Participants' baseline characteristics and feedback of the nature-based social intervention "friends in nature" among lonely older adults in assisted living facilities in finland: a randomised controlled trial of the RECETAS EU-project.
Assisted living facility
Health-related quality of life
Loneliness
Nature-based intervention
Randomised controlled trial
Journal
BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548
Informations de publication
Date de publication:
07 Oct 2024
07 Oct 2024
Historique:
received:
26
02
2024
accepted:
25
09
2024
medline:
8
10
2024
pubmed:
8
10
2024
entrez:
7
10
2024
Statut:
epublish
Résumé
Loneliness is common among older adults in institutional settings. It leads to adverse effects on health and wellbeing, for which nature contact with peers in turn may have positive impact. However, the effects of nature engagement among older adults have not been studied in randomised controlled trials (RCT). The "Friends in Nature" (FIN) group intervention RCT for lonely older adults in Helsinki assisted living facilities (ALFs) aims to explore the effects of peer-related nature experiences on loneliness and health-related quality of life (HRQoL). In this study we aim describe the participants' baseline characteristics of the RCT, feasibility of FIN intervention and intervention participants' feedback on the FIN. Lonely participants were recruited from 22 ALFs in Helsinki area, Finland, and randomised into two groups: 1) nature-based social intervention once a week for nine weeks (n = 162) and 2) usual care (n = 157). Demographics, diagnoses and medication use were retrieved from medical records, and baseline cognition, functioning, HRQoL, loneliness and psychological wellbeing were assessed. Primary trial outcomes will be participants' loneliness (De Jong Giervald Loneliness Scale) and HRQoL (15D). The mean age of participants was 83 years, 73% were female and mean Minimental State Examination of 21 points. The participants were living with multiple co-morbidities and/or disabilities. The intervention and control groups were comparable at baseline. The adherence with intervention was moderate, with a mean attendance of 6.8 out of the nine sessions. Of the participants, 14% refused, fell ill or were deceased, and therefore, participated three sessions or less. General subjective alleviation of loneliness was achieved in 57% of the intervention participants. Of the respondents, 96% would have recommended a respective group intervention to other older adults. Intervention participants appreciated their nature excursions and experiences. We have successfully randomised 319 lonely residents in assisted living facilities into a trial about the effects of nature experiences in a group-format. The feedback from participants was favourable. The trial will provide important information about possibilities of alleviating loneliness with peer-related nature-based experiences in frail residents. ClinicalTrials.gov, ID: NCT05507684. Registration 19/08/2022.
Sections du résumé
BACKGROUND
BACKGROUND
Loneliness is common among older adults in institutional settings. It leads to adverse effects on health and wellbeing, for which nature contact with peers in turn may have positive impact. However, the effects of nature engagement among older adults have not been studied in randomised controlled trials (RCT). The "Friends in Nature" (FIN) group intervention RCT for lonely older adults in Helsinki assisted living facilities (ALFs) aims to explore the effects of peer-related nature experiences on loneliness and health-related quality of life (HRQoL). In this study we aim describe the participants' baseline characteristics of the RCT, feasibility of FIN intervention and intervention participants' feedback on the FIN.
METHODS
METHODS
Lonely participants were recruited from 22 ALFs in Helsinki area, Finland, and randomised into two groups: 1) nature-based social intervention once a week for nine weeks (n = 162) and 2) usual care (n = 157). Demographics, diagnoses and medication use were retrieved from medical records, and baseline cognition, functioning, HRQoL, loneliness and psychological wellbeing were assessed. Primary trial outcomes will be participants' loneliness (De Jong Giervald Loneliness Scale) and HRQoL (15D).
RESULTS
RESULTS
The mean age of participants was 83 years, 73% were female and mean Minimental State Examination of 21 points. The participants were living with multiple co-morbidities and/or disabilities. The intervention and control groups were comparable at baseline. The adherence with intervention was moderate, with a mean attendance of 6.8 out of the nine sessions. Of the participants, 14% refused, fell ill or were deceased, and therefore, participated three sessions or less. General subjective alleviation of loneliness was achieved in 57% of the intervention participants. Of the respondents, 96% would have recommended a respective group intervention to other older adults. Intervention participants appreciated their nature excursions and experiences.
