Wang Zhenyu, Liu Zhihan
School of Public Administration, Central South University, Changsha, Hunan Province, China.
Int J Integr Care. 2021 Dec 6;21(4):28. doi: 10.5334/ijic.5946. eCollection 2021 Oct-Dec.
Integration has become a major concern for governments, healthcare and aged care systems in many countries. However, the research on and implementation of integrated care in China started relatively late, and there is no review on the needs of older adults with regard to integrated care and the influencing factors. Therefore, this paper aims to provide a scoping review by searching, evaluating, and summarizing the Chinese and international literature on the need for and the factors influencing integrated care for older people. In addition, this review highlights evidence of the gap between China and the world in integrated care.
Using a framework proposed by Arksey and O'Malley, a systematic search of 12 domestic and international databases was conducted. Of the 890 original studies retrieved, those that met the established inclusion criteria were screened and scored using the Ekman quality assessment tool. The qualitative description method was used to summarize the demand for integrated care for older adults and the influencing factors.
A total of 49 papers were included. These studies were from eleven countries on five continents (most commonly China and the US) and were mostly cross-sectional quantitative studies that surveyed the integrated care needs of older people living in homes/communities or long-term care facilities. The analysis shows that existing research on the integrated care needs of older people in China adopts a single perspective and is inadequate and unsystematic in its assessment; the integrated care needs of older adults and the factors influencing them are multifaceted; and both in China and internationally, the community-home care scenario most consistently meets the needs and expectations of older adults.
Although there is no uniform definition of integrated care in China or abroad and each country has its own national definition and system of integrated care, there are certain commonalities regarding the needs of older adults and the factors that influence them across countries. Our research reveals a gap between China and the international community in terms of integrated care.
整合已成为许多国家政府、医疗保健和老年护理系统的主要关注点。然而,中国在综合护理方面的研究和实施起步相对较晚,且尚无关于老年人综合护理需求及其影响因素的综述。因此,本文旨在通过检索、评估和总结中国和国际上关于老年人综合护理需求及影响因素的文献,进行一项范围综述。此外,本综述还突出了中国与世界在综合护理方面的差距证据。
采用阿克西和奥马利提出的框架,对12个国内外数据库进行了系统检索。在检索到的890项原始研究中,对符合既定纳入标准的研究使用埃克曼质量评估工具进行筛选和评分。采用定性描述方法总结老年人对综合护理的需求及其影响因素。
共纳入49篇论文。这些研究来自五大洲的11个国家(最常见的是中国和美国),大多是横断面定量研究,调查了居住在家中/社区或长期护理机构的老年人的综合护理需求。分析表明,中国现有关于老年人综合护理需求的研究采用单一视角,评估不够充分且缺乏系统性;老年人的综合护理需求及其影响因素是多方面的;在中国和国际上,社区居家护理模式最能持续满足老年人的需求和期望。
尽管国内外对综合护理没有统一的定义,每个国家都有自己的综合护理国家定义和体系,但各国在老年人需求及其影响因素方面存在一定的共性。我们的研究揭示了中国与国际社会在综合护理方面的差距。