How to Promote Gerotranscendence in Older Adults? A Scoping Review of Interventions.
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SUBMITTER: Abreu T
PROVIDER: S-EPMC10466938 | biostudies-literature | 2023 Sep
REPOSITORIES: biostudies-literature
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How to Promote Gerotranscendence in Older Adults? A Scoping Review of Interventions.
Abreu Taiane T Araújo Lia L Ribeiro Oscar O
Journal of applied gerontology : the official journal of the Southern Gerontological Society 20230413 9
Gerotranscendence is a psychosocial theory that proposes older adults experience a mindset shift in multiple dimensions (cosmic, coherence, solitude), associated with different constructs, such as life satisfaction and well-being. Increasing studies are employing gerotranscendence, but the practical aspects of how gerotranscendence can be developed are still underexplored. This review involved an assessment of the size and scope of the existing literature on interventions related to gerotranscen ...[more]
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Project description:BackgroundWith the aging of the population and rising rates of chronic diseases, web-based interventions could be considered to support older adults in adopting healthy lifestyles. To date, published knowledge syntheses have focused on quantitative studies among older adults aged ≥50 years. However, those aged ≥65 years may have different needs to be met by these interventions because of the biological and physiological changes associated with aging, and qualitative studies could help advance knowledge in this field.ObjectiveThe objective of this scoping review is to explore the extent of the literature on web-based interventions aimed at promoting healthy lifestyles among people aged ≥65 years.MethodsA scoping review was conducted based on the framework proposed by Levac et al. Six databases (ie, MEDLINE, CINAHL, PsycINFO, Web of Science, the Cochrane Database of Systematic Reviews, and the Joanna Briggs Library) and gray literature (ie, Google Scholar and OpenGrey) were searched. The final search was conducted on June 23, 2021. The studies were selected by 2 persons (AL and ML) independently. The included studies were systematic reviews and qualitative and quantitative studies focusing on web-based interventions to promote healthy lifestyles in people aged ≥65 years that were published in French or English between 1990 and 2021. Data were extracted in a table and synthesized based on the conceptualization of web-based interventions (ie, according to the use parameters, behavior change techniques, delivery modes, and theories). A thematic analysis was performed.ResultsIn total, 20 articles were included in this review, which represents studies focused on 11 distinct interventions. All of the interventions (11/11, 100%) aimed to promote physical activity among older adults. The number of intervention sessions varied from 5 to 16, with a frequency from daily to once every 2 weeks. Diverse delivery modes such as electronic diary, video, and phone call were found. The most used behavior change techniques were instruction, feedback, and self-monitoring. Few interventions (6/11, 55%) were based on a theory. A favorable trend was observed in increasing physical activity, and 5 themes emerged that appeared to be central to behavior change among older adults: motivation, support, tailoring, barriers, and perceptions.ConclusionsThis scoping review provides a better understanding of the components of web-based interventions and their outcomes on the healthy lifestyles of people aged ≥65 years. These findings could provide important guidance for the design and development of future web-based interventions in this field. Further research is needed to continue the development and evaluation of innovative and accessible interventions to promote healthy lifestyles among older adults.International registered report identifier (irrid)RR2-10.2196/23207.
| S-EPMC9449830 | biostudies-literature
Project description:BackgroundWith the aging of the population and rising rates of chronic diseases, older adults need support if they are to adopt healthy lifestyles. Web-based interventions should be considered for this purpose, since they are easily accessed and can foster healthy lifestyles among older adults. However, the literature on such interventions discusses a variety of components and effects and provides only 2 syntheses of knowledge on web-based interventions with older adults. These studies focus on populations aged 50 years and older, whereas the components and effects of interventions for a population of older adults (ie, 65 years and older) may differ. In addition, these 2 syntheses examined only quantitative studies, although other types of studies (ie, qualitative) are available and could help advance knowledge in this field. A scoping review is therefore relevant in order to explore the extent of the literature on this subject.ObjectiveThe purpose of the study described by this protocol is to explore the extent of the literature (experimental, quasi-experimental, qualitative, systematic reviews, and grey literature) on the components and effects of web-based interventions as a way to promote healthy lifestyles among older adults.MethodsThe databases MEDLINE, CINAHL, PsycInfo, Web of Science, Cochrane Database of Systematic Review and Joanna Briggs Library will be searched, in addition to the grey literature using Google Scholar and OpenGrey. Studies will be selected for the review by 2 researchers, working independently. The data will be synthesized based on the conceptualization of web-based interventions (ie, behavior change techniques, dispensation modes, and theories). A thematic analysis will be performed to summarize the components of the interventions studied.ResultsThe database search will begin in August 2020 and be completed in October 2020.ConclusionsThis scoping review should highlight web-based interventions designed to promote healthy lifestyles, as well as their components and effects, among people aged 65 years and older. These results could provide important guidance for intervention developers and designers in identifying the components of web-based interventions relevant to older adults and lead to further studies on this topic.International registered report identifier (irrid)PRR1-10.2196/23207.
