Centre of Excellence for Public Health, Centre for Public Health, Queen's University, Belfast, Northern Ireland.
BMC Public Health. 2020 Feb 14;20(1):129. doi: 10.1186/s12889-020-8251-6.
BACKGROUND: Loneliness and social isolation are growing public health concerns in our ageing society. Whilst these experiences occur across the life span, 50% of individuals aged over 60 are at risk of social isolation and one-third will experience some degree of loneliness later in life. The aim of this scoping review was to describe the range of interventions to reduce loneliness and social isolation among older adults that have been evaluated; in terms of intervention conceptualisation, categorisation, and components. METHODS: Three electronic databases (CINAHL, Embase and Medline) were systematically searched for relevant published reviews of interventions for loneliness and social isolation. Inclusion criteria were: review of any type, published in English, a target population of older people and reported data on the categorisation of loneliness and/or social isolation interventions. Data extracted included: categories of interventions and the reasoning underpinning this categorisation. The methodology framework proposed by Arskey and O'Malley and further developed by Levac, et al. was used to guide the scoping review process. RESULTS: A total of 33 reviews met the inclusion criteria, evaluating a range of interventions targeted at older people residing in the community or institutionalised settings. Authors of reviews included in this paper often used the same terms to categorise different intervention components and many did not provide a clear definition of these terms. There were inconsistent meanings attributed to intervention characteristics. Overall, interventions were commonly categorised on the basis of: 1) group or one-to-one delivery mode, 2) the goal of the intervention, and 3) the intervention type. Several authors replicated the categorisation system used in previous reviews. CONCLUSION: Many interventions have been developed to combat loneliness and social isolation among older people. The individuality of the experience of loneliness and isolation may cause difficulty in the delivery of standardised interventions. There is no one-size-fits-all approach to addressing loneliness or social isolation, and hence the need to tailor interventions to suit the needs of individuals, specific groups or the degree of loneliness experienced. Therefore, future research should be aimed at discerning what intervention works for whom, in what particular context and how.
背景:在老龄化社会中,孤独和社会隔离是日益严重的公共卫生问题。虽然这些经历发生在整个生命周期中,但超过 60 岁的人中有 50%面临社会隔离的风险,三分之一的人在晚年将经历某种程度的孤独。本范围综述的目的是描述已评估的旨在减少老年人孤独和社会隔离的各种干预措施,从干预措施的概念化、分类和组成方面进行描述。
方法:系统检索了 CINAHL、Embase 和 Medline 三个电子数据库,以查找有关孤独和社会隔离干预措施的相关已发表综述。纳入标准为:任何类型的综述,发表于英文期刊,目标人群为老年人,并且报告了孤独和/或社会隔离干预措施的分类数据。提取的数据包括:干预措施类别以及对这种分类的推理。使用 Arskey 和 O'Malley 提出的方法框架,并由 Levac 等人进一步发展,以指导范围综述过程。
结果:共有 33 篇综述符合纳入标准,评估了针对居住在社区或机构环境中的老年人的一系列干预措施。本文中纳入的综述作者经常使用相同的术语来分类不同的干预措施组成部分,而且许多人没有对这些术语给出明确的定义。干预措施特征的含义不一致。总体而言,干预措施通常基于以下三个方面进行分类:1)团体或一对一的交付模式;2)干预的目标;3)干预类型。一些作者复制了之前综述中使用的分类系统。
结论:已经开发了许多干预措施来对抗老年人的孤独和社会隔离。孤独和隔离的个体经历可能导致标准化干预措施的实施困难。解决孤独或社会隔离问题没有一刀切的方法,因此需要根据个人、特定群体或孤独程度的需要来调整干预措施。因此,未来的研究应该旨在确定哪种干预措施对谁、在什么特定环境中以及如何有效。
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