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Results for 'systematic reviews'

Results 11 - 20 of 56

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.

Indoor nature interventions for health and wellbeing of older adults in residential settings: a systematic review

YEO Nicola L., et al
2019

Background and Objectives: Having contact with nature can be beneficial for health and wellbeing, but many older adults face barriers with getting outdoors. This study conducted a systematic review of quantitative studies on health and wellbeing impacts of indoor forms of nature (both real and simulated/artificial), for older adults in residential settings. Research Design and Methods: Search terms relating to older adults and indoor nature were run in 13 scientific databases (MEDLINE, CINAHL, AgeLine, Environment Complete, AMED, PsychINFO, EMBASE, HMIC, PsychARTICLES, Global Health, Web of Knowledge, Dissertations and Theses Global, and ASSIA). This study also pursued grey literature, global clinical trials registries, and a range of supplementary methods. Results: Of 6,131 articles screened against eligibility criteria, 26 studies were accepted into the review, and were quality-appraised using the Effective Public Health Practice Project (EPHPP) tool. The participants were 930 adults aged over 60. Nature interventions and health/wellbeing outcomes were heterogeneous, which necessitated a narrative synthesis. The evidence base was generally weak, with 18 of 26 studies having a high risk of bias. However, several higher-quality studies found indoor gardening and horticulture programs were effective for cognition, psychological wellbeing, social outcomes, and life satisfaction. Discussion and Implications: There is inconsistent evidence that indoor nature exposures are beneficial for older care residents. This study suggests that successful interventions were, at least partly, facilitating social interaction, supporting feelings of autonomy/control, and promoting skill development, that is, factors not necessarily associated with nature per se. Higher-quality studies with improved reporting standards are needed to further elucidate these mechanisms.

Impact of individualised music listening intervention on persons with dementia: A systematic review of randomised controlled trials

GAVIOLA Minah Amor, et al
2019

Objective: To summarise the evidence regarding the impact of individualised music listening on persons with dementia. Methods: Six electronic databases (CINAHL, Medline, ProQuest, PsycINFO, Music Periodicals and Cochrane) were searched up to July 2018 for randomised controlled trials (RCTs) evaluating the efficacy of individualised music listening compared to other music and non–music‐based interventions. Results: Four studies were included. Results showed evidence of a positive impact of individualised music listening on behavioural and psychological symptoms of dementia (BPSDs) including agitation, anxiety and depression and physiological outcomes. Evidence for other outcomes such as cognitive function and quality of life was limited. Conclusions: The limited evidence suggests individualised music listening has comparable efficacy to more resource‐intensive interventions. However, there was a small number of RCTs and some outcomes were evaluated by a single study. This limits the conclusions drawn, warranting more RCTs evaluating other outcomes beyond the BPSDs.

Combatting social isolation and increasing social participation of older adults through the use of technology: a systematic review of existing evidence

BAKER Steven, et al
2018

Objectives: There are growing concerns that social isolation presents risks to older people's health and well‐being. Thus, the objective of the review was to explore how technology is currently being utilised to combat social isolation and increase social participation, hence improving social outcomes for older people. Methods: A systematic review of the literature was conducted across the social science and human‐computer interaction databases. Results: A total of 36 papers met the inclusion criteria and were analysed using a four‐step process. Findings were threefold, suggesting that: (i) technologies principally utilised social network services and touch‐screen technologies; (ii) social outcomes are often ill‐defined or not defined at all; and (iii) methodologies used to evaluate interventions were often limited and small‐scale. Conclusion: Results suggest a need for studies that examine new and innovative forms of technology, evaluated with rigorous methodologies, and drawing on clear definitions about how these technologies address social isolation/participation. Policy Impact: This systematic review explores how technology is currently being utilised to combat social isolation and increase social participation for older people. A unique aspect of this review is that it incorporates smaller design studies and prototypes. These insights will benefit those considering the potential for information and communication technologies to contribute to older adults’ health and well‐being. Practice Impact: This systematic review explores how technology is currently being utilised to combat social isolation and increase social participation for older people. Insights from the review will benefit practitioners seeking to understand the broad range of technologies that are being applied to these issues, and the common benefits and challenges associated with each approach.

The effectiveness of mindfulness- and acceptance-based interventions for informal caregivers of people with dementia: a meta-analysis

COLLINS Rebecca N., KISHITA Naoko
2019

Background and Objectives: The application of mindfulness- and acceptance-based interventions (MABIs) for informal caregivers of people with dementia (PwD) is relatively novel, and the current state of the evidence base is unclear. This meta-analysis examined the effectiveness of MABIs on reducing symptoms of depression and burden in informal caregivers of PwD. The quality of included studies was evaluated and moderator variables explored. Research Design and Methods: A literature search of six electronic databases (PsycARTICLES, PsycINFO, MEDLINE Complete, SCOPUS, Web of Science, and ProQuest) was conducted from the first available date to 20 December 2016. Inclusion criteria involved studies that quantitatively investigated the impact of MABIs on depression and/or burden in informal caregivers of PwD. Results: Twelve studies, providing data on 321 caregivers, were included. Most used mindfulness-based stress reduction and were conducted in the United States. The average attrition among participants was 15.83%. The pre–post effect of MABIs was large for depression and moderate for burden. These effects were largely maintained at follow-up. Significant heterogeneity of effect sizes was observed, with no significant moderators identified. Study quality varied from very poor to moderately good. Discussion and Implications: The low attrition and moderate to large effects suggest that MABIs are acceptable and beneficial for informal caregivers of PwD. The lack of significant moderators could advocate services using more cost-effective forms of MABIs. Further higher-quality research is needed to improve the robustness of the evidence base and enable a meta-analysis to thoroughly examine and quantify moderator variables.

Acceptance and use of innovative assistive technologies among people with cognitive impairment and their caregivers: a systematic review

THORDARDOTTIR Bjorg, et al
2019

Cognitive impairments (CI), associated with the consequences of Alzheimer’s disease and other dementias, are increasingly prevalent among older adults, leading to deterioration in self-care, mobility, and interpersonal relationships among them. Innovative Assistive Technologies (IAT) such as electronic reminders and surveillance systems are considered as increasingly important tools to facilitate independence among this population and their caregivers. The aim of this study is to synthesise knowledge on facilitators and barriers related to acceptance of and use of IAT among people with CI and their caregivers. This systematic review includes original papers with quantitative, qualitative, or mixed methods design. Relevant peer-reviewed articles published in English between 2007 and 2017 were retrieved in the following databases: CINAHL; PubMed; Inspec; and PsycINFO. The Mixed Method Appraisal Tool (MMAT) was used for quality assessment. We retrieved thirty studies, including in total 1655 participants from Europe, USA/Canada, Australia, and Asia, enrolled in their homes, care-residences, day-care centres, or Living Labs. Two-thirds of the studies tested technologies integrating home sensors and wearable devices for care and monitoring CI symptoms. Main facilitators for acceptance and adherence to IAT were familiarity with and motivation to use technologies, immediate perception of effectiveness (e.g., increase in safety perceptions), and low technical demands. Barriers identified included older age, low maturity of the IAT, little experience with technologies in general, lack of personalization, and support. More than 2/3 of the studies met 80% of the quality criteria of the MMAT. Low acceptance and use of IAT both independently and with caregivers remains a significant concern. More knowledge on facilitators and barriers to use of IAT among clients of health care and social services is crucial for the successful implementation of innovative programmes aiming to leverage innovative technologies for the independence of older people with CI.

Results 11 - 20 of 56

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