| S-EPMC7813627 | biostudies-literature
Project description:BackgroundPain is prevalent and poorly managed in older adults. Although pain self-management strategies are helpful, adoption and access are limited; thus, technology provides an opportunity for intervention delivery. Mobile health (mHealth) is feasible to use in older adults; however, we have yet to understand the effect of mHealth pain self-management interventions on pain outcomes in older adults.ObjectiveThe purpose of this scoping review is to examine the characteristics of mHealth interventions and their efficacy on pain outcomes in older adults with musculoskeletal pain.MethodsWith the assistance of a medical librarian, keywords and subject headings were generated, including but not limited to mobile health application, mHealth, digital, pain, pain management, and older. A search was conducted for papers in journal databases, including PubMed, Embase, CINAHL, Scopus, and IEEE Xplore, between 2000 and 2022. Papers were screened according to predetermined inclusion and exclusion criteria, and reference lists were reviewed for additional paper inclusion. Three authors appraised the methodology of papers independently, then collaboratively to synthesize the evidence.ResultsSix publications were included in the scoping review. The design and methodology ranged widely from pilot studies to a comparative effectiveness trial. Older participants in the studies reported a variety of musculoskeletal conditions. Delivery of the mHealth pain self-management interventions incorporated mobile devices, such as a smartphone or tablet. Most mHealth-delivered interventions were multicomponent and incorporated elements of in-person and telephone access to an interventionist. The findings suggested mHealth interventions may reduce pain intensity; however, pain interference and other pain-related conditions did not have a statistically significant reduction.ConclusionsResearch that has explored mHealth for pain self-management is beginning to move beyond feasibility. The few experimental studies conducted in older adults are heterogeneous, and the interventions are mostly multicomponent. It is premature to conclude the interventions' significant effect on pain or pain-related symptoms. As technology continues to integrate into health care, more experimental research is warranted to examine the efficacy of mHealth interventions on a variety of pain outcomes in older adults.
| S-EPMC10267779 | biostudies-literature
Project description:Background: Polypharmacy paves the way for non-adherence, adverse drug reactions, negative health outcomes, increased use of healthcare services and rising costs. Since it is most prevalent in the older adults, there is an urgent need for introducing effective strategies to prevent and manage the problem in this age group. Purpose: To perform a scoping review critically analysing the available literature referring to the issue of polypharmacy management in the older adults and provide narrative summary. Data sources: Articles published between January 2010-March 2018 indexed in CINHAL, EMBASE and PubMed addressing polypharmacy management in the older adults. Results: Our search identified 49 papers. Among the identified interventions, the most often recommended ones involved various types of drug reviews based on either implicit or explicit criteria. Implicit criteria-based approaches are used infrequently due to their subjectivity, and limited implementability. Most of the publications advocate the use of explicit criteria, such as e.g. STOPP/START, Beers and Medication Appropriateness Index (MAI). However, their applicability is also limited due to long lists of potentially inappropriate medications covered. To overcome this obstacle, such instruments are often embedded in computerised clinical decision support systems. Conclusion: Multiple approaches towards polypharmacy management are advised in current literature. They vary in terms of their complexity, applicability and usability, and no "gold standard" is identifiable. For practical reasons, explicit criteria-based drug reviews seem to be advisable. Having in mind that in general, polypharmacy management in the older adults is underused, both individual stakeholders, as well as policymakers should strengthen their efforts to promote these activities more strongly.
