James Cook University, College of Medicine and Dentistry, Cairns, QLD, Australia.
Queensland Health, Brisbane, QLD, Australia.
Front Public Health. 2022 Feb 10;10:780898. doi: 10.3389/fpubh.2022.780898. eCollection 2022.
As life expectancy increases for Indigenous populations, so does the number of older adults with complex, chronic health conditions and age-related geriatric syndromes. Many of these conditions are associated with modifiable lifestyle factors that, if addressed, may improve the health and wellbeing of Indigenous peoples as they age. If models of healthy aging are to be promoted within health services, a clearer understanding of what aging well means for Indigenous peoples is needed. Indigenous peoples hold a holistic worldview of health and aging that likely differs from Western models. The aims of this review were to: investigate the literature that exists and where the gaps are, on aging well for Indigenous peoples; assess the quality of the existing literature on Indigenous aging; identify the domains of aging well for Indigenous peoples; and identify the enablers and barriers to aging well for Indigenous peoples. A systematic search of online databases, book chapters, gray literature, and websites identified 32 eligible publications on Indigenous aging. Reflexive thematic analysis identified four major themes on aging well: (1) achieving holistic health and wellbeing; (2) maintaining connections; (3) revealing resilience, humor, and a positive attitude; and (4) facing the challenges. Findings revealed that aging well is a holistic concept enabled by spiritual, physical, and mental wellbeing and where reliance on connections to person, place, and culture is central. Participants who demonstrated aging well took personal responsibility, adapted to change, took a positive attitude to life, and showed resilience. Conversely, barriers to aging well arose from the social determinants of health such as lack of access to housing, transport, and adequate nutrition. Furthermore, the impacts of colonization such as loss of language and culture and ongoing grief and trauma all challenged the ability to age well. Knowing what aging well means for Indigenous communities can facilitate health services to provide culturally appropriate and effective care.
随着原住民人口预期寿命的延长，患有复杂慢性健康状况和与年龄相关的老年综合病症的老年人数量也在增加。许多这些状况都与可改变的生活方式因素有关，如果加以解决，可能会改善原住民的健康和福祉。如果要在卫生服务中推广健康老龄化模式，就需要更清楚地了解原住民健康老龄化的含义。原住民对健康和老龄化持有整体的世界观，这可能与西方模式不同。本研究的目的是：调查现有的关于原住民健康老龄化的文献，了解其中的差距；评估现有的关于原住民老龄化的文献质量；确定原住民健康老龄化的领域；并确定原住民健康老龄化的促进因素和障碍。通过对在线数据库、书籍章节、灰色文献和网站进行系统搜索，确定了 32 篇关于原住民老龄化的合格文献。反思性主题分析确定了原住民健康老龄化的四个主要主题：（1）实现整体健康和福祉；（2）保持联系；（3）展现韧性、幽默和积极的态度；（4）应对挑战。研究结果表明，健康老龄化是一个整体的概念，它需要精神、身体和心理健康，并且依赖于与个人、地方和文化的联系。表现出健康老龄化的参与者承担个人责任，适应变化，对生活持积极态度，表现出韧性。相反，健康老龄化的障碍来自健康的社会决定因素，如缺乏住房、交通和充足的营养。此外，殖民化的影响，如语言和文化的丧失以及持续的悲伤和创伤，都对健康老龄化的能力构成了挑战。了解原住民社区健康老龄化的含义可以促进卫生服务提供文化上适当和有效的护理。
