Objectives: Hope/hopelessness is an important determinant of health and death, and is a modifiable risk factor for older adults. The present review aimed to evaluate the effectiveness of interventions on hope among older populations.Methods: PsychINFO and PubMed were systematically searched. Publications reporting on interventions delivered to older adults that included quantitative data on hope/hopelessness were systematically reviewed.Results: Thirty-six studies were included, most with hope/hopelessness as a secondary outcome. Interventions based on CBT alone or combined with antidepressants significantly decreased hopelessness in depressed older adults. Psychological interventions based on life review effectively improved hope/hopelessness in a range of samples, including depressed, bereaving, or medically ill older adults. Little to no support was found for exercise programs for healthy older adults, educational interventions for medically ill individuals, or Dignity Therapy for palliative care patients.Conclusions: Hope/hopelessness in older adults can be improved using psychological interventions based on CBT and life review. Controlled trials with hope/hopelessness as a primary objective are needed to more clearly demonstrate effectiveness.Clinical implications: Cognitive-behavioral interventions can improve hopelessness in depressed older adults. Life-review based interventions can positively impact hope in a range of older populations. Dignity Therapy, physical exercise, and educational programs may not effectively improve hope/hopelessness in older adults.

中文翻译：

---

对老年人希望/绝望干预措施的系统评价

目标：希望/绝望是健康和死亡的重要决定因素，并且是老年人可改变的风险因素。本综述旨在评估干预措施对老年人希望的有效性。方法：系统地检索了 PsychINFO 和 PubMed。对包括希望/绝望的定量数据的老年人干预措施报告的出版物进行了系统审查。结果：纳入了 36 项研究，大多数将希望/绝望作为次要结果。单独基于 CBT 或与抗抑郁药联合使用的干预措施显着降低了抑郁老年人的绝望情绪。基于生活回顾的心理干预有效地改善了一系列样本的希望/绝望，包括抑郁、丧亲或生病的老年人。几乎没有发现支持健康老年人的运动计划、医疗病人的教育干预或姑息治疗患者的尊严疗法。结论：可以使用基于 CBT 和生活回顾的心理干预来改善老年人的希望/绝望。需要以希望/绝望为主要目标的对照试验更清楚地证明有效性。临床意义：认知行为干预可以改善抑郁老年人的绝望。基于生活回顾的干预措施可以对一系列老年人群的希望产生积极影响。尊严疗法、体育锻炼和教育计划可能无法有效改善老年人的希望/绝望。医疗病人的教育干预，或姑息治疗患者的尊严疗法。结论：可以使用基于 CBT 和生活回顾的心理干预来改善老年人的希望/绝望。需要以希望/绝望为主要目标的对照试验更清楚地证明有效性。临床意义：认知行为干预可以改善抑郁老年人的绝望。基于生活回顾的干预措施可以对一系列老年人群的希望产生积极影响。尊严疗法、体育锻炼和教育计划可能无法有效改善老年人的希望/绝望。医疗病人的教育干预，或姑息治疗患者的尊严疗法。结论：可以使用基于 CBT 和生活回顾的心理干预来改善老年人的希望/绝望。需要以希望/绝望为主要目标的对照试验更清楚地证明有效性。临床意义：认知行为干预可以改善抑郁老年人的绝望。基于生活回顾的干预措施可以对一系列老年人群的希望产生积极影响。尊严疗法、体育锻炼和教育计划可能无法有效改善老年人的希望/绝望。需要以希望/绝望为主要目标的对照试验更清楚地证明有效性。临床意义：认知行为干预可以改善抑郁老年人的绝望。基于生活回顾的干预措施可以对一系列老年人群的希望产生积极影响。尊严疗法、体育锻炼和教育计划可能无法有效改善老年人的希望/绝望。需要以希望/绝望为主要目标的对照试验更清楚地证明有效性。临床意义：认知行为干预可以改善抑郁老年人的绝望。基于生活回顾的干预措施可以对一系列老年人群的希望产生积极影响。尊严疗法、体育锻炼和教育计划可能无法有效改善老年人的希望/绝望。