者继续参与。该干预措施为缓解老年人孤独感提供了一种新颖且可行的基于社会资本的方法，同时促使他们的生活发生有意义的变化。
