School of Rehabilitation Science,McMaster University,Hamilton,Ontario,Canada.
Intergo,Laval,Quebec,Canada.
Int Psychogeriatr. 2019 Mar;31(3):393-415. doi: 10.1017/S1041610218000972. Epub 2018 Jul 11.
ABSTRACTBackground:Major life transitions can negatively impact the emotional well-being of older people. This study examined the effectiveness of interventions that target the three most common transitions in later life, namely bereavement, retirement, and relocation.
A systematic search was performed via MEDLINE, EMBASE, CINAHL, Cochrane Library, PsycINFO, and reference lists of retrieved non-randomized and randomized controlled trials (RCTs) in English that studied the effectiveness of interventions addressing the three transitions in those >50 years of age. Two researchers independently selected the publications, piloted the data extraction form, and critically appraised studies specific to transition type and study design.
A total of 11 studies (bereavement: 7; retirement: 2; relocation: 2) of 8 unique interventions met the inclusion criteria of which nine were RCTs and two were of quasi-experimental designs were reviewed. Six studies were group-based interventions, three studies used individualized sessions, and one intervention used a combination of group and individualized programming. Group size varied (20-32 participants), as did qualifications of those administering the interventions. The methodological quality of included studies was weak. Findings suggest that group-based approaches provided by trained personnel can mitigate the negative health-related consequences associated with major transitions in later life.
Evidence concerning interventions that address mental health challenges associated with these major transitions is limited. Future research should better characterize participants at study outset and use validated measures to capture effectiveness. Use of peer mentorship to navigate such transitions is promising, but given the small number of studies and their methodological weaknesses, further research on effectiveness is warranted.
背景：重大生活转变可能对老年人的情绪健康产生负面影响。本研究旨在检验针对老年人生活中最常见的三种转变（丧亲、退休和搬迁）的干预措施的有效性。
通过 MEDLINE、EMBASE、CINAHL、Cochrane 图书馆、PsycINFO 以及英语非随机和随机对照试验（RCT）的参考文献列表进行系统检索，以研究针对年龄在 50 岁以上的人群的三种转变的干预措施的有效性。两名研究人员独立选择出版物，试用数据提取表格，并对特定于转变类型和研究设计的研究进行批判性评估。
共有 11 项研究（丧亲：7 项；退休：2 项；搬迁：2 项）符合纳入标准，其中 9 项为 RCT，2 项为准实验设计。有 6 项研究为基于小组的干预措施，3 项研究采用个体化的方案，1 项干预措施采用小组和个体化方案的组合。小组规模不同（20-32 名参与者），实施干预措施的人员的资质也不同。纳入研究的方法学质量较弱。研究结果表明，由经过培训的人员提供的基于小组的方法可以减轻与老年人重大转变相关的负面健康相关后果。
关于解决这些重大转变相关的心理健康挑战的干预措施的证据有限。未来的研究应在研究开始时更好地描述参与者，并使用经过验证的措施来衡量效果。利用朋辈指导来应对这些转变是有前途的，但由于研究数量较少且方法学上存在弱点，因此需要进一步研究其有效性。
