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Results for 'systematic reviews'

Results 1 - 10 of 51

Interventions for preventing falls in older people living in the community (review)

GILLESPIE Lesley D., et al
2012

Background: Approximately 30 per cent of people over 65 years of age living in the community fall each year. This is an update of a Cochrane review first published in 2009.Objective: To assess the effects of interventions designed to reduce the incidence of falls in older people living in the community. Search methods: this review searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (February 2012), CENTRAL (The Cochrane Library2012, Issue 3), MEDLINE (1946 to March 2012), EMBASE (1947 to March 2012), CINAHL (1982 to February 2012), and online trial registers. Selection criteria: Randomised trials of interventions to reduce falls in community-dwelling older people. Main results: this review included 159 trials with 79,193 participants. Most trials compared a fall prevention intervention with no intervention or an intervention not expected to reduce falls. The most common interventions tested were exercise as a single intervention (59 trials) and multifactorial programmes (40 trials).Findings: Group and home‐based exercise programmes, usually containing some balance and strength training exercises, effectively reduced falls, as did Tai Chi. Overall, exercise programmes aimed at reducing falls appear to reduce fractures. Multifactorial interventions assess an individual's risk of falling, and then carry out treatment or arrange referrals to reduce the identified risks. Overall, current evidence shows that this type of intervention reduces the number of falls in older people living in the community but not the number of people falling during follow‐up. These are complex interventions, and their effectiveness may be dependent on factors yet to be determined. Interventions to improve home safety appear to be effective, especially in people at higher risk of falling and when carried out by occupational therapists. An anti‐slip shoe device worn in icy conditions can also reduce falls. Taking vitamin D supplements does not appear to reduce falls in most community‐dwelling older people, but may do so in those who have lower vitamin D levels in the blood before treatment. Some medications increase the risk of falling. Three trials in this review failed to reduce the number of falls by reviewing and adjusting medications. A fourth trial involving family physicians and their patients in medication review was effective in reducing falls. Gradual withdrawal of a particular type of drug for improving sleep, reducing anxiety, and treating depression (psychotropic medication) has been shown to reduce falls. Cataract surgery reduces falls in women having the operation on the first affected eye. Insertion of a pacemaker can reduce falls in people with frequent falls associated with carotid sinus hypersensitivity, a condition which causes sudden changes in heart rate and blood pressure. In people with disabling foot pain, the addition of footwear assessment, customised insoles, and foot and ankle exercises to regular podiatry reduced the number of falls but not the number of people falling. The evidence relating to the provision of educational materials alone for preventing falls is inconclusive.

Nostalgia as a psychological resource for people with dementia: a systematic review and meta-analysis of evidence of effectiveness from experimental studies

ISMAIL Sanda Umar, et al
2020

Objective: This review systematically examines evidence relating to the effect of nostalgia on psychological well-being through a meta-analysis of measures of social connectedness, self-esteem, meaning in life, self-continuity, optimism and positive and negative affect. Rationale: If nostalgia is to be used as a clinical intervention to boost well-being in dementia by reducing threat, then it is important to assess its therapeutic potential. Results: Searches carried out in July 2014 and updated in February 2018 identified 47 eligible experimental studies comparing nostalgic reminiscence and non-nostalgic reminiscence to be included in the meta-analysis. Nostalgic reminiscence had moderate effects on positive affect (0.51 (0.37, 0.65), p= 0.001), social connectedness (0.72 (0.57, 0.87), p= 0.001), self-esteem (0.50 (0.30, 0.70), p= 0.001), meaning in life (0.77 (0.47, 1.08), p= 0.001) and optimism (0.38 (0.28, 0.47), p= 0.001) and a large effect on self-continuity (0.81 (0.55, 1.07), p= 0.001). There was, however, no difference between the effect of nostalgic reminiscence and non-nostalgic reminiscence for negative affect (−0.06 (−0.20, 0.09), p= 0.443). Conclusion: This systematic review and meta-analysis provides an overview of the evidence base for nostalgia. This is an important stage in developing nostalgia as a clinical intervention for people with dementia which might be achieved, for instance, by adapting current reminiscence and life review techniques. This meta-analysis will therefore also serve as a valuable reference point for the continued exploration of nostalgia as an intervention.

