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Results for 'randomised controlled trials'

Results 1 - 7 of 7

Improving social support for older adults through technology: findings from the prism randomized controlled trial

CZAJA Sara J., et al
2018

Objectives: Information and communication technology holds promise in terms of providing support and reducing isolation among older adults. The impact of a specially designed computer system for older adults, the Personal Reminder Information and Social Management (PRISM) system is evaluated in this study. Design, Setting, and Participants: The trial was a multisite randomized field trial conducted at 3 sites. PRISM was compared to a Binder condition wherein participants received a notebook that contained paper content similar to that contained in PRISM. The sample included 300 older adults at risk for social isolation who lived independently in the community (Mage = 76.15 years). Primary outcome measures included indices of social isolation, social support, loneliness, and well-being. Secondary outcome measures included indices of computer proficiency and attitudes toward technology. Data were collected at baseline and at 6 and 12 months post-randomization. Results: The PRISM group reported significantly less loneliness and increased perceived social support and well-being at 6 months. There was a trend indicating a decline in social isolation. Group differences were not maintained at 12 months, but those in the PRISM condition still showed improvements from baseline. There was also an increase in computer self-efficacy, proficiency, and comfort with computers for PRISM participants at 6 and 12 months. Discussion: The findings suggest that access to technology applications such as PRISM may enhance social connectivity and reduce loneliness among older adults and has the potential to change attitudes toward technology and increase technology self-efficacy.

Efficacy of nature-based therapy for individuals with stress-related illnesses: randomised controlled trial

STIGSDOTTER Ulrika Karlsson, et al
2018

Background: Stress-related illnesses are a major threat to public health, and there is increasing demand for validated treatments. Aims: To test the efficacy of nature-based therapy (NBT) for patients with stress-related illnesses. Method: Randomised controlled trial (ClinicalTrials.gov ID NCT01849718) comparing Nacadia® NBT (NNBT) with the cognitive–behavioural therapy known as Specialised Treatment for Severe Bodily Distress Syndromes (STreSS). In total, 84 participants were randomly allocated to one of the two treatments. The primary outcome measure was the mean aggregate score on the Psychological General Well-Being Index (PGWBI). Results: Both treatments resulted in a significant increase in the PGWBI (primary outcome) and a decrease in burnout (the Shirom–Melamed Burnout Questionnaire, secondary outcome), which were both sustained 12 months later. No significant difference in efficacy was found between NNBT and STreSS for primary outcome and secondary outcomes. Conclusions: The study showed no statistical evidence of a difference between NNBT and STreSS for treating patients with stress-related illnesses.

Yoga-based exercise improves health-related quality of life and mental well-being in older people: a systematic review of randomised controlled trials

TULLOCH Alice, et al
2018

Objective: health-related quality of life (HRQOL) and mental well-being are associated with healthy ageing. Physical activity positively impacts both HRQOL and mental well-being. Yoga is a physical activity that can be modified to suits the needs of older people and is growing in popularity. A systematic review was conducted with meta-analysis to determine the impact of yoga-based exercise on HRQOL and mental well-being in people aged 60+. Methods: searches were conducted for relevant trials in the following electronic databases; MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, Allied and Complementary Medicine Database, PsycINFO and the Physiotherapy Evidence Database (PEDro) from inception to January 2017. Trials that evaluated the effect of physical yoga on HRQOL and/or on mental well-being in people aged 60+ years were included. Data on HRQOL and mental well-being were extracted. Standardised mean differences and 95% confidence intervals (CI) were calculated using random effects models. Methodological quality of trials was assessed using the PEDro scale. Results: twelve trials of high methodological quality (mean PEDro score 6.1), totalling 752 participants, were identified and provided data for the meta-analysis. Yoga produced a medium effect on HRQOL (Hedges’ g = 0.51, 95% CI 0.25–0.76, 12 trials) and a small effect on mental well-being (Hedges’ g = 0.38, 95% CI 0.15–0.62, 12 trials). Conclusion: yoga interventions resulted in small to moderate improvements in both HRQOL and mental well-being in people aged 60+ years. Further, research is needed to determine the optimal dose of yoga to maximise health impact.

