Clinical Sciences Institute, National University of Ireland, Galway, Galway City, Ireland.
Clinical Sciences Institute, National University of Ireland, Galway, Galway City, Ireland.
Int J Nurs Stud. 2019 Apr;92:16-26. doi: 10.1016/j.ijnurstu.2018.12.014. Epub 2018 Dec 31.
To identify and examine definitions of frailty using qualitative thematic analysis.
A qualitative meta-aggregative systematic review.
The database search was performed using ASSIA, CINAHL, Cochrane Library, Embase, PsycINFO, PubMed and Google Scholar databases. Studies providing definitions of frailty, published in English from 1 January 2000 to 25 July 2018 were included.
Data were extracted by independent reviewers for qualitative thematic analysis.
In total, 86 studies met inclusion criteria. Five major themes with specific sub-themes were identified following thematic analysis including: (1) types of definitions (operational, conceptual, theoretical, older adults' perspective); (2) characteristics of frailty (a multi-domain and dimensional state, deficits/decline, weakness, a continuum-dynamic concept, clinically identifiable); (3) associated factors (age, comorbidity, nutrition, sarcopenia, social networks and environment); (4) mechanism (reduced adaptability, hormonal dysregulation); and (5) changes in health status and adverse outcomes (disability, increased risk of mortality, other healthcare related outcomes such as increased dependency or risk of falls).
Several themes were found that defined frailty, focusing predominantly on operational definitions and frailty as a physical syndrome. A universally accepted standard definition, which includes all dimensions of frailty is currently warranted.
通过定性主题分析来确定和研究衰弱的定义。
定性元聚合系统评价。
使用 ASSIA、CINAHL、Cochrane 图书馆、Embase、PsycINFO、PubMed 和 Google Scholar 数据库进行数据库搜索。纳入了 2000 年 1 月 1 日至 2018 年 7 月 25 日发表的以英文撰写的提供衰弱定义的研究。
由独立评审员提取数据进行定性主题分析。
共有 86 项研究符合纳入标准。通过主题分析确定了五个主要主题，包括：（1）定义类型（操作性、概念性、理论性、老年人视角）；（2）衰弱的特征（多领域和多维状态、缺陷/下降、虚弱、连续动态概念、临床可识别）；（3）相关因素（年龄、合并症、营养、肌肉减少症、社交网络和环境）；（4）机制（适应性降低、激素失调）；以及（5）健康状况变化和不良后果（残疾、死亡风险增加、其他与医疗保健相关的结果，如依赖性增加或跌倒风险增加）。
发现了一些定义衰弱的主题，主要集中在操作性定义和衰弱作为一种身体综合征上。目前需要一个普遍接受的包含衰弱所有维度的标准定义。
