群居式长期护理环境中老年人社交联系的健康影响：定量和定性证据的系统评价。
Health effects of social connectedness in older adults living in congregate long-term care settings: A systematic review of quantitative and qualitative evidence.
机构信息
Department of Gerontology, Manning College of Nursing & Health Sciences, University of Massachusetts Boston, Massachusetts, Boston, USA.
Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
出版信息
Int J Older People Nurs. 2023 Nov;18(6):e12577. doi: 10.1111/opn.12577. Epub 2023 Oct 7.
BACKGROUND
The overall impact of social connectedness on health outcomes in older adults living in nursing homes and assisted living settings is unknown. Given the unclear health impact of social connectedness for older adults in congregate long-term care settings worldwide, a comprehensive systematic review is required to evaluate the overall relationship between social connectedness and health outcomes for them.
OBJECTIVES
The purpose of this article was to synthesize the literature regarding the health impact of social connectedness among older adults living in nursing homes or assisted living settings.
METHODS
Using PRISMA guidelines, we identified eligible studies from Scopus, MEDLINE, PsycINFO, CINAHL and Cochrane databases (1990-2021). Bias and quality reporting assessment was performed using standardized criteria for cohort, cross sectional and qualitative studies. At each stage, ≥ 2 researchers conducted independent evaluations.
RESULTS
Of the 7350 articles identified, 25 cohort (follow-up range: 1 month-11 years; with two also contributing to cross sectional), 86 cross sectional, eight qualitative and two mixed methods were eligible. Despite different instruments used, many residents living in nursing homes and assisted living settings had reduced social engagement. Quantitative evidence supports a link between higher social engagement and health outcomes most studied (e.g. depression, quality of life). Few studies evaluated important health outcomes (e.g. cognitive and functional decline). Most cohort studies showed that lack of social connectedness accelerated time to death.
CONCLUSIONS
Social connectedness may be an important modifiable risk factor for adverse health outcomes for older adults living in nursing homes and assisted living facilities. Most studies were cross sectional and focused on quality of life and mental health outcomes. Longitudinal studies suggest that higher social engagement delays time to death. Evidence regarding other health outcomes important to older adults was scant and requires further longitudinal studies.
背景
社交联系对居住在养老院和辅助生活环境中的老年人的健康结果的整体影响尚不清楚。鉴于社交联系对全球集中长期护理环境中的老年人的健康影响尚不清楚，需要进行全面的系统评价，以评估社交联系与他们的健康结果之间的整体关系。
目的
本文旨在综合有关居住在养老院或辅助生活环境中的老年人社交联系对健康影响的文献。
方法
我们使用 PRISMA 指南，从 Scopus、MEDLINE、PsycINFO、CINAHL 和 Cochrane 数据库（1990-2021 年）中确定了合格的研究。使用针对队列、横断面和定性研究的标准化标准进行偏倚和质量报告评估。在每个阶段，≥2 名研究人员进行了独立评估。
结果
在确定的 7350 篇文章中，有 25 项队列研究（随访时间范围为 1 个月至 11 年；其中两项也为横断面研究提供了数据）、86 项横断面研究、8 项定性研究和 2 项混合方法研究符合条件。尽管使用了不同的工具，但许多居住在养老院和辅助生活环境中的居民社交参与度降低。定量证据支持更高的社交参与度与大多数研究的健康结果之间存在关联（例如，抑郁、生活质量）。很少有研究评估重要的健康结果（例如认知和功能下降）。大多数队列研究表明，缺乏社交联系会加速死亡时间。
结论
社交联系可能是居住在养老院和辅助生活设施中的老年人不良健康结果的一个重要可改变的危险因素。大多数研究都是横断面研究，重点关注生活质量和心理健康结果。纵向研究表明，更高的社交参与度可以延迟死亡时间。关于对老年人重要的其他健康结果的证据很少，需要进一步的纵向研究。
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