Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, Ontario, Canada.
Department of Occupational Sciences and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
J Am Geriatr Soc. 2023 Oct;71(10):3287-3296. doi: 10.1111/jgs.18486. Epub 2023 Jun 19.
We conducted the first known comprehensive literature review to (1) identify, categorize, and summarize the existing knowledge about the experiences of older persons and their caregivers during conflict situations; (2) identify the support needs of older persons and their caregivers, and; (3) identify gaps in the literature and understanding that may inform future research.
A scoping review methodology of academic peer-reviewed and gray English language literature was employed using six academic literature databases and one gray literature database. We further performed comprehensive searches of relevant search engines and organization websites and bibliographic hand searches to identify additional academic and gray literature. Two authors screened for eligibility of identified studies and documents. One reviewer extracted data regarding authors, article type, geographic origin, key participant characteristics, aims, study design and data collection method, results, conclusions and limitations. Data were analyzed thematically.
83 documents met this review's inclusion criteria, including 21 academic documents and 62 from the gray literature. Thematic analysis revealed that conflict situations exacerbate existing inequalities experienced by older persons. Within this overarching theme were three interconnected sub-themes: (1) Older adults are particularly vulnerable during conflict situations; (2) Older persons are inadequately supported in conflict situations; (3) In the face of great challenges, many older adults still manage to endure through conflict situations. We identified 15 recommendations from the reviewed documents to better support older adults in conflict situations.
Existing inequalities, such as ageism and ableism, targeted discrimination, and poor health outcomes, become exacerbated during conflict situations, resulting in older persons being less able to flee and meet their daily needs with sufficient access to necessities and healthcare. Little is known of the experiences and needs of family caregivers during conflict situations. We identified several opportunities to improve the experience and support of older persons in conflict situations.
我们进行了首次全面的文献综述,旨在:(1) 确定、分类和总结在冲突情况下老年人及其照顾者的经验;(2) 确定老年人及其照顾者的支持需求;(3) 确定文献和理解中的差距,以告知未来的研究。
采用学术同行评议和英文灰色文献的范围综述方法,使用六个学术文献数据库和一个灰色文献数据库。我们进一步全面搜索了相关搜索引擎和组织网站,并进行文献检索,以确定更多的学术和灰色文献。两位作者筛选出符合研究条件的研究和文献。一位审查员提取了有关作者、文章类型、地理来源、主要参与者特征、目的、研究设计和数据收集方法、结果、结论和局限性的数据。数据进行了主题分析。
83 份文件符合本综述的纳入标准,包括 21 份学术文件和 62 份灰色文献。主题分析显示,冲突情况加剧了老年人现有的不平等。在这个总主题下有三个相互关联的子主题:(1) 老年人在冲突情况下特别脆弱;(2) 老年人在冲突情况下得不到充分支持;(3) 在面临巨大挑战的情况下,许多老年人仍能在冲突中坚持下来。我们从审查的文件中确定了 15 项建议,以更好地支持老年人在冲突情况下的生活。
现有的不平等现象,如年龄歧视和能力歧视、针对性歧视以及健康状况不佳,在冲突情况下会加剧,导致老年人在逃离和满足日常需求方面的能力下降,难以获得足够的必需品和医疗保健。在冲突情况下,家庭照顾者的经历和需求知之甚少。我们确定了一些机会,可以改善冲突情况下老年人的体验和支持。