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      COVID-19 experiences of social isolation and loneliness among older adults in Africa: a scoping review

      systematic-review

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          Abstract

          Objective

          Social isolation and loneliness (SI/L) are considered critical public health issues. The primary objective of this scoping review is to document the experience of SI/L among older adults in Africa during the COVID-19 pandemic, given research gaps in this area. We identified the reasons for SI/L, the effects of SI/L, SI/L coping strategies, and research and policy gaps in SI/L experiences among older adults in Africa during COVID-19.

          Methods

          Six databases (PubMed, Scopus, CINAHL, APA PsycINFO, Web of Science, and Ageline) were used to identify studies reporting the experiences of SI/L among older adults in Africa during the COVID-19 lockdown. We adopted the Joanna Briggs Institute (JBI) methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).

          Results

          Social isolation and loneliness due to COVID-19 in Africa affected older adults' mental, communal, spiritual, financial, and physical health. The use of technology was vital, as was the role of social networks within the family, community, religious groups, and government. Methodological challenges include the risk of selective survival bias, sampling biases, and limited inductive value due to context. Also, lack of large-scale mixed methods longitudinal studies to capture the experiences of older adults during COVID-19. There were essential policy gaps for African mental health support services, media programs, and community care service integration targeting older adults in the era of the COVID-19 lockdown.

          Discussion

          Like in other countries, COVID-19 lockdown policies and the lockdown restrictions primarily caused the experience of SI/L among older adults in Africa. In African countries, they resulted in a severance of older adults from the cultural structure of care for older adults and their familial support systems. Weak government intervention, personal situations, challenges regarding technology, and detachment from daily activities, disproportionately affected older adults in Africa.

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          Most cited references43

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          Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach

          Background Scoping reviews are a relatively new approach to evidence synthesis and currently there exists little guidance regarding the decision to choose between a systematic review or scoping review approach when synthesising evidence. The purpose of this article is to clearly describe the differences in indications between scoping reviews and systematic reviews and to provide guidance for when a scoping review is (and is not) appropriate. Results Researchers may conduct scoping reviews instead of systematic reviews where the purpose of the review is to identify knowledge gaps, scope a body of literature, clarify concepts or to investigate research conduct. While useful in their own right, scoping reviews may also be helpful precursors to systematic reviews and can be used to confirm the relevance of inclusion criteria and potential questions. Conclusions Scoping reviews are a useful tool in the ever increasing arsenal of evidence synthesis approaches. Although conducted for different purposes compared to systematic reviews, scoping reviews still require rigorous and transparent methods in their conduct to ensure that the results are trustworthy. Our hope is that with clear guidance available regarding whether to conduct a scoping review or a systematic review, there will be less scoping reviews being performed for inappropriate indications better served by a systematic review, and vice-versa.
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            Validity, reliability, and generalizability in qualitative research

            In general practice, qualitative research contributes as significantly as quantitative research, in particular regarding psycho-social aspects of patient-care, health services provision, policy setting, and health administrations. In contrast to quantitative research, qualitative research as a whole has been constantly critiqued, if not disparaged, by the lack of consensus for assessing its quality and robustness. This article illustrates with five published studies how qualitative research can impact and reshape the discipline of primary care, spiraling out from clinic-based health screening to community-based disease monitoring, evaluation of out-of-hours triage services to provincial psychiatric care pathways model and finally, national legislation of core measures for children's healthcare insurance. Fundamental concepts of validity, reliability, and generalizability as applicable to qualitative research are then addressed with an update on the current views and controversies.
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              Impact of Social Isolation Due to COVID-19 on Health in Older People: Mental and Physical Effects and Recommendations

              Objectives To review the impact of social isolation during COVID-19 pandemic on mental and physical health of older people and the recommendations for patients, caregivers and health professionals. Design Narrative review. Setting Non-institutionalized community-living people. Participants 20.069 individuals from ten descriptive cross-sectional papers. Measurements Articles since 2019 to 2020 published on Pubmed, Scielo and Google Scholar databases with the following MeSh terms (‘COVID-19’, ‘coronavirus’, ‘aging’, ‘older people’, ‘elderly’, ‘social isolation’ and ‘quarantine’) in English, Spanish or Portuguese were included. The studies not including people over 60 were excluded. Guidelines, recommendations, and update documents from different international organizations related to mental and physical activity were also analysed. Results 41 documents have been included in this narrative review, involving a total of 20.069 individuals (58% women), from Asia, Europe and America. 31 articles included recommendations and 10 addressed the impact of social distancing on mental or physical health. The main outcomes reported were anxiety, depression, poor sleep quality and physical inactivity during the isolation period. Cognitive strategies and increasing physical activity levels using apps, online videos, telehealth, are the main international recommendations. Conclusion Mental and physical health in older people are negatively affected during the social distancing for COVID-19. Therefore, a multicomponent program with exercise and psychological strategies are highly recommended for this population during the confinement. Future investigations are necessary in this field.
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                Author and article information

                Contributors
                Journal
                Front Public Health
                Front Public Health
                Front. Public Health
                Frontiers in Public Health
                Frontiers Media S.A.
                2296-2565
                09 May 2023
                2023
                09 May 2023
                : 11
                : 1158716
                Affiliations
                [1] 1Department of Gerontology, Simon Fraser University , Burnaby, BC, Canada
                [2] 2Gerontology Research Centre, Simon Fraser University , Burnaby, BC, Canada
                Author notes

                Edited by: Laura-Alejandra Rico-Uribe, International University of La Rioja, Spain

                Reviewed by: Qi Wang, The University of Hong Kong, Hong Kong SAR, China; Candace S. Brown, University of North Carolina at Charlotte, United States

                *Correspondence: Isaac Akinkunmi Adedeji isaac_adedeji@ 123456sfu.ca ; adedejiia@ 123456yahoo.com
                Article
                10.3389/fpubh.2023.1158716
                10203559
                37228728
                5e262b3c-530d-4590-a4dd-41ea5dd668df
                Copyright © 2023 Adedeji, Wister and Pickering.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 04 February 2023
                : 03 April 2023
                Page count
                Figures: 1, Tables: 4, Equations: 0, References: 48, Pages: 12, Words: 8410
                Funding
                IA was supported by the Fogarty International Center and the National Institute of Aging (NIA) of the National Institutes of Health under Award Number D43 TW010543.
                Categories
                Public Health
                Systematic Review
                Custom metadata
                Aging and Public Health

                africa,covid-19,loneliness,older adults,social isolation
                africa, covid-19, loneliness, older adults, social isolation

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