CONCLUSIONS
CONCLUSIONS
We have successfully randomised 319 lonely residents in assisted living facilities into a trial about the effects of nature experiences in a group-format. The feedback from participants was favourable. The trial will provide important information about possibilities of alleviating loneliness with peer-related nature-based experiences in frail residents.
TRIAL REGISTRATION
BACKGROUND
ClinicalTrials.gov, ID: NCT05507684. Registration 19/08/2022.
Identifiants
pubmed: 39375627
doi: 10.1186/s12877-024-05408-0
pii: 10.1186/s12877-024-05408-0
doi:
Banques de données
ClinicalTrials.gov
['NCT05507684']
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
812Investigateurs
Acurio David
(A)
Bártová Alzbeta
(B)
Cattaneo Lucie
(C)
Holmerova Iva
(H)
Garcia Gabriela
(G)
Informations de copyright
© 2024. The Author(s).
Références
Perlman D, Peplau LA. Toward a social psychology of loneliness. In: Duck S, Gilmour R, editors. Personal relationships in disorder. London: Academic Press; 1981. p. 31–56.
Ong AD, Uchino BN, Wethington E. Loneliness and health in older adults: a mini-review and synthesis. Gerontology. 2016;62(4):443–9. https://doi.org/10.1159/000441651 .
doi: 10.1159/000441651
pubmed: 26539997
Gardiner C, Laud P, Heaton T, Gott M. What is the prevalence of loneliness amongst older people living in residential and nursing care homes? A systematic review and meta-analysis. Age Ageing. 2020;49:748–57. https://doi.org/10.1093/ageing/afaa049 .
doi: 10.1093/ageing/afaa049
pubmed: 32396600
Cacioppo S, Capitanio JP, Cacioppo JT. Toward a neurology of loneliness. Psychol Bull. 2014;140(6):1464–504. https://doi.org/10.1037/a0037618 . Epub 2014 Sep 15.
doi: 10.1037/a0037618
pubmed: 25222636
pmcid: 5130107
Jansson AH, Muurinen S, Savikko N, Soini H, Suominen M, Kautiainen H, Pitkala KH. Loneliness in nursing homes and assisted living facilities: prevalence, associated factors and prognosis. J Nurs Home Res Sci. 2017;3:43–9. https://doi.org/10.14283/jnhrs.2017.7 .
doi: 10.14283/jnhrs.2017.7
Gerst-Emerson K, Jayawardhana J. Loneliness as a public health issue: the impact of loneliness on health care utilization among older adults. Am J Public Health. 2015;105:1013–9. https://doi.org/10.2105/AJPH.2014.302427 .
doi: 10.2105/AJPH.2014.302427
pubmed: 25790413
pmcid: 4386514
Aerts R, Honnay O, Van Nieuwenhuyse A. Biodiversity and human health: mechanisms and evidence of the positive health effects of diversity in nature and green spaces. Br Med Bull. 2018;127(1):5–22. https://doi.org/10.1093/bmb/ldy021 .
doi: 10.1093/bmb/ldy021
pubmed: 30007287
Jones R, Tarter R, Ross AM. Greenspace interventions, stress and cortisol: a scoping review. Int J Environ Res Public Health. 2021;18(6):2802. https://doi.org/10.3390/ijerph18062802 .
doi: 10.3390/ijerph18062802
pubmed: 33801917
pmcid: 8001092
Yuan Y, Huang F, Lin F, Zhu P, Zhu P. Green space exposure on mortality and cardiovascular outcomes in older adults: a systematic review and meta-analysis of observational studies. Aging Clin Exp Res. 2021;33(7):1783–97. https://doi.org/10.1007/s40520-020-01710-0 .
doi: 10.1007/s40520-020-01710-0
pubmed: 32951189
Moeller C, King N, Burr V, Gibbs GR, Gomersall T. Nature-based interventions in institutional and organisational settings: a scoping review. Int J Environ Health Res. 2018;28(3):293–305. https://doi.org/10.1080/09603123.2018.1468425 .
doi: 10.1080/09603123.2018.1468425
pubmed: 29699406
Zhao Y, Liu Y, Wang Z. Effectiveness of horticultural therapy in people with dementia: a quantitative systematic review. J Clin Nurs. 2022;31(13–14):1983–97. https://doi.org/10.1111/jocn.15204 .
