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      Computer and Internet Interventions for Loneliness and Depression in Older Adults: A Meta-Analysis

      research-article
      , RN, PhD 1 , , RN 1 , , RN, PhD 2 ,
      Healthcare Informatics Research
      Korean Society of Medical Informatics
      Computer, Internet, Loneliness, Depression, Meta-Analysis

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          Abstract

          Objectives

          This study conducted a meta-analysis to examine the effectiveness of computer and Internet training interventions intended to reduce loneliness and depression in older adults.

          Methods

          Searches were performed to retrieve studies that had been published in peer-reviewed journals from January 2001 to July 2012 and written in English or Korean from PubMed, CINAHL, Scopus, the Cochrane Library, PsycINFO, KoreaMed, KMbase, KISS, MEDLIS, and RISS. We used combinations of the keywords for population, intervention, and psychosocial problems. A meta-analysis was employed to summarize the findings of studies on computer and Internet interventions for older adults. An overall mean weighted effect size for each outcome was calculated, and Q statistics were used to test the heterogeneity of variance in the effect sizes of the selected studies.

          Results

          As the Q statistics revealed heterogeneity, random effects models were chosen for the meta-analysis. The overall mean weighted effect size for loneliness from five studies was statistically significant for decreased loneliness (Z = 2.085, p = 0.037). However, the overall mean weighted effect size for depression from five studies was not statistically significant (Z = 1.528, p = 0.126).

          Conclusions

          These results suggest that computer and Internet programs were effective in managing loneliness among older adults. Therefore, further computer-mediated social support should be considered to help manage loneliness in this population.

          Related collections

          Most cited references24

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          A randomized controlled trial of the psychosocial impact of providing internet training and access to older adults.

          The Internet (electronic mail and the World Wide Web) may provide new opportunities for communication that can help older adults avoid social isolation. This randomized controlled trial assessed the psychosocial impact of providing Internet access to older adults over a five-month period. One hundred volunteers from four congregate housing sites and two nursing facilities were randomly assigned to receive Internet training or to a wait list control group. The pre & post measures included the UCLA Loneliness scale, modified CES Depression scale, a measure of locus of control, computer attitudes, number of confidants, and overall quality of life. Participants received nine hours of small group training in six sessions over two weeks. Computers were available for continued use over five months and the trainer was available two hours/week for questions. At the end of the trial, 60% of the intervention group continued to use the Internet on a weekly basis. Although there was a trend toward decreased loneliness and depression in intervention subjects compared to controls, there were no statistically significant changes from baseline to the end of trial between groups. Among Internet users (n = 29) in the intervention group there were trends toward less loneliness, less depression, more positive attitudes toward computers, and more confidants than among intervention recipients who were not regular users (n = 19) of this technology. Most elderly participants in this trial learned to use the Internet and the majority continued to use it on a weekly basis. The psychosocial impact of Internet use in this sample suggested trends in a positive direction. Further research is needed to determine more precisely, which older adults, residing in which environmental contexts are more likely than others to benefit from this rapidly expanding information and communication link.
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            Internet use and psychological well-being: a meta-analysis.

            This meta-analysis examines the relationship between various Internet uses and measures of psychological well-being, including depression, loneliness, self-esteem, and life satisfaction. Forty studies represent a total sample of 21,258 participants and yield a data of 43 independent correlations. The mean correlation was -0.0504 for the fixed-effects model and r = -0.0385 for the random-effects model, indicating a small detrimental effect of Internet use on psychological well-being. According to the random-effects model, the effect of all moderators, including type of Internet use, indicator of well-being, quality of Internet use measure, and participant age and gender were insignificant. Since these moderators failed to explain the variation in the relationship between Internet use and psychological well-being, future investigations should consider the possible sources of these differences.
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              Escape loneliness by going digital: a quantitative and qualitative evaluation of a Dutch experiment in using ECT to overcome loneliness among older adults.

              This study evaluates the outcomes of an Internet-at-home intervention experiment that intended to decrease loneliness among chronically ill and physically handicapped older adults through introducing them to the use of an electronic communication facility. To determine the effectiveness of the experiment in terms of reducing loneliness, 15 older adults were interviewed three times: shortly before the start, two years later and immediately after termination of the experiment, while their loneliness scores at zero and post-measurement were compared with those of a control group. Both the participants and the control persons experienced a reduction in loneliness over time. However, the reduction was only significant for the intervention participants. Moreover, the changes in loneliness were significantly greater among the participants compared to the control persons. When looking more in detail, the effect of the experiment was only significant regarding emotional loneliness and among the highest educated. Findings of the qualitative research enabled us to understand the mechanisms through which the intervention helped alleviate loneliness. E-mail was found to facilitate social contact. Furthermore, the computer and Internet were often used to pass the time, taking people's minds off their loneliness. Unexpectedly, the intervention also improved people's self-confidence. The decline in loneliness is likely to be greater if persons under more favorable circumstances are selected and if more social functions of the Internet are used.
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                Author and article information

                Journal
                Healthc Inform Res
                Healthc Inform Res
                HIR
                Healthcare Informatics Research
                Korean Society of Medical Informatics
                2093-3681
                2093-369X
                September 2012
                30 September 2012
                : 18
                : 3
                : 191-198
                Affiliations
                [1 ]Nursing Policy and Research Institute, Yonsei University College of Nursing, Seoul, Korea.
                [2 ]Department of Nursing Science, Ewha Womans University College of Health Sciences, Seoul, Korea.
                Author notes
                Corresponding Author: Dukyoo Jung, RN, PhD. Department of Nursing Science, Ewha Womans University College of Health Sciences, 52 Ewhayeodae 7-gil, Seodaemun-gu, Seoul 120-750, Korea. Tel: +82-2-3277-6693, Fax: +82-2-3277-2850, dyjung@ 123456ewha.ac.kr
                Article
                10.4258/hir.2012.18.3.191
                3483477
                23115742
                bfcd2092-2583-4354-b227-e27be3df7401
                © 2012 The Korean Society of Medical Informatics

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 07 September 2012
                : 24 September 2012
                : 25 September 2012
                Categories
                Original Article

                Bioinformatics & Computational biology
                meta-analysis,computer,depression,loneliness,internet
                Bioinformatics & Computational biology
                meta-analysis, computer, depression, loneliness, internet

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