Liebzeit Daniel, Krupp Anna, Bunch Jacinda, Tonelli Shalome, Griffin Emily, McVeigh Sarah, Chi Nai-Ching, Jaboob Saida, Nakad Lynn, Arbaje Alicia I, Buck Harleah
The University of Iowa College of Nursing Iowa City Iowa USA.
Department of Medicine, Division of Geriatric Medicine and Gerontology, Center for Transformative Geriatric Research Johns Hopkins University School of Medicine Baltimore Maryland USA.
Health Sci Rep. 2023 May 5;6(5):e1241. doi: 10.1002/hsr2.1241. eCollection 2023 May.
The population of older adults in rural areas is rising, and they experience higher rates of poverty and chronic illness, have poorer health behaviors, and experience different challenges than those in urban areas. This scoping review seeks to (1) map the state of the science of age-friendly systems in rural areas regarding structural characteristics, processes for delivering age-friendly practices, and outcomes of age-friendly systems, (2) analyze strengths, weakness, opportunities, and threats of age-friendly system implementation, and (3) make person, practice, and policy-level recommendations to support active aging and development of age-friendly communities.
An international scoping review was conducted of articles that used age-friendly framing, had a sample age of 45 years of age or older, self-identified as rural, and reported empiric data. Searches were conducted in PubMed, CINAHL, AgeLine, PsychINFO, EMBASE, Scopus, and Academic Search Elite on October 26, 2021, and rerun March 10, 2023. Data were charted across three analytic layers: socioecological model, Donabedian's framework, and SWOT analysis.
Results reveal limited data on outcomes relevant to organizations, such as return on investment or healthcare utilization. While the SWOT analysis revealed many strengths of age-friendly systems, including their impact on persons' outcomes, it also revealed several weaknesses, threats, and gaps. Namely, age-friendly systems have weaknesses due to reliance on trained volunteers and staff, communication, and teamwork. System-level threats include community and health system barriers, and challenges in poor/developing areas.
While age-friendly systems in this review were heterogeneous, there is an opportunity to focus on unifying elements including the World Health Organization age-friendly cities framework or 4Ms framework for age-friendly care. Despite the many benefits of age-friendly systems, we must acknowledge limitations of the evidence base, pursue opportunities to examine organizational metrics to support implementation and sustainability of age-friendly systems, and leverage improvements in age-friendliness at a community level.
农村地区老年人数量不断增加，他们面临着更高的贫困率和慢性病发病率，健康行为较差，且面临着与城市地区不同的挑战。本综述旨在：（1）梳理农村地区老年友好型系统在结构特征、提供老年友好型服务的过程以及老年友好型系统成果方面的科学现状；（2）分析老年友好型系统实施的优势、劣势、机遇和威胁；（3）提出个人、实践和政策层面的建议，以支持积极老龄化和老年友好型社区的发展。
对使用老年友好型框架、样本年龄在45岁及以上、自我认定为农村地区且报告实证数据的文章进行了一项国际综述。于2021年10月26日在PubMed、CINAHL、AgeLine、PsychINFO、EMBASE、Scopus和Academic Search Elite中进行检索，并于2023年3月10日重新检索。数据在三个分析层面进行梳理：社会生态模型、唐纳贝迪安框架和SWOT分析。
结果显示，与组织相关的成果数据有限，如投资回报率或医疗保健利用率。虽然SWOT分析揭示了老年友好型系统的许多优势，包括其对个人成果的影响，但也揭示了一些劣势、威胁和差距。具体而言，老年友好型系统存在劣势，原因在于依赖训练有素的志愿者和工作人员、沟通以及团队合作。系统层面的威胁包括社区和卫生系统障碍以及贫困/发展中地区的挑战。
尽管本综述中的老年友好型系统各不相同，但仍有机会专注于统一要素，包括世界卫生组织的老年友好型城市框架或老年友好型护理的4M框架。尽管老年友好型系统有诸多益处，但我们必须承认证据基础的局限性，寻求机会审视组织指标以支持老年友好型系统的实施和可持续性，并利用社区层面老年友好度的提升。
