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针对工作场所中老年护士的年龄歧视:系统评价。

Ageism directed at older nurses in their workplace: A systematic review.

机构信息

AUT Centre for Active Ageing, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.

National Head of Nursing, Te Pūkenga, New Zealand.

出版信息

J Clin Nurs. 2024 Jul;33(7):2388-2411. doi: 10.1111/jocn.17088. Epub 2024 Mar 3.

Abstract

AIMS

To identify and synthesise evidence related to ageism in older regulated nurses' practice settings.

DESIGN

A systematic review following Joanna Briggs Institute methodology.

METHODS

The review included empirical studies that involved older nurses as the primary study population and studies that focused on ageism in older nurses' work environments, including strategies or interventions to address ageism within the workplace. Following the initial screening, all relevant studies were critically appraised by two reviewers to ensure they were appropriate to include in the review. A synthesis without meta-analysis reporting (SWiM) guideline was employed in the review.

DATA SOURCES

Medical Literature Analysis and Retrieval Systems Online, Scopus, Psychological Information Database and Cumulative Index to Nursing and Allied Health Literature and Google Scholar were searched to identify empirical studies and a range of academic institutional websites were accessed for master's and doctoral dissertations and theses. The search covered the period from January 2022 to May 2022, and only publications in English from 2000 onwards were considered.

RESULTS

Nineteen studies were included, ten qualitative studies, seven quantitative studies and two mixed methods secondary analyses. Our results revealed that negative perceptions and beliefs about older nurses' competencies and skills prevail in their practice settings, which influences older nurses' health and well-being as well as their continuation of practice. Further, older nurses' continuation of practice can be facilitated by having a positive personal outlook on ageing, meaningful relationships in their practice settings and working in an environment that is age-inclusive.

CONCLUSION

To combat ageism in older nurses' practice settings and support their continuation of practice, effective interventions should be organisational-led. The interventions should focus on fostering meaningful relationships between older nurses and their colleagues and managers. Further, healthcare institutions should implement initiatives to promote an age-inclusive work environment that supports an age-diverse nursing workforce.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The review findings offer insights for healthcare managers, policymakers and researchers, emphasising the need for anti-ageism policies in healthcare organisations. According to WHO (2021), educational activities such as role-playing and simulation during in-service training may also be effective interventions. Additionally, incorporating anti-ageism initiatives into staff meetings and mandating anti-ageism training could support the continuation of practice for older nurses while fostering a more age-diverse nursing workforce.

IMPACT

We found evidence on the presence of ageism in older nurses' workplace and the detrimental effects of ageism on older nurses' well-being and continuation of practice. Importantly, we identified a lack of organisational initiatives to address ageism and support older nurses. These findings should encourage healthcare organisations to address ageism in older nurses' practice settings and prompt policymakers to develop age-inclusive policies that support older nurses' continuation of practice.

REPORTING METHOD

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Synthesis Without Meta-analysis checklists were used to report the screening process.

TRIAL AND PROTOCOL REGISTRATION

The PROSPERO registration number for the review was CRD42022320214 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022320214). No Patient or Public Contribution.

摘要

目的

确定和综合与老年注册护士实践环境中的年龄歧视相关的证据。

设计

遵循乔安娜布里格斯研究所方法的系统评价。

方法

该评价纳入了以老年护士为主要研究人群的实证研究,以及关注老年护士工作环境中的年龄歧视的研究,包括解决工作场所内年龄歧视的策略或干预措施。在最初筛选后,两名评审员对所有相关研究进行了严格评估,以确保它们适合纳入评价。采用了没有荟萃分析报告(SWiM)指南的综合评价。

资料来源

医学文献分析与检索系统在线、Scopus、心理信息数据库和护理学及相关健康文献累积索引以及 Google Scholar 被用于确定实证研究,并且访问了一系列学术机构网站以获取硕士和博士论文和论文。搜索涵盖了 2022 年 1 月至 2022 年 5 月的时间段,仅考虑了 2000 年以后发表的英文出版物。

结果

纳入了 19 项研究,其中 10 项是定性研究,7 项是定量研究,2 项是混合方法的二次分析。我们的研究结果表明,老年护士的能力和技能的负面看法和信念在他们的实践环境中普遍存在,这影响了老年护士的健康和幸福感,以及他们继续实践的意愿。此外,老年护士的继续实践可以通过对衰老的积极个人看法、在实践环境中建立有意义的关系以及在包容年龄的环境中工作来实现。

结论

为了在老年护士的实践环境中消除年龄歧视并支持他们继续实践,应该采取组织主导的有效干预措施。这些干预措施应侧重于促进老年护士与其同事和管理者之间的有意义的关系。此外,医疗机构应实施举措,以促进支持多样化护理人员队伍的包容年龄的工作环境。

对专业和/或患者护理的影响:评价结果为医疗保健管理者、政策制定者和研究人员提供了见解,强调了医疗保健组织中需要反年龄歧视政策。根据世界卫生组织(2021 年)的建议,在职培训期间的角色扮演和模拟等教育活动也可能是有效的干预措施。此外,将反年龄歧视举措纳入员工会议并强制进行反年龄歧视培训,可以支持老年护士的继续实践,同时培养更具年龄多样性的护理人员队伍。

重要性

我们发现了有关老年护士工作场所中年龄歧视的证据,以及年龄歧视对老年护士的健康和继续实践意愿的不利影响。重要的是,我们发现缺乏针对年龄歧视的组织举措来支持老年护士。这些发现应鼓励医疗保健组织解决老年护士实践环境中的年龄歧视问题,并促使政策制定者制定支持老年护士继续实践的包容性年龄政策。

报告方法

使用系统评价和无荟萃分析的首选报告项目和无荟萃分析检查表报告筛选过程。

试验和议定书注册

评价的 PROSPERO 注册号为 CRD42022320214(https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022320214)。无患者或公众贡献。

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