Changi General Hospital, 2 Simei Street 3, Singapore 529889, Singapore.
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 3, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.
Health Promot Int. 2023 Jun 1;38(3). doi: 10.1093/heapro/daac007.
Salutogenesis is a health-promoting orientation and sense of coherence (SOC) is a vital coping factor associated with quality of life (QOL) and self-efficacy. Although salutogenic-based interventions showed potential in improving health outcomes, the application of salutogenic concepts and effectiveness on SOC, QOL and self-efficacy among community-dwelling older adults remained unclear. This review aimed to consolidate evidence on salutogenic approaches and evaluate the effectiveness of salutogenic-based interventions on SOC, QOL and self-efficacy in community-dwelling older adults. Databases systematically searched include PubMed, CINAHL, Embase, Cochrane Central Register of Controlled Trials, Scopus, Medline, PsycINFO and ProQuest Dissertations & Theses Global electronic databases. Two reviewers screened study eligibility, assessed risk of bias and extracted data of included studies independently. Meta-analyses on SOC and QOL were performed using RevMan. Where meta-analysis was not possible, narrative synthesis was employed. Eight studies involving 1201 older adults were included in this review. Subgroup analysis on SOC showed significant effects favouring salutogenic-based interventions using the empowering self-management model or strengths/resource-based approaches. However, results were mixed for the reflection-based approach. No significant effect favouring salutogenic-based interventions on QOL outcomes were found. High heterogeneity was observed for the outcome on self-efficacy. Two SOC strengthening processes, empowerment and reflection, were found to potentially underlie salutogenic-based intervention mechanisms. Effectiveness of salutogenic-based interventions on SOC, QOL and self-efficacy among community-dwelling older adults remained inconclusive due to high heterogeneity. Future salutogenic-based interventions should employ longitudinal designs and standardization on intervention delivery, utilizing a dual pathway via empowerment and reflection.
健康促进取向的优势作用学及健康知觉（SOC）是与生活质量（QOL）和自我效能相关的重要应对因素。虽然基于优势作用学的干预措施在改善健康结果方面显示出了潜力，但基于优势作用学的概念在社区居住的老年人中的 SOC、QOL 和自我效能方面的应用和效果仍不清楚。本综述旨在整合基于优势作用学的方法的证据，并评估基于优势作用学的干预措施对社区居住的老年人中的 SOC、QOL 和自我效能的有效性。系统检索的数据库包括 PubMed、CINAHL、Embase、Cochrane 中央对照试验注册库、Scopus、Medline、PsycINFO 和 ProQuest Dissertations & Theses Global 电子数据库。两名审查员独立筛选研究的纳入资格、评估偏倚风险和提取纳入研究的数据。使用 RevMan 对 SOC 和 QOL 进行荟萃分析。在无法进行荟萃分析的情况下，采用叙述性综合法。本综述纳入了 8 项涉及 1201 名老年人的研究。SOC 的亚组分析显示，使用赋权自我管理模式或优势/资源为基础的方法的基于优势作用学的干预措施具有显著效果。然而，基于反思的方法的结果则较为混杂。基于优势作用学的干预措施对 QOL 结果没有显著效果。自我效能的结果存在高度异质性。发现了两个 SOC 强化过程，赋权和反思，它们可能是基于优势作用学的干预机制的基础。由于高度异质性，基于优势作用学的干预措施对社区居住的老年人的 SOC、QOL 和自我效能的有效性仍不确定。未来的基于优势作用学的干预措施应采用纵向设计和干预提供的标准化，通过赋权和反思双重途径。
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