doi: 10.1111/jocn.15204
pubmed: 32017241
Haluza D, Schönbauer R, Cervinka R. Green perspectives for public health: a narrative review on the physiological effects of experiencing outdoor nature. Int J Environ Res Public Health. 2014;11(5):5445–61. https://doi.org/10.3390/ijerph110505445 .
doi: 10.3390/ijerph110505445
pubmed: 24852391
pmcid: 4053896
Leavell MA, Leiferman JA, Gascon M, Braddick F, Gonzalez JC, Litt JS. Nature-based social prescribing in urban settings to improve social connectedness and mental well-being: review. Curr Environ Health Rep. 2019;6(4):297–308. https://doi.org/10.1007/s40572-019-00251-7 .
doi: 10.1007/s40572-019-00251-7
pubmed: 31713144
Robinson JM, Brindley P, Cameron R, MacCarthy D, Jorgensen A. Nature’s role in supporting health during the COVID-19 pandemic: a geospatial and socioecological study. Int J Environ Res Public Health. 2021;18(5):2227. https://doi.org/10.3390/ijerph18052227 .
doi: 10.3390/ijerph18052227
pubmed: 33668228
pmcid: 7967714
Gardiner C, Geldenhuys G, Gott M. Interventions to reduce social isolation and loneliness among older people: an integrative review. Health Soc Care Community. 2018;26(2):147–57. https://doi.org/10.1111/hsc.12367 .
doi: 10.1111/hsc.12367
pubmed: 27413007
Reinhardt GY, Vidovic D, Hammerton C. Understanding loneliness: a systematic review of the impact of social prescribing initiatives on loneliness. Perspect Public Health. 2021;141(4):204–13. https://doi.org/10.1177/1757913920967040 .
doi: 10.1177/1757913920967040
pubmed: 34159848
pmcid: 8295963
Pitkala KH, Routasalo P, Kautiainen H, Tilvis RS. Effects of psychosocial group rehabilitation on health, use of health care services, and mortality of older persons suffering from loneliness: a randomized, controlled trial. J Gerontol A Biol Sci Med Sci. 2009;64(7):792–800. https://doi.org/10.1093/gerona/glp011 .
doi: 10.1093/gerona/glp011
pubmed: 19223606
Coll-Planas L, Carbó-Cardeña A, Jansson A, Dostálová V, Bartova A, Rautiainen L, et al. Nature-based social interventions to address loneliness among vulnerable populations: a common study protocol for three related randomized controlled trials in Barcelona, Helsinki, and Prague within the RECETAS European project. BMC Public Health. 2024;24(1):172. https://doi.org/10.1186/s12889-023-17547-x .
doi: 10.1186/s12889-023-17547-x
pubmed: 38218784
pmcid: 10787456
Litt JS, Coll-Planas L, Sachs A, Rochau U, Beacom A, Jansson A, et al. RECETAS: Rationale and logic model of a nature-based social intervention for people experiencing loneliness. Cities and Health. 2023. https://doi.org/10.1080/23748834.2023.2300207 . (in press).
doi: 10.1080/23748834.2023.2300207
Morris JN, Fries BE, Mehr DR, Hawes C, Phillips C, Mor V, et al. MDS cognitive performance scale. J Gerontol. 1994;49(4):M174–82. https://doi.org/10.1093/geronj/49.4.m174 .
doi: 10.1093/geronj/49.4.m174
pubmed: 8014392
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state” a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98. https://doi.org/10.1016/0022-3956(75)90026-6 .
doi: 10.1016/0022-3956(75)90026-6
pubmed: 1202204
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83. https://doi.org/10.1016/0021-9681(87)90171-8 .
doi: 10.1016/0021-9681(87)90171-8
pubmed: 3558716
Merikanto I, Kronholm E, Peltonen M, Laatikainen T, Lahti T, Partonen T. Relation of chronotype to sleep complaints in the general Finnish population. Chronobiol Int. 2012;29(3):311–7. https://doi.org/10.3109/07420528.2012.655870 .
doi: 10.3109/07420528.2012.655870
pubmed: 22390244
Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia. Br J Psychiatry. 1982;140:566–72. https://doi.org/10.1192/bjp.140.6.566 .
