Zhu Mingyue, Chen Huimin, Wang Qing, Ding Xiaotong, Li Zheng
School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
School of Nursing, Lanzhou University, Lanzhou, China.
Worldviews Evid Based Nurs. 2025 Feb;22(1):e70004. doi: 10.1111/wvn.70004.
Existing interventions targeting perceived stress in older adults exhibit a diverse range of types and inconsistent effectiveness. It remains unclear which interventions are most effective for older adults in terms of perceived stress, anxiety, depression, and cortisol levels.
This study aimed to assess the effectiveness of interventions targeting perceived stress in older adults for perceived stress, depression, anxiety, and cortisol levels.
A systematic search was conducted using PubMed, EMBASE, Web of Science, Cochrane, CINAHL, PsycINFO, CNKI, SinoMed, VIP, and WanFang databases on January 9, 2024 for randomized controlled trials (RCTs). Pairwise meta-analysis and network meta-analysis (NMA) were conducted using Review Manager v.5.4 and Stata v.16.0.
A total of 23 RCTs were included. The reminiscence therapy had the highest probability (98.6%) of being the most promising intervention to reduce perceived stress, followed by exercise (68.1%) and yoga (56.1%). The included interventions had benefits on cortisol levels (SMD = -0.30; 95% CI [-0.54, -0.06]; p = 0.01). Moreover, exercise showed positive effects on reducing depression (SMD = -1.84; 95% CI [-3.69, 0.01]; p = 0.05), and it was ranked as the most promising method for depression or anxiety. Health education also reduced anxiety symptoms compared to control group (SMD = -0.77; 95% CI [-1.27, -0.26]; p = 0.03).
Interventions targeting perceived stress had overall benefits in reducing perceived stress in older adults, especially reminiscence therapy and exercise. Exercise and health education each had potential benefits for alleviating depression and anxiety, respectively. More high-quality RCTs are needed to obtain more robust conclusions.
现有的针对老年人感知压力的干预措施呈现出多种类型且效果不一。目前尚不清楚就感知压力、焦虑、抑郁和皮质醇水平而言，哪些干预措施对老年人最为有效。
本研究旨在评估针对老年人感知压力的干预措施对感知压力、抑郁、焦虑和皮质醇水平的有效性。
于2024年1月9日使用PubMed、EMBASE、科学网、考科蓝、护理学与健康领域数据库、心理学文摘数据库、中国知网、中国生物医学文献数据库、维普资讯和万方数据库进行系统检索，以查找随机对照试验（RCT）。使用Review Manager v.5.4和Stata v.16.0进行成对荟萃分析和网状荟萃分析（NMA）。
共纳入23项随机对照试验。回忆疗法是最有希望减轻感知压力的干预措施，概率最高（98.6%），其次是运动（68.1%）和瑜伽（56.1%）。纳入的干预措施对皮质醇水平有有益影响（标准化均数差 = -0.30；95%置信区间[-0.54, -0.06]；p = 0.01）。此外，运动对减轻抑郁有积极作用（标准化均数差 = -1.84；95%置信区间[-3.69, 0.01]；p = 0.05），并且它被列为治疗抑郁或焦虑最有希望的方法。与对照组相比，健康教育也减轻了焦虑症状（标准化均数差 = -0.77；95%置信区间[-1.27, -0.26]；p = 0.03）。
针对感知压力的干预措施总体上有助于减轻老年人的感知压力，尤其是回忆疗法和运动。运动和健康教育分别对缓解抑郁和焦虑有潜在益处。需要更多高质量的随机对照试验以得出更可靠的结论。
