Migration of adult children and mental health of older parents ‘left behind’: An integrative review

BackgroundAlthough a number of studies have examined the effect of the out-migration of children on the mental health of ‘left behind’ elderly parents, research on the consequences of children’s migration on the mental health and well-being of elderly parents left behind is inconclusive and a systematic review is warranted.ObjectivesTo identify the association between the left behind or empty nest status and the mental health of older parents, and to identify common risk factors for poor mental health among those left behind.MethodsOnline databases CINAHL, PsycINFO, PubMed, Scopus and ProQuest were searched for research (2000-September 2017) that focused on the relationship between the migration of adult children and the mental health of the older parents (≥50 years) left behind. The JBI Checklist for Analytical Cross Sectional Studies was used to assess the methodological quality of the articles.Results25 articles met the inclusion criteria. The studies identified that left behind older parents had higher levels of mental health problems compared to non-left behind. Left behind parents had higher depressive symptoms, higher levels of loneliness, lower life satisfaction, lower cognitive ability and poorer psychological health. A number of risk factors were identified for mental health disorders among the left behind parents, which included living arrangements, gender, education, income, physical health status, physical activity, family and social support, age, rural residence and frequency of children’s visit.ConclusionsThis review synthesised the various studies related to the mental health of left behind parents, advancing the theoretical and empirical understanding of the implications of out-migration of adult children on the psychological health and well-being of older parents. More responsive preventive measures and effective management approaches are required for this vulnerable cohort.

【研究背景】尽管已有多项研究探讨了子女外流对“留守”老年父母（left-behind elderly parents）心理健康的影响，但针对子女迁移对留守老年父母心理健康与福祉的影响的相关研究结论仍不统一，因此有必要开展一项系统综述。
【研究目的】明确留守或空巢状态与老年父母心理健康之间的关联，并筛查留守老年父母心理健康状况不佳的常见风险因素。
【研究方法】检索CINAHL、PsycINFO、PubMed、Scopus及ProQuest五大在线数据库，筛选2000年至2017年9月期间发表的、聚焦成年子女迁移与≥50岁留守老年父母心理健康之间关联的研究。采用《乔安娜·布里格斯研究所分析性横断面研究检查表》（JBI Checklist for Analytical Cross Sectional Studies）评估纳入文献的方法学质量。
【研究结果】共有25篇文献符合纳入标准。研究显示，留守老年父母的心理健康问题检出率显著高于非留守老年父母。留守父母的抑郁症状水平更高、孤独感更强、生活满意度更低、认知能力更差且心理健康状况更不佳。本研究还筛查出留守老年父母罹患心理健康障碍的多项风险因素，包括居住安排、性别、受教育程度、收入水平、身体健康状况、体育锻炼情况、家庭与社会支持、年龄、农村居住身份以及子女探望频率。
【研究结论】本系统综述整合了所有与留守父母心理健康相关的研究，深化了对成年子女外流对老年父母心理健康与福祉影响的理论与实证认知。针对这一脆弱群体，亟需制定更具针对性的预防措施与有效的管理方案。