Moore Ainsley, Motagh Shahrzad, Sadeghirad Behnam, Begum Housne, Riva John J, Gaber Jessica, Dolovich Lisa
Department of Family Medicine, McMaster University, Hamilton, ON, Canada.
The Michael G. DeGroote Institute of Pain Research and Care, McMaster University, Hamilton, ON, Canada.
Can Geriatr J. 2021 Mar 2;24(1):44-72. doi: 10.5770/cgj.24.434. eCollection 2021 Mar.
Volunteers are increasingly promoted to improve health-related outcomes for community-dwelling elderly without synthesized evidence for effectiveness. This systematic review and meta-analysis evaluates the effects of unpaid volunteer interventions on health-related outcomes for such seniors.
MEDLINE, EMBASE and Cochrane (CENTRAL) were searched up to November 2018. We included English language, randomized trials. Two reviewers independently identified studies, extracted data, and assessed evidence certainty (using GRADE). Meta-analysis used random-effects models. Univariate meta-regressions investigated the relationship between volunteer intervention effects and trial participant age, percentage females, and risk of bias.
28 included studies focussed on seniors with a variety of chronic conditions (e.g., dementia, diabetes) and health states (e.g., frail, palliative). Volunteers provided a range of roles (e.g., counsellors, educators and coaches). Low certainty evidence found that volunteers may improve both physical function (MD = 3.2 points on the 100-point SF-36 physical component score [PCS]; 95% CI: 1.09, 5.27) and physical activity levels (SMD = 0.5, 95% CI: 0.14 to 0.83). Adverse events were not increased.
Volunteers may increase physical activity levels and subjective ratings of physical function for seniors without apparent harm. These findings support the WHO call to action on evidence-based policies to align health systems in support of older adults.
志愿者越来越多地被推广用于改善社区老年人与健康相关的结果,但缺乏关于有效性的综合证据。本系统评价和荟萃分析评估了无偿志愿者干预对这类老年人与健康相关结果的影响。
检索截至2018年11月的MEDLINE、EMBASE和Cochrane(CENTRAL)数据库。纳入英文随机试验。两名评价员独立识别研究、提取数据并评估证据确定性(使用GRADE)。荟萃分析采用随机效应模型。单变量荟萃回归研究了志愿者干预效果与试验参与者年龄、女性百分比和偏倚风险之间的关系。
28项纳入研究聚焦于患有各种慢性病(如痴呆、糖尿病)和健康状况(如虚弱、姑息治疗)的老年人。志愿者发挥了一系列作用(如顾问、教育工作者和教练)。低确定性证据表明,志愿者可能改善身体功能(在100分的SF-36身体成分评分[PCS]上提高3.2分;95%CI:1.09,5.27)和身体活动水平(标准化均数差=0.5,95%CI:0.14至0.83)。不良事件没有增加。
志愿者可能提高老年人的身体活动水平和身体功能主观评分,且无明显危害。这些发现支持了世界卫生组织关于基于证据的政策的行动呼吁,以调整卫生系统以支持老年人。