Betty Irene Moore School of Nursing, University of California, Davis, Sacramento.
The Valley Foundation School of Nursing, San Jose State University, San Jose, California.
Gerontologist. 2020 Feb 14;60(Suppl 1):S14-S28. doi: 10.1093/geront/gnz148.
Although most people have some experience as caregivers, the nature and context of care are highly variable. Caregiving, socioeconomic factors, and health are all interrelated. For these reasons, caregiver interventions must consider these factors. This review examines the degree to which caregiver intervention research has reported and considered social determinants of health.
We examined published systematic reviews and meta-analyses of interventions for older adults with age-related chronic conditions using the PRISMA and AMSTAR 2 checklists. From 2,707 papers meeting search criteria, we identified 197 potentially relevant systematic reviews, and selected 33 for the final analysis.
We found scant information on the inclusion of social determinants; the papers lacked specificity regarding race/ethnicity, gender, sexual identity, socioeconomic status, and geographic location. The majority of studies focused on dementia, with other conditions common in later life vastly underrepresented.
Significant gaps in evidence persist, particularly for interventions targeting diverse conditions and populations. To advance health equity and improve the effectiveness of interventions, research should address caregiver heterogeneity and improve assessment, support, and instruction for diverse populations. Research must identify aspects of heterogeneity that matter in intervention design, while recognizing opportunities for common elements and strategies.
尽管大多数人都有过照顾他人的经历，但照顾的性质和背景却存在很大差异。照顾、社会经济因素和健康都是相互关联的。基于这些原因，照顾者干预措施必须考虑这些因素。本综述考察了照顾者干预研究报告和考虑健康社会决定因素的程度。
我们使用 PRISMA 和 AMSTAR 2 清单检查了针对与年龄相关的慢性病的老年患者的干预措施的已发表系统评价和荟萃分析。在符合搜索标准的 2707 篇论文中，我们确定了 197 篇可能相关的系统评价，并选择了 33 篇进行最终分析。
我们发现有关纳入社会决定因素的信息很少；这些论文缺乏关于种族/族裔、性别、性身份、社会经济地位和地理位置的具体信息。大多数研究都集中在痴呆症上，而其他在晚年中常见的病症则严重代表性不足。
证据中仍然存在重大差距，特别是针对不同条件和人群的干预措施。为了促进健康公平并提高干预措施的有效性，研究应解决照顾者的异质性问题，并为不同人群提供评估、支持和指导。研究必须确定干预设计中重要的异质因素，同时认识到共同要素和策略的机会。
