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社会处方应对孤独感的影响:一项全国社会处方计划的混合方法评估。

Impact of social prescribing to address loneliness: A mixed methods evaluation of a national social prescribing programme.

机构信息

School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK.

School of Nursing and Midwifery, The University of Sheffield, Sheffield, UK.

出版信息

Health Soc Care Community. 2021 Sep;29(5):1439-1449. doi: 10.1111/hsc.13200. Epub 2020 Oct 20.

Abstract

Loneliness is considered a global public health issue because of its detrimental impact on physical and mental health but little is known about which interventions can reduce loneliness. One potential intervention is social prescribing, where a link worker helps service-users to access appropriate support such as community activities and social groups. Some qualitative studies have identified that social prescribing may help to reduce service-users' loneliness. Given this, the British Red Cross (a third sector organisation) developed and delivered a national social prescribing service in the United Kingdom to support people who were experiencing, or at risk of, loneliness. Service-users could receive up to 12 weeks of support from a link worker. A mixed methods study was conducted to understand the impact of the support on loneliness, and to identify the facilitators and barriers to service delivery. The study included: (a) analysis of quantitative data collected routinely between May 2017 and December 2019 (n = 10,643) including pre-post analysis of UCLA data (n = 2,250) and matched comparator work to measure changes in loneliness; (b) semi-structured interviews with service-users, link workers and volunteers (n = 60) and (c) a Social Return on Investment Analysis. The majority of the service-users (72.6%, n = 1634/2250) felt less lonely after receiving support. The mean change in UCLA score was -1.84 (95% CI -1.91 to -1.77) of a maximum change of 6.00 (decrease indicates an improvement). Additional benefits included improved wellbeing, increased confidence and life having more purpose. The base case analysis estimated a social return on investment of £3.42 per £1 invested in the service. Having skilled link workers and support tailored to individual needs appeared key. However, challenges included utilising volunteers, meeting some service-users' needs in relation to signposting and sustaining improvements in loneliness. Nonetheless, the service appeared successful in supporting service-users experiencing loneliness.

摘要

孤独被认为是一个全球性的公共卫生问题,因为它对身心健康有不利影响,但人们对哪些干预措施可以减少孤独知之甚少。一种潜在的干预措施是社会处方,即联系工作者帮助服务使用者获得适当的支持,如社区活动和社会团体。一些定性研究已经表明,社会处方可能有助于减少服务使用者的孤独感。有鉴于此,英国红十字会(一个第三部门组织)在英国开发并提供了一项全国性的社会处方服务,以支持那些正在经历或有孤独感风险的人。服务使用者可以从联系工作者那里获得长达 12 周的支持。一项混合方法研究旨在了解支持对孤独感的影响,并确定服务提供的促进因素和障碍。该研究包括:(a) 对 2017 年 5 月至 2019 年 12 月期间收集的常规定量数据进行分析(n=10643),包括对 UCLA 数据(n=2250)进行前后分析和匹配比较工作,以衡量孤独感的变化;(b) 对服务使用者、联系工作者和志愿者(n=60)进行半结构化访谈;以及 (c) 社会投资回报率分析。大多数服务使用者(72.6%,n=1634/2250)在接受支持后感到孤独感减轻。UCLA 评分的平均变化为-1.84(95%CI-1.91 至-1.77),最大变化为 6.00(减少表示改善)。额外的好处包括改善幸福感、增强信心和生活更有目标。基础案例分析估计,每投资 1 英镑在该服务上可获得 3.42 英镑的社会投资回报率。拥有熟练的联系工作者和针对个人需求的支持似乎是关键。然而,挑战包括利用志愿者、满足一些服务使用者在转介方面的需求以及维持孤独感的改善。尽管如此,该服务似乎成功地支持了孤独的服务使用者。

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