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社会处方干预措施解决老年人的社会隔离和孤独问题:整合实地资源的元综述。

Social Prescription Interventions Addressing Social Isolation and Loneliness in Older Adults: Meta-Review Integrating On-the-Ground Resources.

机构信息

Département de Marketing, Faculté des Sciences de l'Administration, Université Laval, Québec, QC, Canada.

Centre de Recherche, Centre Hospitalier Universitaire de Québec - Université Laval, Quebec, QC, Canada.

出版信息

J Med Internet Res. 2023 May 17;25:e40213. doi: 10.2196/40213.

Abstract

BACKGROUND

Social prescription programs represent a viable solution to linking primary care patients to nonmedical community resources for improving patient well-being. However, their success depends on the integration of patient needs with local resources. This integration could be accelerated by digital tools that use expressive ontology to organize knowledge resources, thus enabling the seamless navigation of diverse community interventions and services tailored to the needs of individual users. This infrastructure bears particular relevance for older adults, who experience a range of social needs that impact their health, including social isolation and loneliness. An essential first step in enabling knowledge mobilization and the successful implementation of social prescription initiatives to meet the social needs of older adults is to incorporate the evidence-based academic literature on what works, with on-the-ground solutions in the community.

OBJECTIVE

This study aims to integrate scientific evidence with on-the-ground knowledge to build a comprehensive list of intervention terms and keywords related to reducing social isolation and loneliness in older adults.

METHODS

A meta-review was conducted using a search strategy combining terms related to older adult population, social isolation and loneliness, and study types relevant to reviews using 5 databases. Review extraction included intervention characteristics, outcomes (social [eg, loneliness, social isolation, and social support] or mental health [eg, psychological well-being, depression, and anxiety]), and effectiveness (reported as consistent, mixed, or not supported). Terms related to identified intervention types were extracted from the reviewed literature as well as descriptions of corresponding community services in Montréal, Canada, available from web-based regional, municipal, and community data sources.

RESULTS

The meta-review identified 11 intervention types addressing social isolation and loneliness in older adults by either increasing social interactions, providing instrumental support, promoting mental and physical well-being, or providing home and community care. Group-based social activities, support groups with educational elements, recreational activities, and training or use of information and communication technologies were the most effective in improving outcomes. Examples of most intervention types were found in community data sources. Terms derived from the literature that were the most commonly congruent with those describing existing community services were related to telehealth, recreational activities, and psychological therapy. However, several discrepancies were observed between review-based terms and those addressing the available services.

CONCLUSIONS

A range of interventions found to be effective at addressing social isolation and loneliness or their impact on mental health were identified from the literature, and many of these interventions were represented in services available to older residents in Montréal, Canada. However, different terms were occasionally used to describe or categorize similar services across data sources. Establishing an efficient means of identifying and structuring such sources is important to facilitate referrals and help-seeking behaviors of older adults and for strategic planning of resources.

摘要

背景

社会处方项目代表了一种将初级保健患者与非医疗社区资源联系起来以改善患者福祉的可行解决方案。然而,它们的成功取决于将患者需求与当地资源相结合。数字工具可以通过使用表达性本体论来组织知识资源,从而加速这种整合,从而能够无缝浏览针对个别用户需求定制的各种社区干预措施和服务。这种基础设施对于老年人尤为重要,他们面临着一系列影响其健康的社会需求,包括社会孤立和孤独。为了实现知识动员并成功实施社会处方计划以满足老年人的社会需求,至关重要的第一步是将关于行之有效的循证学术文献与社区中的实地解决方案相结合。

目的

本研究旨在将科学证据与实地知识相结合,构建一份关于减少老年人社会孤立和孤独的干预措施术语和关键词的综合清单。

方法

使用结合了与老年人人口、社会孤立和孤独以及与使用 5 个数据库的综述相关的研究类型相关的术语的搜索策略进行元综述。综述提取包括干预措施特征、结果(社会[如孤独、社会孤立和社会支持]或心理健康[如心理幸福感、抑郁和焦虑])和效果(报告为一致、混合或不支持)。从综述文献中提取与确定的干预类型相关的术语,以及从加拿大蒙特利尔的基于网络的区域、市和社区数据来源中获取的对应社区服务的描述。

结果

元综述确定了 11 种干预类型,这些类型通过增加社交互动、提供工具支持、促进身心健康或提供家庭和社区护理来解决老年人的社会孤立和孤独问题。基于小组的社交活动、具有教育元素的支持小组、娱乐活动以及培训或使用信息和通信技术是最有效的改善结果的方法。在社区数据来源中发现了大多数干预类型的示例。从文献中得出的与描述现有社区服务最常用的术语是与远程医疗、娱乐活动和心理治疗相关的术语。然而,在基于综述的术语和针对可用服务的术语之间观察到了一些差异。

结论

从文献中确定了一系列被发现对解决社会孤立和孤独或其对心理健康的影响有效的干预措施,并且在加拿大蒙特利尔的老年居民可获得的服务中,许多这些干预措施都有代表。然而,在不同的数据来源中,偶尔会使用不同的术语来描述或分类类似的服务。建立一种有效的方法来识别和构建这些资源对于促进老年人的转介和寻求帮助行为以及资源的战略规划非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/642e/10233446/15c438ad858c/jmir_v25i1e40213_fig1.jpg

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