Cognitive behavioural therapy for fear of falling and balance among older people: a systematic review and meta-analysis

LIU Tai-Wa, et al
2018

Background: fear of falling is prevalent among older people and associated with various health outcomes. A growing number of studies have examined the effects of interventions designed to reduce the fear of falling and improve balance among older people, yet our current understanding is restricted to physiological interventions. Psychological interventions such as cognitive behavioural therapy (CBT) have not been reviewed and meta-analysed. Objective: to perform a systematic review and meta-analysis evaluating the effects of CBT on reducing fear of falling and enhancing balance in community-dwelling older people. Method: randomised controlled trials (RCTs) addressing fear of falling and balance were identified through searches of six electronic databases, concurrent registered clinical trials, forward citation and reference lists of three previous systematic reviews. Results: a total of six trials involving 1,626 participants were identified. Four studies used group-based interventions and two adopted individual intervention. Intervention period ranged from 4 to 20 weeks, and the number and duration of face-to-face contact varied. Core components of the CBT intervention included cognitive restructuring, personal goal setting and promotion of physical activities. The risk of bias was low across the included studies. Our analysis suggests that CBT interventions have significant immediate and retention effects up to 12 months on reducing fear of falling, and 6 months post-intervention effect on enhancing balance. Conclusions: CBT appears to be effective in reducing fear of falling and improving balance among older people. Future researches to investigate the use of CBT on reducing fear of falling and improving balance are warranted.

Effectiveness and cost-effectiveness of community singing on mental health-related quality of life of older people: randomised controlled trial

COULTON Simon, et al
2015

Aims: This study aimed to evaluate the effectiveness and cost-effectiveness of community group singing for a population of older people in England. Method: A pilot pragmatic individual randomised controlled trial comparing group singing with usual activities in those aged 60 years or more. Results: A total of 258 participants were recruited across five centres in East Kent. At 6 months post-randomisation, significant differences were observed in terms of mental health-related quality of life measured using the SF12 in favour of group singing. In addition, the intervention was found to be marginally more cost-effective than usual activities. At 3 months, significant differences were observed for the mental health components of quality of life, anxiety and depression. Conclusions: Community group singing appears to have a significant effect on mental health-related quality of life, anxiety and depression, and it may be a useful intervention to maintain and enhance the mental health of older people.

Physical activity interventions for treatment of social isolation, loneliness or low social support in older adults: a systematic review and meta-analysis of randomised controlled trials

SHVEDKO Anastasia, et al
2018

Objectives: This article reviews the effects of physical activity (PA) interventions on social isolation, loneliness or low social support in older adults. Design: Systematic review and meta-analysis of randomised controlled trials (RCTs). Method: MEDLINE, EMBASE, PsycINFO, the Cochrane CENTRAL, CINAHL, were screened up to February 2017. RCTs comparing PA versus non-PA interventions or control (sedentary) condition were included. Risk of bias was assessed using the 12 criteria Cochrane Review Book Group risk of bias. The outcome measures were: social isolation, loneliness, social support, social networks, and social functioning. Standardised mean differences (SMDs) with associated 95% confidence intervals (CIs) were calculated for continuous outcomes. Meta-analysis was performed using a random effects model. Results: The search strategy identified 38 RCTs, with a total of 5288 participants, of which 26 had a low risk of bias and 12 had a high risk of bias. Meta-analysis was performed on 23 RCTs. A small significant positive effect favouring the experimental condition was found for social functioning with strongest effects obtained for PA interventions, diseased populations, group exercise setting, and delivery by a medical healthcare provider. No effect of PA was found for loneliness, social support, or social networks. Conclusion: This review shows, for social functioning, the specific aspects of PA interventions can successfully influence social health. PA did not appear to be effective for loneliness, social support and social networks.

Only the lonely: a randomized controlled trial of a volunteer visiting programme for older people experiencing loneliness

LAWLOR Brian, et al
2015

Loneliness is a significant problem among older people living in Ireland. The negative effects of loneliness on physical and emotional health are well documented in the literature. This study was established in the context of a dearth of effective interventions to alleviate loneliness. A peer visiting intervention for community dwelling older adults experiencing loneliness was designed and subjected to the rigour of a randomised controlled trial. It consisted of ten home visits to the intervention participants from a volunteer, themselves an older person. The volunteer built up a rapport with the participant and encouraged them to identify a social connection they wished to establish. Several participants made new social connections outside their home while most continued to receive visits from their volunteer following the end of the study period. The main study finding was very positive. The primary outcome, loneliness, decreased in the intervention group at one month and three month follow up. Potential benefits for the volunteers were also identified, in particular a decrease in loneliness. Both participants and volunteers reported that they enjoyed the intervention. The intervention is low cost and could be incorporated into existing support services or non-government organisations caring for community dwelling older adults. It is a potentially scalable model to deal with the major societal challenge of loneliness.

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