老年人心理社会干预与心理健康的系统综述

doi:10.3969/j.issn.1006-9771.2023.10.007

Abstract

Abstract:

Objective To systematically review the effects of psychosocial support-related activities on mental health of older adults.
Methods Randomized controlled trails (RCTs) on mental health benefits for older adults were retrieved from PubMed, Web of Science, EBSCO and CNKI, until August, 2022. A systematic review was conducted.
Results Seven RCTs were included, from Spain, Chile, Canada, Finland, the United Kingdom, South Korea and the United States, mainly from psychiatry, mental health of the elderly and other journals, published after 2017. The subjects aged 60 to 80 years, accounting to 1 258 cases. Psychosocial interventions included Pilates, mindfulness, behavioral activation, cognitive stimulation, daily difficult problem solving training, pain and depression symptom management, health education and guidance, nursing coordination, group exercise (such as circuit training, pedal training or rubber band training), and water sports, etc. The frequency of intervention was 30 to 120 minutes a time, one to nine times a week, and the intensity of the intervention was low to high intensity for four to 64 weeks. Intervention sites included sports venues, community health centres, ageing services, and intervention staff included sports therapists (yoga), psychologists, health professionals, community health services, and health care workers. All interventions were carried out under supervision. The benefits of psychosocial intervention on the mental health of the older adults mainly reflected in the improving cognitive function and self-efficacy, reducing anxiety and depression, improving depressed mood or loneliness, improving sleep quality, increasing sense of social integration and relieving pain and other problems.
Conclusion Mental health interventions (psychological interventions or support, social interventions or support, psychosocial interventions) and mental health-related interventions (physical activity interventions) benefit older people's mental health, including improving cognitive function, alleviating anxiety and depression, improving sleep quality, and improving quality of life and well-being.

Key words: older adults, psychosocial intervention, physical activity, mental health, systematic review

CLC Number:

R493

TANG Jiayu, QIU Fubing. Psychosocial intervention and mental health for older adults: a systematic review[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(10): 1164-1170.

Figures/Tables 4

纳入文献	国家	样本	干预条件	干预处方	比较	心理健康效益
Aibar-Almazán 等^[17](2019)	西班牙	n = 110 年龄> 60岁	干预类型：身体活动干预场所：体育场馆有监督干预人员：瑜伽治疗师	普拉提：热身10 min、主训练35 min和恢复15 min。第3~6周，行渐进强度的强化和拉伸站立锻炼。第7~12周，垫上行器械运动(弹力带、魔术圈和健身球)。每次60 min，每周1次，低强度，共12周	与对照组相比，普拉提组焦虑、抑郁缓解更明显; 与干预前相比，老年人睡眠质量提高	认知功能未提及情绪状态焦虑、抑郁减轻睡眠质量睡眠障碍改善生活质量与福祉未提及
Saldivia等^[18](2019)	智利	n = 340 年龄65~80岁	干预类型：心理干预或支持干预场所：社区卫生保健中心有监督干预人员：心理学家、健康专业人员	正念训练、行为激活、认知刺激、日常困难问题解决训练及疼痛和抑郁症状管理;每次120 min，每周9次，低强度，共12周	干预组焦虑、抑郁改善更显著	认知功能未提及情绪状态压力和焦虑减少睡眠质量未提及生活质量与福祉未提及
Miklavcic等^[19](2020)	加拿大	n = 132 平均年龄68岁	干预类型：社会干预或支持干预场所：社区卫生服务中心有监督干预人员：社区卫生服务人员	家访、健康教育与指导、护理协调;每次30~60 min，每周1次，干预强度未提及，共24周	干预组身心功能、自我效能、抑郁、焦虑改善更显著	认知功能认知、自我效能改善情绪状态抑郁、焦虑改善睡眠质量未提及生活质量与福祉未提及
Pynnönen 等^[20](2018)	芬兰	n = 75 年龄76~79岁	干预类型：心理社会干预干预场所：社区老年服务机构有监督干预人员：卫生保健人员	团体运动锻炼(循环训练、踏板训练或橡皮筋训练)、健康知识培训、困难问题积极应对与管理训练;每次60~120 min，每周1~3次，低~中强度，共4周	与干预前相比，老年人孤独和忧郁评分下降，依恋和引导评分增加; 与对照组相比，干预组社会融合增加	认知功能未提及情绪状态抑郁或孤独感下降睡眠质量未提及生活质量与福祉社会融合感增加
Bosanquet 等^[21](2017)	英国	n = 485 平均年龄72岁	干预类型：心理社会干预干预场所：卫生保健中心有监督干预人员：卫生保健人员	行为激活(自我反思和自我监测、活动日记和家务劳动等);每次60 min，每周1~2次，低强度，共64周	与常规护理组相比，协作护理组老年人疼痛、便秘和睡眠模式紊乱改善	认知功能未提及情绪状态抑郁改善睡眠质量睡眠模式改善生活质量与福祉疼痛等问题改善
Kang等^[22](2020)	韩国	n = 20 平均年龄67.5岁	干预类型：身体活动干预场所：体育场馆有监督干预人员：体育运动专家	水上运动：热身10 min，锻炼40 min，恢复10 min;每次60 min，每周3次，低~高强度，每4周增强1次，共16周	与干预前相比，老年人认知功能增强; 与对照组相比，水上运动组的脑源性神经营养因子、胰岛素样生长因子和认知功能水平较高	认知功能认知功能(如记忆力等)增强情绪状态未提及睡眠质量未提及生活质量与福祉未提及
Gilbody等^[23](2021)	美国	n = 96 平均年龄65岁	干预类型：心理社会干预干预场所：初级保健中心有监督干预人员：初级保健人员	行为激活;每次30~60 min，每天2~3次，低强度，持续4~6周	干预组抑郁和焦虑改善更显著	认知功能未提及情绪状态缓解抑郁和焦虑睡眠质量未提及生活质量与福祉未提及

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纳入文献	资格标准	随机分配	分配隐藏	基线相似	被试施盲	治疗师施盲	评估者施盲	被试流失率 ≤15%	意向性分析	组间统计比较	变异性测量	总分
Aibar-Almazán 等^[17](2019)	√	√	√	√	√		√	√	√	√	√	9
Saldivia等^[18](2019)	√	√	√	√	√	√	√	√	√	√	√	10
Miklavcic 等^[19] (2020)	√	√	√			√	√	√	√	√	√	8
Pynnönen 等^[20](2018)	√	√	√	√	√	√	√	√	√	√	√	10
Bosanquet 等^[21](2017)	√	√	√	√	√			√	√	√	√	8
Kang 等^[22](2020)	√	√	√	√		√	√	√	√	√	√	9
Gilbody 等^[23](2021)	√	√	√	√		√	√	√	√	√	√	9

Psychosocial intervention and mental health for older adults: a systematic review

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