Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, The Innovation Centre, The University of Sheffield, 217 Portobello, Sheffield, S1 4DP, UK.
Aging and Health Research Unit, Faculty of Health sciences, the University of Sydney, 75 East Street, J block, Lidcombe, NSW, 2141, Australia.
BMC Geriatr. 2019 Jul 22;19(1):195. doi: 10.1186/s12877-019-1189-9.
The number of older people with unmet care and support needs is increasing substantially due to the challenges facing the formal and informal care system in the United Kingdom. Addressing these unmet needs is becoming one of the urgent public health priorities. In order to develop effective solutions to address some of these needs, it is important first to understand the care and support needs of older people.
A scoping review was conducted, using the Arksey and O'Malley original and enhanced framework, to understand the care and support needs of older people, focusing on those living at home with chronic conditions in the UK. The search was conducted using five electronic data bases, grey literature and reference list checks. The WHO International Classification of Functioning, Disability and Health (ICF) framework was used to analyse and categorise the literature findings.
Forty studies were included in the final analysis- 32 from academic literature and 8 from grey literature. The review highlighted that older adults faced a range of physical, social and psychological challenges due to living with chronic conditions and required care and support in three main areas: 1) social activities and relationships; 2) psychological health; and 3) activities related to mobility, self-care and domestic life. The review also highlighted that many older people demonstrated a desire to cope with their illness and maintain independence, however, environmental factors interfered with these efforts including: 1) lack of professional advice on self-care strategies; 2) poor communication and coordination of services; and 3) lack of information on services such as care pathways. A gap in the knowledge was also identified about the care and support needs of two groups within the older population: 1) older workers; and 2) older carers.
The review highlighted that older people living with chronic conditions have unmet care needs related to their physical and psychological health, social life, as well as the environment in which they live and interact. Findings of this review also emphasized the importance of developing care models and support services based around the needs of older people.
由于英国正规和非正规护理体系面临的挑战，有护理和支持需求但未得到满足的老年人数量正在大幅增加。满足这些未满足的需求正成为紧迫的公共卫生重点之一。为了制定解决其中一些需求的有效解决方案，首先了解老年人的护理和支持需求非常重要。
使用 Arksey 和 O'Malley 的原始和增强框架进行了范围审查，以了解英国居家患有慢性病的老年人的护理和支持需求。使用五个电子数据库、灰色文献和参考文献检查进行了搜索。使用世界卫生组织（WHO）的国际功能、残疾和健康分类（ICF）框架来分析和分类文献结果。
最终分析包括 40 项研究——其中 32 项来自学术文献，8 项来自灰色文献。该综述强调，由于患有慢性病，老年人面临着一系列身体、社会和心理挑战，他们需要在以下三个主要领域得到护理和支持：1）社会活动和关系；2）心理健康；3）与移动性、自我护理和家庭生活相关的活动。该综述还强调，许多老年人表现出应对疾病和保持独立的愿望，但环境因素干扰了这些努力，包括：1）缺乏有关自我护理策略的专业建议；2）服务沟通和协调不善；3）缺乏有关护理途径等服务的信息。还发现老年人中两个群体的护理和支持需求存在知识差距：1）老年工人；2）老年照顾者。
该综述强调，患有慢性病的老年人在身体和心理健康、社会生活以及他们生活和互动的环境方面存在未满足的护理需求。本综述的研究结果还强调了根据老年人的需求制定护理模式和支持服务的重要性。