| S-EPMC8661120 | biostudies-literature
Project description:Background and objectivesMinimizing disability is critical to reduce the costly health care associated with disability and maintain quality of life into old age. We examined the effect sizes of nonpharmacological intervention studies in reducing disability and explored the active ingredients of interventions.Research design and methodsA scoping review was conducted via PubMed, PsycINFO, and CINAHL databases. Thirty-one randomized controlled trials were included. Eight active ingredients were identified by three experts (exercise, problem-solving, cognitive behavioral therapy, environmental modification, education, goal setting, comprehensive geriatric assessment, and cognitive training).ResultsThe range of Cohen's d was -0.85 to 1.76 across 31 studies (included 33 interventions); 67% studies (n = 22) obtained small-to-negative effect sizes (d = -0.85 to 0.18), accounting for 83% participants across studies. Interventions that incorporated exercise, problem-solving, cognitive behavior therapy, and environmental modification were associated with stronger effect sizes. Interventions that incorporated comprehensive geriatric assessment obtained small effect sizes.Discussion and implicationsMajority of intervention studies found little or no effect in reducing disability for older adults. To optimize the effects of nonpharmacological interventions, we recommend researchers to (i) develop a screening tool for "risk of disability" to inform those who are early on the disability progression, yet not experience any difficulties in activities of daily living and instrumental activities of daily living; (ii) specify the active ingredients embedded in complex interventions to facilitate change in disability; and (iii) select sensitive tools to capture the progression of disability in late life.
| S-EPMC7182004 | biostudies-literature
Project description:BackgroundOlder adults are at risk for loneliness, and interventions to promote social connectedness are needed to directly address this problem. The nature of interventions aimed to affect the distinct, subjective concepts of loneliness/social connectedness has not been clearly described. The purpose of this review was to map the literature on interventions and strategies to affect loneliness/social connectedness for older adults.MethodsA comprehensive scoping review was conducted. Six electronic databases were searched from inception in July 2015, resulting in 5530 unique records. Standardized inclusion/exclusion criteria were applied, resulting in a set of 44 studies (reported in 54 articles) for further analysis. Data were extracted to describe the interventions and strategies, and the context of the included studies. Analytic techniques included calculating frequencies, manifest content analysis and meta-summary.ResultsInterventions were described or evaluated in 39 studies, and five studies described strategies to affect loneliness/social connectedness of older adults or their caregivers in a qualitative descriptive study. The studies were often conducted in the United States (38.6%) among community dwelling (54.5%), cognitively intact (31.8%), and female-majority (86.4%) samples. Few focused on non-white participants (4.5%). Strategies described most often were engaging in purposeful activity and maintaining contact with one's social network. Of nine intervention types identified, the most frequently described were One-to-One Personal Contact and Group Activity. Authors held divergent views of why the same type of intervention might impact social connectedness, but social contact was the most frequently conceptualized influencing factor targeted, both within and across intervention types.ConclusionsResearch to test the divergent theories of why interventions work is needed to advance understanding of intervention mechanisms. Innovative conceptualizations of intervention targets are needed, such as purposeful activity, that move beyond the current focus on the objective social network as a way to promote social connectedness for older adults.
| S-EPMC6139173 | biostudies-literature
Project description:Background/objectivesOlder adults are at high risk for adverse outcomes as they transition from hospital to home. Transitional care interventions primarily focus on care coordination and medication management and may miss key components. The objective of this study is to examine the current scope of hospital-to-home transitional care interventions that impact health-related outcomes and to examine other key components including engagement by older adults and their caregivers.DesignScoping review.MethodsEligible articles focused on hospital transition to home intervention, measured primary outcomes posthospitalization, used randomized controlled trial designs, and included primarily adults aged 60 years and older. Articles included in this review were reviewed in full and all data were extracted that related to study objective, setting, population, sample, intervention, primary and secondary outcomes, and main results.ResultsFive hundred sixty-seven records were identified by title. Forty-four articles were deemed eligible and included. Most common transitional care intervention components were care continuity and coordination, medication management, symptom recognition, and self-management. Few studies reported a focus on caregiver needs or goals. Common modes of intervention delivery included by phone, in person while the patient was hospitalized, and in person in the community following hospital discharge. The most common outcomes were readmission and mortality.ConclusionTo improve outcomes beyond healthcare utilization, a paradigm shift is required in the design and study of care transition interventions. Future interventions should explore methods or novel interventions for caregiver engagement; leverage an interdisciplinary team or care coordination hub with engagement from underrepresented specialties such as social work and occupational therapy; and examine opportunities for interventions designed specifically to address older adult and caregiver-reported needs and their well-being.
