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远程管理的韧性和智慧为重点的干预措施,以减少压力和孤独感:老年人的试点对照临床试验。

Remotely Administered Resilience- and Wisdom-Focused Intervention to Reduce Perceived Stress and Loneliness: Pilot Controlled Clinical Trial in Older Adults.

机构信息

Department of Psychiatry and Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA; VA San Diego Healthcare System, San Diego CA.

Department of Psychiatry and Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA; VA San Diego Healthcare System, San Diego CA.

出版信息

Am J Geriatr Psychiatry. 2023 Jan;31(1):58-64. doi: 10.1016/j.jagp.2022.07.006. Epub 2022 Jul 21.

Abstract

OBJECTIVE

Older adults are vulnerable to perceived stress and loneliness, exacerbated by the COVID-19 pandemic. We previously reported inverse relationships between loneliness/perceived stress and wisdom/resilience. There are few evidence-based tele-health interventions for older adults. We tested a new remotely-administered manualized resilience- and wisdom-focused behavioral intervention to reduce perceived stress and loneliness in older adults.

METHODS

This pilot controlled clinical trial used a multiple-phase-change single-case experimental design, with three successive 6-week phases: control, intervention, and follow-up periods. The intervention included six once-a-week one-hour sessions. Participants were 20 adults >65 years, without dementia.

RESULTS

All 20 participants completed every session. The study indicated feasibility and acceptability of the intervention. While the sample was too small for demonstrating efficacy, there was a reduction (small-to-medium effect size) in perceived stress and loneliness, and increase in resilience, happiness, and components of wisdom and positive perceptions of aging.

CONCLUSION

These preliminary data support feasibility, acceptability, and possible efficacy of a remotely-administered resilience- and wisdom-focused intervention in older adults to reduce stress and loneliness.

摘要

目的

老年人易受到压力和孤独感的影响,而 COVID-19 大流行则加剧了这种情况。我们之前报告过孤独感/压力感与智慧/适应力之间的反比关系。针对老年人的基于证据的远程医疗干预措施很少。我们测试了一种新的远程管理的、以适应力和智慧为重点的行为干预措施,以减轻老年人的压力感和孤独感。

方法

这项试点对照临床试验采用多阶段变化的单病例实验设计,包括三个连续的 6 周阶段:对照期、干预期和随访期。干预包括六次每周一次的一小时会议。参与者为 20 名年龄在 65 岁以上、无痴呆的成年人。

结果

所有 20 名参与者都完成了每一次会议。该研究表明干预措施具有可行性和可接受性。尽管样本太小,无法证明疗效,但压力感和孤独感有所降低(中等至小效应量),适应力、幸福感以及智慧和积极老龄化观念的组成部分有所提高。

结论

这些初步数据支持远程管理的以适应力和智慧为重点的干预措施在老年人中减轻压力和孤独感的可行性、可接受性和可能的疗效。

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