What approaches to social prescribing work, for whom, and in what circumstances? A realist review

HUSK Kerryn, et al
2020

The use of non‐medical referral, community referral or social prescribing interventions has been proposed as a cost‐effective alternative to help those with long‐term conditions manage their illness and improve health and well‐being. However, the evidence base for social prescribing currently lags considerably behind practice. In this paper, we explore what is known about whether different methods of social prescribing referral and supported uptake do (or do not) work. Supported by an Expert Advisory Group, we conducted a realist review in two phases. The first identified evidence specifically relating to social prescribing in order to develop programme theories in the form of ‘if‐then’ statements, articulating how social prescribing models are expected to work. In the second phase, we aimed to clarify these processes and include broader evidence to better explain the proposed mechanisms. The first phase resulted in 109 studies contributing to the synthesis, and the second phase 34. We generated 40 statements relating to organising principles of how the referral takes place (Enrolment), is accepted (Engagement), and completing an activity (Adherence). Six of these statements were prioritised using web‐based nominal group technique by our Expert Group. Studies indicate that patients are more likely to enrol if they believe the social prescription will be of benefit, the referral is presented in an acceptable way that matches their needs and expectations, and concerns elicited and addressed appropriately by the referrer. Patients are more likely to engage if the activity is both accessible and transit to the first session supported. Adherence to activity programmes can be impacted through having an activity leader who is skilled and knowledgeable or through changes in the patient's conditions or symptoms. However, the evidence base is not sufficiently developed methodologically for us to make any general inferences about effectiveness of particular models or approaches.

The effectiveness of interventions for reducing subjective and objective social isolation among people with mental health problems: a systematic review

MA Ruimin, et al
2019

Purpose: Subjective and objective social isolation are important factors contributing to both physical and mental health problems, including premature mortality and depression. This systematic review evaluated the current evidence for the effectiveness of interventions to improve subjective and/or objective social isolation for people with mental health problems. Primary outcomes of interest included loneliness, perceived social support, and objective social isolation. Methods: Three databases were searched for relevant randomised controlled trials (RCTs). Studies were included if they evaluated interventions for people with mental health problems and had objective and/or subjective social isolation (including loneliness) as their primary outcome, or as one of a number of outcomes with none identified as primary. Results: In total, 30 RCTs met the review’s inclusion criteria: 15 included subjective social isolation as an outcome and 11 included objective social isolation. The remaining four evaluated both outcomes. There was considerable variability between trials in types of intervention and participants’ characteristics. Significant results were reported in a minority of trials, but methodological limitations, such as small sample size, restricted conclusions from many studies. Conclusion: The evidence is not yet strong enough to make specific recommendations for practice. Preliminary evidence suggests that promising interventions may include cognitive modification for subjective social isolation, and interventions with mixed strategies and supported socialisation for objective social isolation. This study highlights the need for more thorough, theory-driven intervention development and for well-designed and adequately powered RCTs.

A systematic review of interventions for loneliness among older adults living in long-term care facilities

QUAN Nicolas G., et al
2019

Objectives: This study aimed to review loneliness interventions for older adults living in long-term care (LTC) facilities over the past 10 years, to categorise interventions by type, and to compare effectiveness of loneliness interventions in these settings. Methods: Systematic review followed PRISMA guidelines. Articles matching search criteria were collected from PubMed, PsycINFO, and Web of Science from 2009 to 2019. The inclusion criteria were as follows: 1) English language, 2) intervention studies with a quantitative measure that compares pre-trial to post-trial changes, 3) loneliness as a primary or secondary outcome 4) subjects age >65, and 5) subjects living in a LTC facility, such as a nursing home, assisted-living, or hospice. Results: A total of 15 intervention studies qualified for systematic review. Most of these interventions were psychological therapies and leisure/skill development interventions. Approximately, 87% of studies reported significant decreases in loneliness following intervention. Laughter therapy, horticultural therapy, and reminiscence therapy were associated with the greatest decreases in loneliness. Discussion: Results suggest that, although less common than interventions in the community, there are several effective interventions to reduce loneliness among older adults living in LTC facilities. Lack of standardised measures and high-quality studies limits comparisons between intervention types and generalizability to different populations.

