Fu Zhengke, Yan Mengsi, Meng Chao
Department of Computational Communication, School of Media and Law, Ningbo Tech University, Ningbo, China.
Department of Japanese Language Study, School of Humanity, Ningbo University of Finance and Economics, Ningbo, China.
Front Psychol. 2022 Jul 28;13:935544. doi: 10.3389/fpsyg.2022.935544. eCollection 2022.
Remotely delivered intervention is widely applied to loneliness treatment in older adults, but the effect is controversial. This study aimed to evaluate the effects of remotely delivered intervention on loneliness using a systematic review and meta-analysis.
The PubMed, the Cochrane Central Register of Controlled Trials, EMBASE, CINAHL (EBSCO), PsycINFO (EBSCO) databases were searched for studies, the search ended on 7 July 2021. Thirteen randomized controlled trials of remotely delivered intervention compared with usual care, brief contact, or no intervention for loneliness were included. A random-effects model measured estimation of loneliness reduction. Furthermore, standardized mean differences (SMDs), 95% confidence intervals (CIs), publication bias, and heterogeneity were calculated. Subgroup analysis was used to explore the factors that might affect the treatment effects.
The evidence of remotely delivered intervention on loneliness reduction was certain (SMD = -0.41 [95% CI, -0.70 to -0.13]). Media subgroup analysis supported the effectiveness of intervention delivered by video call (SMD = -0.54 [95% CI, -0.83 to -0.25]); treatment strategy subgroup analysis found evidence to support the effectiveness of increasing social support and maladaptive social cognition treatment strategy (SMD = -0.47 [95% CI, -0.77 to -0.18] and SMD = -1.04 [95% CI, -1.98 to -0.10], respectively); participants subgroup analysis shown the effectiveness of intervention for older adults living in LTC and social isolation (SMD = -1.40 [95% CI, -2.43 to -0.36] and SMD = -0.55 [95% CI, -0.74 to -0.36], respectively); group format subgroup analysis testified the effectiveness of intervention carried out in individual format (SMD = -0.39 [95% CI, -0.71 to -0.07]); measurement time points subgroup analysis found the positive effect of intervention at 3 months and 3 to 6 months stage (SMD = -0.33 [95% CI, -0.52 to -0.14] and SMD = -0.32 [95% CI, -0.57 to -0.07], respectively). Significant publication bias was detected ( < 0.05), and the heterogeneity of the studies was substantial.
This systematic review and meta-analysis demonstrate that remotely delivered intervention can reduce loneliness in older adults, and it appears to be affected by media type, treatment strategy, participants characteristics, group format, and measurement time points.
远程干预在老年人孤独治疗中应用广泛，但效果存在争议。本研究旨在通过系统评价和荟萃分析评估远程干预对孤独感的影响。
检索了PubMed、Cochrane对照试验中央注册库、EMBASE、CINAHL（EBSCO）、PsycINFO（EBSCO）数据库中的研究，检索截至2021年7月7日。纳入了13项比较远程干预与常规护理、短暂接触或无干预对孤独感影响的随机对照试验。采用随机效应模型测量孤独感降低的估计值。此外，计算了标准化均数差（SMD）、95%置信区间（CI）、发表偏倚和异质性。进行亚组分析以探索可能影响治疗效果的因素。
远程干预降低孤独感的证据确凿（SMD = -0.41 [95% CI，-0.70至-0.13]）。媒体亚组分析支持视频通话干预的有效性（SMD = -0.54 [95% CI，-0.83至-0.25]）；治疗策略亚组分析发现有证据支持增加社会支持和不良适应社会认知治疗策略的有效性（分别为SMD = -0.47 [95% CI，-0.77至-0.18]和SMD = -1.04 [95% CI，-1.98至-0.10]）；参与者亚组分析显示干预对居住在长期护理机构和处于社会隔离状态的老年人有效（分别为SMD = -1.40 [95% CI，-2.43至-0.36]和SMD = -0.55 [95% CI，-0.74至-0.36]）；小组形式亚组分析证实了个体形式干预的有效性（SMD = -0.39 [95% CI，-0.71至-0.07]）；测量时间点亚组分析发现干预在3个月和3至6个月阶段有积极效果（分别为SMD = -0.33 [95% CI，-0.52至-0.14]和SMD = -0.32 [95% CI，-0.57至-0.07]）。检测到显著的发表偏倚（<0.05），且研究的异质性较大。
本系统评价和荟萃分析表明，远程干预可降低老年人的孤独感，且似乎受媒体类型、治疗策略、参与者特征、小组形式和测量时间点的影响。
