Australian Health Services Research Institute, University of Wollongong, New South Wales, Wollongong, Australia.
School of Nursing, University of Wollongong, New South Wales, Wollongong, Australia.
Scand J Caring Sci. 2023 Sep;37(3):611-627. doi: 10.1111/scs.13151. Epub 2023 Feb 2.
Social connection is a fundamental human need. Its absence can lead to loneliness and social isolation, adversely impacting health and well-being. Given their regular contact and trusted relationships with older people, practitioners delivering community-based primary care are well-positioned to address this issue. However, their contribution to addressing loneliness and social isolation is unclear.
This integrative review explores the contribution of the primary care workforce to interventions aimed at reducing loneliness and social isolation in community-dwelling older people.
Using an integrative review method, Scopus, Web of Science, CINAHL and PubMed were searched for original research published between 2000 and 2022. Fourteen papers reporting 13 primary studies were appraised for methodological quality and included in the review. Data were extracted into a summary table and analysed using thematic analysis.
Included studies came from over six countries. Internationally, primary care services have diverse structures, funding and workforces influencing their response to loneliness and social isolation. All but one intervention was multi-component, with ten studies including a group-based activity and three providing primarily individual-level activities. Only six studies reported reductions in loneliness following the intervention. Three themes were identified: characteristics of interventions; implementation context, barriers and facilitators; and differing contributions of primary care practitioners in addressing loneliness and social isolation of older people.
There is increasing demand and scope for primary care practitioners to assist lonely and socially isolated older people. It is important to understand how to equip and incentivise these practitioners to routinely identify, assess and respond to lonely and socially isolated older people despite varying implementation contexts. There is a need for further research that explores how the primary care team can be better utilised to deliver effective interventions that reduce the health impacts of loneliness and social isolation.
社会联系是人类的基本需求。缺乏社会联系会导致孤独和社会隔离，从而对健康和幸福产生不利影响。由于社区初级保健从业者与老年人经常接触并建立了信任关系，他们非常适合解决这个问题。然而，他们在解决孤独和社会隔离问题上的贡献尚不清楚。
本综合评价探讨了初级保健工作者对旨在减少社区居住老年人孤独和社会隔离的干预措施的贡献。
采用综合评价方法，检索了 Scopus、Web of Science、CINAHL 和 PubMed 数据库，以获取 2000 年至 2022 年期间发表的原始研究。评估了 14 篇报告 13 项原始研究的论文的方法学质量，并将其纳入综述。将数据提取到一个汇总表中，并使用主题分析进行分析。
纳入的研究来自六个以上的国家。国际上，初级保健服务的结构、资金和劳动力各不相同，这影响了它们对孤独和社会隔离的反应。除一项干预措施外，所有干预措施均为多组分，其中 10 项研究包括基于小组的活动，三项研究主要提供个人层面的活动。只有六项研究报告干预后孤独感有所减轻。确定了三个主题：干预措施的特征；实施背景、障碍和促进因素；以及初级保健从业者在解决老年人孤独和社会隔离方面的不同贡献。
初级保健从业者协助孤独和社会隔离的老年人的需求和范围不断扩大。重要的是要了解如何装备和激励这些从业者，以便他们尽管面临不同的实施背景，但能常规地识别、评估和应对孤独和社会隔离的老年人。需要进一步研究如何更好地利用初级保健团队来提供有效的干预措施，以减轻孤独和社会隔离对健康的影响。