doi: 10.1192/bjp.140.6.566
pubmed: 7104545
Forti P, Olivelli V, Rietti E, Maltoni B, Ravaglia G. Diagnostic performance of an executive clock drawing task (CLOX) as a screening test for mild cognitive impairment in elderly persons with cognitive complaints. Dement Geriatr Cogn Disord. 2010;30:20–7. https://doi.org/10.1159/000315515 .
doi: 10.1159/000315515
pubmed: 20606441
Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965;14:61–5.
pubmed: 14258950
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56. https://doi.org/10.1093/gerona/56.3.m146 .
doi: 10.1093/gerona/56.3.m146
pubmed: 11253156
Kurlowicz L, Greenberg SA. The geriatric depression scale (GDS). Am J Nurs. 2007;107(10):67–8. https://doi.org/10.1097/01.NAJ.0000292207.37066.2f .
doi: 10.1097/01.NAJ.0000292207.37066.2f
De Jong GJ, Van Tilburg T. The De Jong Gierveld short scales for emotional and social loneliness: tested on data from 7 countries in the UN generations and gender surveys. Eur J Ageing. 2010;7(2):121–30. https://doi.org/10.1007/s10433-010-0144-6 .
doi: 10.1007/s10433-010-0144-6
Sintonen H. The 15D instrument of health-related quality of life: properties and applications. Ann Med. 2001;33:328–36. https://doi.org/10.3109/07853890109002086 .
doi: 10.3109/07853890109002086
pubmed: 11491191
De Jong Gierveld J, Tilburg TV. A 6-item scale for overall, emotional, and social loneliness: confirmatory tests on survey data. Res Aging. 1 de septiembre de 2006;28(5):582-98. https://doi.org/10.1177/0164027506289 .
Liimatta HA, Lampela P, Kautiainen H, Laitinen-Parkkonen P, Pitkala KH. The effects of preventive home visits on older people’s use of health care and social services and related costs. J Gerontol A Biol Sci Med Sci. 2020;75(8):1586–93. https://doi.org/10.1093/gerona/glz139 .
doi: 10.1093/gerona/glz139
pubmed: 31139827
Routasalo PE, Tilvis RS, Kautiainen H, Pitkala KH. Effects of psychosocial group rehabilitation on social functioning, loneliness and well-being of lonely, older people: randomized controlled trial. J Adv Nurs. 2009;65:297–305. https://doi.org/10.1111/j.1365-2648.2008.04837.x .
doi: 10.1111/j.1365-2648.2008.04837.x
pubmed: 19054177
Savikko N. Loneliness of Older People and Elements of an Intervention for Its Alleviation. [medical thesis]. Annales Universitates Turkuensis. Turku: University of Turku; 2008.
Jansson AH, Savikko NM, Pitkälä KH. Training professionals to implement a group model for alleviating loneliness among older people – 10-year follow-up study. Educ Gerontol. 2018;44(2–3):119–27. https://doi.org/10.1080/03601277.2017.1420005 .
doi: 10.1080/03601277.2017.1420005
Pitkala KH, Savikko N, Routasalo P. Group dynamics in older people’s closed groups. Findings from Finnish psychosocial group rehabilitation for lonely older people. In: Derrickson H (Ed.): Group Therapy. Hauppauge, N.Y.: Nova Publishers; 2015. pp. 39–73.
Onder G, Carpenter I, Finne-Soveri H, Gindin J, Frijters D, Henrard JC, et al. Assessment of nursing home residents in Europe: the Services and Health for Elderly in Long TERm care (SHELTER) study. BMC Health Serv Res. 2012;9(12):5. https://doi.org/10.1186/1472-6963-12-5 .
doi: 10.1186/1472-6963-12-5
Aalto UL, Finne-Soveri H, Kautiainen H, Öhman H, Roitto HM, Pitkälä KH. Relationship between anticholinergic burden and health-related quality of life among residents in long-term care. J Nutr Health Aging. 2021;25(2):224–9. https://doi.org/10.1007/s12603-020-1493-2 .
Juola AL, Bjorkman M, Pylkkanen S, Finne-Soveri UH, Soini H, Kautiainen H, et al. Feasibility and baseline findings of an educational intervention in a randomized, controlled trial to optimize drug treatment among residents assisted living facilities. Eur Geriatric Med. 2014;5:195–9. https://doi.org/10.1016/j.eurger.2014.02.005 .
doi: 10.1016/j.eurger.2014.02.005