Department of General Practice and Primary Health Care, University of Helsinki, PO Box 20, 00014, Helsinki, Finland.
Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland.
BMC Geriatr. 2024 Oct 7;24(1):812. doi: 10.1186/s12877-024-05408-0.
Loneliness is common among older adults in institutional settings. It leads to adverse effects on health and wellbeing, for which nature contact with peers in turn may have positive impact. However, the effects of nature engagement among older adults have not been studied in randomised controlled trials (RCT). The "Friends in Nature" (FIN) group intervention RCT for lonely older adults in Helsinki assisted living facilities (ALFs) aims to explore the effects of peer-related nature experiences on loneliness and health-related quality of life (HRQoL). In this study we aim describe the participants' baseline characteristics of the RCT, feasibility of FIN intervention and intervention participants' feedback on the FIN.
Lonely participants were recruited from 22 ALFs in Helsinki area, Finland, and randomised into two groups: 1) nature-based social intervention once a week for nine weeks (n = 162) and 2) usual care (n = 157). Demographics, diagnoses and medication use were retrieved from medical records, and baseline cognition, functioning, HRQoL, loneliness and psychological wellbeing were assessed. Primary trial outcomes will be participants' loneliness (De Jong Giervald Loneliness Scale) and HRQoL (15D).
The mean age of participants was 83 years, 73% were female and mean Minimental State Examination of 21 points. The participants were living with multiple co-morbidities and/or disabilities. The intervention and control groups were comparable at baseline. The adherence with intervention was moderate, with a mean attendance of 6.8 out of the nine sessions. Of the participants, 14% refused, fell ill or were deceased, and therefore, participated three sessions or less. General subjective alleviation of loneliness was achieved in 57% of the intervention participants. Of the respondents, 96% would have recommended a respective group intervention to other older adults. Intervention participants appreciated their nature excursions and experiences.
We have successfully randomised 319 lonely residents in assisted living facilities into a trial about the effects of nature experiences in a group-format. The feedback from participants was favourable. The trial will provide important information about possibilities of alleviating loneliness with peer-related nature-based experiences in frail residents.
ClinicalTrials.gov, ID: NCT05507684. Registration 19/08/2022.
孤独在机构环境中的老年人中很常见。它会对健康和幸福感产生不良影响，而与同龄人进行自然接触反过来可能会产生积极影响。然而，老年人参与自然活动的效果尚未在随机对照试验 (RCT) 中进行研究。“自然中的朋友”（FIN）小组干预随机对照试验旨在探索与同龄人相关的自然体验对孤独感和与健康相关的生活质量 (HRQoL) 的影响。在这项研究中，我们旨在描述 RCT 中参与者的基线特征、FIN 干预的可行性以及干预参与者对 FIN 的反馈。
从芬兰赫尔辛基地区的 22 个辅助生活设施中招募孤独的参与者，并将他们随机分为两组：1）每周一次的基于自然的社交干预，共九周（n=162）和 2）常规护理（n=157）。从病历中检索人口统计学、诊断和药物使用情况，并评估基线认知、功能、HRQoL、孤独感和心理幸福感。主要试验结果将是参与者的孤独感（De Jong Giervald 孤独量表）和 HRQoL（15D）。
参与者的平均年龄为 83 岁，73%为女性，平均简易精神状态检查得分为 21 分。参与者患有多种合并症和/或残疾。干预组和对照组在基线时具有可比性。干预的依从性中等，平均参加了 9 次课程中的 6.8 次。由于拒绝、生病或死亡，14%的参与者只参加了三节课或更少的课程。57%的干预参与者普遍减轻了孤独感。在受访者中，96%的人会向其他老年人推荐相应的团体干预。干预参与者欣赏他们的自然远足和体验。
我们已经成功地将 319 名孤独的辅助生活设施居民随机分为一项关于在团体形式下体验自然对缓解孤独感的影响的试验。参与者的反馈是积极的。该试验将提供有关在脆弱居民中通过与同龄人相关的基于自然的体验缓解孤独感的可能性的重要信息。
ClinicalTrials.gov，ID：NCT05507684。注册于 2022 年 8 月 19 日。
