Introduction the aim of this study was to develop a programme theory to inform the design of loneliness interventions and guide any future evaluations. Methods we undertook a mixed-method evaluation, informed by the realist approach, of different approaches to loneliness in one health and social care system in the East Midlands, UK. We used a combination of documentary analysis, interviews/focus groups with service providers and users and quantitative analysis to develop an initial programme theory. Results common aims of local interventions included enhancing social connectivity, providing emotional support and advice/information; recurring interventions included social activities, emotional support, advice and information, lunch clubs, learning new skills and practical support. None were robustly evaluated. Fifty-six service user or providers were involved in interviews or focus groups, which highlighted the causes of loneliness, preferred services, access to services, thoughts about intervention configuration and desired outcomes from services. The themes emerging from the interviews/focus groups from both service provider and service user perspectives were combined with all of the previous emerging data to create an overarching programme theory. Statements were constructed to allow service providers to think about which interventions might be useful to achieve specific outcomes in different contexts. Conclusion the causes and consequences of loneliness vary widely between individuals, so a personalised approach is required to identify the causes and potential solutions. This study provides some high-level principles that can help commissioners and providers to tailor interventions to the individual needs of service users.

中文翻译：

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老年人孤独感干预的现实评估

引言 本研究的目的是开发一种程序理论，为孤独干预的设计提供信息并指导任何未来的评估。方法 我们根据现实主义方法对英国东米德兰兹郡的一个健康和社会护理系统中的孤独感的不同方法进行了混合方法评估。我们结合了文献分析、与服务提供商和用户的访谈/焦点小组以及定量分析来开发初始程序理论。结果 当地干预的共同目标包括加强社会联系、提供情感支持和建议/信息；经常性干预包括社交活动、情感支持、建议和信息、午餐俱乐部、学习新技能和实际支持。没有一个得到强有力的评估。56 名服务用户或提供者参与了访谈或焦点小组讨论，他们强调了孤独的原因、偏好的服务、获得服务的机会、对干预配置的想法以及期望的服务结果。从服务提供者和服务用户的角度从访谈/焦点小组中出现的主题与所有先前出现的数据相结合，以创建一个总体项目理论。构建声明是为了让服务提供者考虑哪些干预措施可能有助于在不同情况下实现特定结果。结论 孤独的原因和后果因人而异，因此需要个性化的方法来确定原因和潜在的解决方案。