| S-EPMC8497409 | biostudies-literature
Project description:ObjectivesRehabilitation interventions for older adults are complex as they involve a number of interacting components, have multiple outcomes of interest and are influenced by a number of contextual factors. The importance of rigorous intervention development prior to formal evaluation has been acknowledged and a number of frameworks have been developed. This review explored which frameworks have been used to guide the development of rehabilitation interventions for older adults.DesignSystematic scoping review.SettingStudies were not limited for inclusion based on setting.ParticipantsStudies were included that featured older adults (>65 years of age).InterventionsStudies were included that reported the development of a rehabilitation intervention.Primary and secondary outcome measuresData were extracted on study population, setting, type of intervention developed and frameworks used. The primary outcome of interest was the type of intervention development framework.ResultsThirty-five studies were included. There was a range of underlying medical conditions including mild cognitive impairment and dementia (n=5), cardiac (n=4), stroke (n=3), falls (n=3), hip fracture (n=2), diabetes (n=2), breast cancer (n=1), Parkinson's disease (n=1), depression (n=1), chronic health problems (n=1), osteoarthritis (n=1), leg ulcer (n=1), neck pain (n=1) and foot problems (n=1). The intervention types being developed included multicomponent, support based, cognitive, physical activities, nursing led, falls prevention and occupational therapy led. Twelve studies (34%) did not report using a framework. Five frameworks were reported with the Medical Research Council (MRC) framework for developing and evaluating complex interventions being the most frequently cited (77%, n=17).ConclusionAt present, the MRC framework is the most popular for developing rehabilitation interventions for older adults. Many studies do not report using a framework. Further, specific guidance to assist this complex field of rehabilitation research is required.
| S-EPMC6398678 | biostudies-literature
Project description:The current study reviewed the effectiveness of mobile health interventions in eliciting behavioral change across a range of health conditions and examined integration of behavioral change theory, techniques, and agents in interventions among people age ≥60. The initial search returned 1,929 articles: 779 in PubMed, 522 in CINAHL, 633 in PsycINFO, and 131 in EMBASE. The final sample included 20 articles. Most interventions targeted and reported increases in physical activity and disease and medication management. Some studies were informed by behavioral change theories and included behavioral change agents. The most commonly used behavior change techniques were in the form of self- or external-monitoring and receiving tailored feedback on a person's progress. As the National Institutes of Health currently calls for an increased focus on mechanisms of change, future studies should specify features promoting behavioral change and consider whether interventions worked by engaging the hypothesized change mechanisms. [Research in Gerontological Nursing, 13(2), 102-116.].
| S-EPMC7082195 | biostudies-literature
Project description:BackgroundLoneliness and social isolation are growing public health concerns in our ageing society. Whilst these experiences occur across the life span, 50% of individuals aged over 60 are at risk of social isolation and one-third will experience some degree of loneliness later in life. The aim of this scoping review was to describe the range of interventions to reduce loneliness and social isolation among older adults that have been evaluated; in terms of intervention conceptualisation, categorisation, and components.MethodsThree electronic databases (CINAHL, Embase and Medline) were systematically searched for relevant published reviews of interventions for loneliness and social isolation. Inclusion criteria were: review of any type, published in English, a target population of older people and reported data on the categorisation of loneliness and/or social isolation interventions. Data extracted included: categories of interventions and the reasoning underpinning this categorisation. The methodology framework proposed by Arskey and O'Malley and further developed by Levac, et al. was used to guide the scoping review process.ResultsA total of 33 reviews met the inclusion criteria, evaluating a range of interventions targeted at older people residing in the community or institutionalised settings. Authors of reviews included in this paper often used the same terms to categorise different intervention components and many did not provide a clear definition of these terms. There were inconsistent meanings attributed to intervention characteristics. Overall, interventions were commonly categorised on the basis of: 1) group or one-to-one delivery mode, 2) the goal of the intervention, and 3) the intervention type. Several authors replicated the categorisation system used in previous reviews.ConclusionMany interventions have been developed to combat loneliness and social isolation among older people. The individuality of the experience of loneliness and isolation may cause difficulty in the delivery of standardised interventions. There is no one-size-fits-all approach to addressing loneliness or social isolation, and hence the need to tailor interventions to suit the needs of individuals, specific groups or the degree of loneliness experienced. Therefore, future research should be aimed at discerning what intervention works for whom, in what particular context and how.
| S-EPMC7020371 | biostudies-literature