Animal-assisted therapy for dementia (Review)

LAI NM, et al
2019

Background: A range of new therapeutic strategies has been evaluated in research, and the use of trained animals in therapy sessions, termed animal‐assisted therapy (AAT), is receiving increasing attention. Objectives: To evaluate the efficacy and safety of animal‐assisted therapy for people with dementia. Search methods: Medical databases were searched for this review to September 2019. Key characteristics of included studies: This study included nine randomised controlled trials (clinical studies where people are randomly put into one of two or more treatment groups), involving 305 people with dementia, which compared AAT to a control treatment (either usual care or an alternative treatment). All studies took place in Europe or the US. Seven studies compared AAT to usual care or to another activity which had nothing to do with animals. Two studies compared AAT (using live animals) to the use of robotic animals. One study compared AAT to the use of a soft toy cat. Key findings: this study found evidence from two studies with 83 participants that people with dementia who had AAT were possibly slightly less depressed at the end of treatment than people who had standard care or other interventions not related to animals. The study also found evidence from three studies with 164 participants that people who received AAT had no clear difference in their quality of life compared to those who did not. However, the study found no evidence of an effect on social functioning (interactions with their environment and families), behaviour, agitation, activities of daily living, self‐care ability or balance. There were no clear differences when AAT was compared with the use of a robotic animal in two studies, or with the use of a soft toy cat in one study. Conclusions: AAT may slightly reduce depressive symptoms. Otherwise, no conclusions can yet be drawn on whether AAT is beneficial or safe for people with dementia. The small size of the included studies, and the diversity of outcomes and outcome measures, were major issues. The researchers recommend further well‐conducted studies with the inclusion of important outcomes such as emotional and social well‐being, quality of life, side effects, and effects on the animals.

The impact of social prescribing services on service users: a systematic review of the evidence

PESCHENY Julia Vera, RANDHAWA Gurch, PAPPAS Yannis
2019

Background: Social prescribing initiatives are widely implemented in the UK National Health Service to integrate health and social care. Social prescribing is a service in primary care that links patients with non-medical needs to sources of support provided by the community and voluntary sector to help improve their health and wellbeing. Such programmes usually include navigators, who work with referred patients and issue onward referrals to sources of non-medical support. This systematic review aimed to assess the evidence of service user outcomes of social prescribing programmes based on primary care and involving navigators. Methods: 11 databases, the grey literature, and the reference lists of relevant studies were searched to identify the available evidence on the impact of social prescribing on service users. Searches were limited to literature written in English. No date restrictions were applied, and searches were conducted to June 2018. Findings were synthesised narratively, employing thematic analysis. The Mixed Methods Appraisal Tool Version 2011 was used to evaluate the methodological quality of included studies. Results: Sixteen studies met the inclusion criteria. The evidence base is mixed, some studies found improvements in health and wellbeing, health-related behaviours, self-concepts, feelings, social contacts and day-to-day functioning post-social prescribing, whereas others have not. The review also shows that the evaluation methodologies utilised were variable in quality. Conclusion: In order to assess the success of social prescribing services, more high quality and comparable evaluations need to be conducted in the future.

A systematic review of loneliness interventions among non-elderly adults

BESSAHA Melissa L., et al
2019

Loneliness - the subjective experience of social isolation—is an important indicator of quality of life for adults and a major determinant of health. While much research has focused on interventions to alleviate loneliness in elderly populations, there has been no systematic investigation of loneliness interventions targeting the non-elderly adult population. The aim of this systematic review is to summarise current understanding on the effectiveness of interventions for alleviating loneliness among non-elderly adults. Littell et al.’s (Systematic reviews and meta-analysis, Oxford University Press, New York, 2008) systematic review process was used to organise, synthesise, and critique findings. An electronic search was conducted using relevant databases (CINAHL, Pubmed, PsycINFO, Social Work Abstracts) and keywords and index terms for three concepts: age, loneliness outcome, and intervention study. Study selection was limited to studies conducted in English, assessed a primary outcome measure of loneliness, and included a population of non-elderly adults ages 18 to 64. Out of 5813 studies identified for initial screening, 264 studies underwent full-text review, and 68 studies met inclusion criteria. Pairs of reviewers extracted and synthesised data including research design, sampling techniques, and outcomes. Results are grouped by primary sub-populations in which interventions were conducted including people with mental illnesses; disabilities; chronic illnesses; military members; parents and caregivers; immigrants and refugees; and other marginalised groups. Several interventions, particularly those involving technology and support groups, significantly reduced loneliness. This review informs clinical social work practice around programs that reduce loneliness and its consequences among specific sub-populations of non-elderly adults.

