Crist Janice D, Liu Jian, Shea Kim D, Peterson Rachel L, Martin-Plank Lori, Lacasse Cheryl L, May Jennifer T, Wyles Christina L, Williams Deborah K, Slebodnik Maribeth, Heasley Beverly J, Phillips Linda R
Community and Systems Health Science Division, College of Nursing, The University of Arizona, Tucson, Arizona.
Department of Systems and Industrial Engineering, The University of Arizona, Tucson, Arizona.
Nurs Forum. 2019 Oct;54(4):582-592. doi: 10.1111/nuf.12373. Epub 2019 Aug 1.
Analyze the concept "tipping point" in the older adult family caregiving context to further knowledge about caregiving families, enhancing transdisciplinary theory, research, and practice.
While used commonly in some disciplines, how "tipping point" has been used in health care, generally, and in relation to caregiving families, specifically, is less clear. This project was conducted to offer conceptual clarity to tipping point.
Walker and Avant's framework.
Searches of scholarly literature in PsycINFO, CINAHL, and PubMed using the search term "tipping point" in either title or abstract.
Definitions used were extracted; instances when the concept was implied but the actual term "tipping point" was not used and contexts where the term was used or implied were identified.
The composite definition of a caregiving tipping point is a seemingly abrupt, severe, and absolute change event involving either the older adult or caregiver(s), or both that indicates a breakdown in the status quo of the caregiving system.
Transdisciplinary research, care, and policy should treat caregiving families as complex systems, use longitudinal assessments, and include colloquial communication. Early detection of impending tipping points will provide family-centered decisional support and enhance families' quality of life and safety.
分析老年家庭照护背景下的“临界点”概念，以增进对照护家庭的了解，完善跨学科理论、研究及实践。
虽然“临界点”在某些学科中常用，但在医疗保健领域总体上以及在照护家庭方面具体是如何使用的，尚不清楚。开展本项目是为了明确“临界点”的概念。
采用沃克和阿凡特的框架。
在PsycINFO、CINAHL和PubMed中检索学术文献，检索词为标题或摘要中的“临界点”。
提取所使用的定义；识别概念被隐含但未使用“临界点”一词的情况，以及该词被使用或隐含的语境。
照护临界点的综合定义是涉及老年人或照护者一方或双方的看似突然、严重且绝对的变化事件，表明照护系统的现状出现崩溃。
跨学科研究、照护和政策应将照护家庭视为复杂系统，采用纵向评估，并纳入通俗交流。尽早发现即将出现的临界点将提供以家庭为中心的决策支持，提高家庭生活质量和安全性。
