Exploring the Unmet and Met Needs of Homebound Older Adults: A Scoping Review
Bibliographic record
Abstract
Abstract Homebound older adults, defined as individuals (65+) who remain indoors for extended periods without venturing outside experience significant challenges that negatively impact their physical activity, psychological health, and overall quality of life (1,2). Researchers have examined both the unmet and met needs of HB older adults, highlighting the necessity for a synthesis of this evidence. Therefore, this scoping review aims to synthesize existing evidence on the cognitive, environmental, financial, personal, physical, psychological, and social met and unmet needs of HB older adults. Method Using Arksey and O’Malley’s (2005) framework, we searched across eight databases and supplemented by hand-searching reference lists of included articles. Screening (title, abstract, full text) and data extraction were conducted in pairs using predefined criteria. We employed thematic analysis (in pairs) to identify the met and unmet needs of HB older adults. Findings A total of 19 articles were included, of which eleven were quantitative studies, seven were qualitative, one was mixed-method studies. More than half of the included articles (n = 12) were conducted in the USA, with the remaining from China, United Kingdom, Portugal, Greece and Canada. Among the included articles, seventeen articles reported unmet needs ranging from cognitive (mild cognitive impairment), personal (lower life satisfaction), physical (functional impairment), psychological (depression), financial (financial constraints), environmental (housing needs) and social needs (loneliness). Remaining articles (n = 2) reported met needs using intervention such as Cognitive behavioural therapy (CBT) combined with Baduanjin qigong that reduced loneliness and Homebound elderly people psychotherapeutic interventions (HEPPI) that improved depression and episodic memory function.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.063 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.003 |
| Bibliometrics | 0.020 | 0.016 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.005 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".