You will be presented with a collection of medical randomized controlled trial (RCT) reports addressing a shared clinical question -- for instance, the efficacy of a medical intervention on a disease or condition. Given the titles and abstracts of these reports, your task is to generate the conclusion of the systematic review article synthesizing the key findings. Your conclusion should be a few sentences long. In your response, include only the conclusion and no other text. The RCT reports are below.



Title 1:
A Systematic Review of Loneliness and Common Chronic Physical Conditions in Adults
Abstract 1:
Loneliness is a prevalent and global problem for adult population s and has been linked to multiple chronic conditions in quantitative studies . This paper presents a systematic review of quantitative studies that examined the links between  loneliness  and common chronic conditions including : heart disease , hypertension , stroke , lung disease , and metabolic disorders . A comprehensive literature search process guided by the PRISMA statement led to the inclusion of 33 articles that measure loneliness in chronic illness population s.  Loneliness is a significant biopsychosocial stressor that is prevalent in adults with heart disease , hypertension , stroke , and lung disease . The relationships among loneliness , obesity , and metabolic disorders are understudied but current research indicates that loneliness is associated with obesity and with psychological stress in obese persons . Limited interventions have demonstrated long-term effectiveness for reducing loneliness in adults with these same chronic conditions . Future longitudinal r and omized trials that enhance knowledge of how diminishing loneliness can lead to improved health outcomes in persons with common chronic conditions would continue to build evidence to support the translation of findings to recommendations for clinical care


Title 2:
The effects of animal-assisted therapy on loneliness in an elderly population in long-term care facilities.
Abstract 2:
BACKGROUND Animal-assisted therapy ( AAT ) is cl aim ed to have a variety of benefits , but almost all published results are anecdotal . We characterized the resident population in long-term care facilities desiring AAT  and determined whether AAT can objective ly improve loneliness . METHODS Of 62 residents , 45 met inclusion criteria for the study . These 45 residents were administered the Demographic and Pet History Question naire ( DPHQ ) and Version 3 of the UCLA Loneliness Scale ( UCLA-LS ) . They were then r and omized into three groups ( no AAT ; AAT once/week ; AAT three times/week ; n = 15/group ) and retested with the UCLA-LS near the end of the 6-week study . RESULTS Use of the DPHQ showed residents volunteering for the study had a strong life-history of emotional intimacy with pets and wished that they currently had a pet . AAT was shown by analysis of covariance followed by pairwise comparison to have significantly reduced loneliness scores in comparison with the no AAT group . CONCLUSIONS The desire for AAT strongly correlates with previous pet ownership . AAT reduces loneliness in residents of long-term care facilities


Title 3:
Indoor gardening older adults: effects on socialization, activities of daily living, and loneliness.
Abstract 3:
This study examined the effects of indoor gardening on socialization , activities of daily living ( ADLs ) , and perceptions of loneliness in elderly nursing home residents . A total of 66 residents from two nursing homes participated in this two-phase study . In phase one , experimental group 1 participated once a week for 5 weeks in gardening activities while a control group received a 20-minute visit . While no significant differences were found between groups in socialization or perceptions of loneliness , there were significant pretest-posttest differences within groups on loneliness and guidance , reassurance of worth , social integration , and reliable alliance . The results also demonstrated gardening interventions had a significant effect on three ADLs ( transfer , eating , and toileting ) . Phase two examined differences in the effects of a 5-week versus a 2-week intervention program . Although no significant within-group differences were noted in socialization , loneliness , or ADLs , the 5-week program was more effective in increasing socialization and physical functioning


Title 4:
Social support and suicidal ideation in older adults using home healthcare services.
Abstract 4:
OBJECTIVE The objective of this study was to examine the associations between objective and subjective social support and suicidal ideation in older adults receiving home healthcare services . METHOD Participants were r and omly selected from a sample of older adults newly starting skilled nursing care from a certified home health agency in Westchester County , NY .  Research interviewers assessed 522 older adults aged 65 years and older who were receiving home care services . Subjective and objective components of social support were assessed using measures of  social network , social interaction patterns , instrumental support  , and  perceptions of social support . Suicidal ideation was assessed using items from the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition and the Hamilton Depression Rating Scale . RESULTS In bivariate analyses , neither objective ly determined size of social network nor instrumental support was associated with suicidal ideation . However , lower social interaction patterns and lower perceived social support were significantly related to suicidal ideation . After adjusting for potential confounders , only lower perceived support remained significantly associated with suicidal ideation . In post hoc analyses of the perceptions of social support scale items , satisfaction with one 's relationships and feeling useful to family and friends were significantly associated with a lower likelihood of suicidal ideation in the final multivariate logistic regression model controlling for possible confounding variables . CONCLUSIONS Subjective social support is a potentially modifiable risk factor for suicide in later life . Findings suggest that the perception of social support is an important construct to examine in future longitudinal studies examining risk and protective factors for suicidal ideation and behaviors in older adults


Title 5:
The effectiveness of physical exercise training in pain, mobility, and psychological well-being of older persons living in nursing homes.
Abstract 5:
Pain is common in the aging population , particularly among older residents of nursing homes . It has been found that 50 % of older people living in the community have been experiencing chronic pain , and the number increased to 80 % for older residents of nursing homes .  Exercise is an effective non-pharmacological intervention that can reduce pain and improve physical and psychological functions . A quasi-experimental study with a pretest-posttest control group design ed was conducted to evaluate the effects of a physical exercise program ( PEP ) on older residents of nursing homes who have chronic pain . Three-hundred-ninety-six older residents with chronic pain were recruited from 10 nursing homes run by non-governmental organizations in Hong Kong . The average age of the older residents was 85.44 ± 6.29 . Five nursing homes were r and omized to the experimental group with PEP ( n = 225 , age = 85.45 ± 6.25 ) ; the other five nursing homes were r and omized to the control group without the PEP ( n = 171 , age = 85.44 ± 6.35 ) . PEP was an eight-week training program given by a physiotherapist and nurses once a week . It consisted of warm-up exercises , muscle strengthening , stretching , balancing , and self-administered massage to acupressure points . At the end of each PEP session , pamphlets with pictures illustrating the " exercise of the day " were given to the older residents of nursing homes as a tool to enhance their self-management skills . The control group received no training during the eight weeks . Upon completion of the PEP , the experimental group experienced a significantly greater reduction in pain intensity from 4.19 ± 2.25 ( on an 11 point scale ) to 2.67 ± 2.08 , as compared to the control group ( p < .05 ) . In addition , the psychological well-being ( happiness , loneliness , life satisfaction , and depression ) of the experimental group was significantly improved ( p < .05 )
The results show that intervention programs are effective to reduce the feeling of loneliness .