针对老年人的基于自然的干预措施：干预类型与方法、健康影响及途径的系统评价

Nature-based interventions for older adults: a systematic review of intervention types and methods, health effects and pathways.

作者信息

Tong Ki, Thompson Catharine Ward, Carin-Levy Gail, Liddle Jennifer, Morton Sarah, Mead Gillian E

机构信息

Edinburgh College of Art, The University of Edinburgh, 74 Lauriston Pl, Edinburgh EH3 9DF, UK.

Advanced Care Research Centre, The University of Edinburgh, Usher Building, 5-7 Little France Road Edinburgh BioQuarter, Edinburgh EH16 4UX, UK.

出版信息

Age Ageing. 2025 Mar 28;54(4). doi: 10.1093/ageing/afaf084.

DOI:10.1093/ageing/afaf084

PMID:40207381

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11982671/

Abstract

BACKGROUND

Nature-based interventions (NBIs) may support older adults' health and well-being, but it remains unclear which interventions are most effective, for whom and in which contexts. The existing Wilkie and Davinson framework explains the pathways between NBIs and health outcomes but underemphasises the effects of environmental qualities. Therefore, the study aims to critically examine existing NBIs and their associated health outcomes, with a focus on identifying the environmental qualities and pathways that are either facilitating or impeding.

METHODS

The review sought 16 databases for any nature-based interventions aimed at enhancing health outcomes where participants are older adults aged ≥65. The Mixed Methods Appraisal Tool assessed risk of bias. Narrative synthesis was used for result presentation.

RESULTS

Of 6143 articles retrieved, 84 studies were included. Participants were primarily community dwelling without specific conditions. Most studies were quantitative experiments. Interventions were predominantly multicomponent, with restoring psychological capacities as the most common pathway. Spiritual, behavioural and socioecological changes were identified. Some health mechanisms were specific to outdoor interventions, but indoor interventions showed comparable outcomes.

CONCLUSIONS

The study predominantly included community-dwelling participants without specific health conditions, potentially limiting the generalisability of findings to older adults with multimorbidity or those in alternative living environments. Multicomponent interventions challenged direct associations between pathways and outcomes. Results extend existing frameworks by identifying spiritual, behavioural and socioecological benefits. Limited detailing of environmental qualities warrants further research to associate them with specific health outcomes.

REGISTRATION

The protocol was registered on PROSPERO (CRD42024496114).

摘要

背景

基于自然的干预措施（NBI）可能有助于老年人的健康和福祉，但目前尚不清楚哪些干预措施最有效、对谁有效以及在何种背景下有效。现有的威尔基和戴维森框架解释了NBI与健康结果之间的途径，但未充分强调环境质量的影响。因此，本研究旨在批判性地审视现有的NBI及其相关的健康结果，重点是确定促进或阻碍健康的环境质量和途径。

方法

该综述在16个数据库中搜索了任何旨在改善健康结果的基于自然的干预措施，研究对象为65岁及以上的老年人。采用混合方法评估工具评估偏倚风险。结果呈现采用叙述性综合分析。

结果

在检索到的6143篇文章中，纳入了84项研究。参与者主要是居住在社区且无特定疾病的老年人。大多数研究是定量实验。干预措施主要是多组分的，恢复心理能力是最常见的途径。确定了精神、行为和社会生态方面的变化。一些健康机制特定于户外干预措施，但室内干预措施显示出类似的结果。

结论

该研究主要纳入了无特定健康状况的社区居住参与者，这可能会限制研究结果对患有多种疾病的老年人或生活在其他环境中的老年人的普遍适用性。多组分干预措施挑战了途径与结果之间的直接关联。研究结果通过确定精神、行为和社会生态效益扩展了现有框架。环境质量的详细描述有限，需要进一步研究以将它们与特定的健康结果联系起来。