Facilitators and barriers to autonomy: a systematic literature review for older adults with physical impairments, living in residential care facilities

van LOON Jolande, et al
2019

Autonomy is important in every stage of life. However, little is known about how autonomy is enhanced for older adults living in residential care facilities (RCFs). This leads to the research question: which facilitators and barriers to autonomy of older adults with physical impairments due to ageing and chronic health conditions living in RCFs are known? The results will be organised according to the framework of person-centred practice, because this is related to autonomy enhancement. To answer the research question, a systematic literature search and review was performed in the electronic databases CINAHL, PsycINFO, PubMed, Social Services Abstracts and Sociological Abstracts. Inclusion and exclusion criteria were derived from the research question. Selected articles were analysed and assessed on quality using the Mixed Methods Appraisal Tool. Facilitators and barriers for autonomy were found and arranged in four themes: characteristics of residents, prerequisites of professional care-givers, care processes between resident and care-giver, and environment of care. The established facilitators and barriers are relational and dynamic. For a better understanding of the facilitators and barriers to autonomy for older adults with physical impairments living in RCFs, a description is based on the 35 included articles. Autonomy is a capacity to influence the environment and make decisions irrespective of having executional autonomy, to live the kind of life someone desires to live in the face of diminishing social, physical and/or cognitive resources and dependency, and it develops in relationships. The results provide an actual overview and lead to a better understanding of barriers and facilitators for the autonomy of older adults with physical impairments in RCFs. For both residents and care-givers, results offer possibilities to sustain and reinforce autonomy. Scientifically, the study creates new knowledge on factors that influence autonomy, which can be used to enhance autonomy.

Interventions to promote early discharge and avoid inappropriate hospital (re)admission: a systematic review

COFFEY Alice, et al
2019

Increasing pressure on limited healthcare resources has necessitated the development of measures promoting early discharge and avoiding inappropriate hospital (re)admission. This systematic review examines the evidence for interventions in acute hospitals including (i) hospital-patient discharge to home, community services or other settings, (ii) hospital discharge to another care setting, and (iii) reduction or prevention of inappropriate hospital (re)admissions. Academic electronic databases were searched from 2005 to 2018. In total, ninety-four eligible papers were included. Interventions were categorized into: (1) pre-discharge exclusively delivered in the acute care hospital, (2) pre- and post-discharge delivered by acute care hospital, (3) post-discharge delivered at home and (4) delivered only in a post-acute facility. Mixed results were found regarding the effectiveness of many types of interventions. Interventions exclusively delivered in the acute hospital pre-discharge and those involving education were most common but their effectiveness was limited in avoiding (re)admission. Successful pre- and post-discharge interventions focused on multidisciplinary approaches. Post-discharge interventions exclusively delivered at home reduced hospital stay and contributed to patient satisfaction. Existing systematic reviews on tele-health and long-term care interventions suggest insufficient evidence for admission avoidance. The most effective interventions to avoid inappropriate re-admission to hospital and promote early discharge included integrated systems between hospital and the community care, multidisciplinary service provision, individualization of services, discharge planning initiated in hospital and specialist follow-up.

Results 1 - 10 of 51

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News

Moving Memory

Moving Memory Practice example about how the Moving Memory Dance Theatre Company is challenging perceived notions of age and ageing.

Chatty Cafe Scheme

Chatty Cafe Scheme Practice example about how the Chatty Cafe Scheme is helping to tackle loneliness by bringing people of all ages together

Oomph! Wellness

Oomph! Wellness Practice example about how Oomph! Wellness is supporting staff to get older adults active and combat growing levels of social isolation

KOMP

KOMP Practice example about how KOMP, designed by No Isolation is helping older people stay connected with their families

LAUGH research project

LAUGH research project Practice example about a research project to develop highly personalised, playful objects for people with advanced dementia
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