Duangjina Thitinan, Hershberger Patricia E, Gruss Valerie, Fritschi Cynthia
Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.
Department of Biobehavioral Nursing, College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA.
J Adv Nurs. 2025 Jan;81(1):156-170. doi: 10.1111/jan.16272. Epub 2024 Jun 11.
To identify factors associated with resilience in family caregivers of Asian older people with dementia based on Luthar and Cicchetti's definition of resilience.
Integrative review of resilience in family caregivers of Asian older people with dementia reported by studies with quantitative and qualitative research designs.
Databases used for the literature search included CINAHL, PubMed, EMBASE, PsycINFO and Google Scholar.
A total of 565 potentially relevant studies published between January 1985 and March 2024 were screened, and 27 articles met the inclusion criteria.
Family caregivers were most commonly adult children of care recipients, female and providing care in their home. Two themes emerged from the review: factors associated with adversity (dementia severity, caregiver role strain, stigma, family stress, female gender, low income and low education) and factors associated with positive adaptational outcomes (positive aspect of caregiving, social support and religiosity/spirituality).
In our review of Asian research, four new factors-caregiver role strain, stigma, family stress and positive aspects of caregiving-emerged alongside those previously identified in Western studies. A paradigm shift was observed from a focus on factors associated with adversity to factors associated with positive adaptational outcomes, particularly after the issuance of the WHO's 2017 global action plan for dementia. However, a gap remains between WHO policy recommendations and actual research, with studies often neglecting to address gender and socioeconomic factors.
The review findings will broaden healthcare providers' understanding of resilience in dementia caregivers and use them to develop comprehensive programmes aimed at reducing factors associated with adversity and enhancing those associated with positive adaptational outcomes. This approach can be customized to incorporate Asian cultural values, empowering caregivers to navigate challenges more effectively.
This paper is an integrative review and does not include patient or public contributions.
根据卢塔尔和西凯提对复原力的定义，确定与患有痴呆症的亚洲老年人家庭照顾者复原力相关的因素。
对采用定量和定性研究设计的研究报告的亚洲痴呆症老年人家庭照顾者复原力进行综合综述。
用于文献检索的数据库包括CINAHL、PubMed、EMBASE、PsycINFO和谷歌学术。
筛选了1985年1月至2024年3月期间发表的565项潜在相关研究，27篇文章符合纳入标准。
家庭照顾者最常见的是受照顾者的成年子女，女性，且在家中提供照顾。综述得出两个主题：与逆境相关的因素（痴呆症严重程度、照顾者角色压力、耻辱感、家庭压力、女性性别、低收入和低教育水平）以及与积极适应结果相关的因素（照顾的积极方面、社会支持和宗教信仰/精神性）。
在我们对亚洲研究的综述中，四个新因素——照顾者角色压力、耻辱感、家庭压力和照顾的积极方面——与西方研究中先前确定的因素一同出现。观察到一种范式转变，即从关注与逆境相关的因素转向关注与积极适应结果相关的因素，特别是在世界卫生组织2017年痴呆症全球行动计划发布之后。然而，世界卫生组织的政策建议与实际研究之间仍存在差距，研究常常忽视解决性别和社会经济因素。
综述结果将拓宽医疗保健提供者对痴呆症照顾者复原力的理解，并利用这些结果制定全面的计划，旨在减少与逆境相关的因素，增强与积极适应结果相关的因素。这种方法可以根据亚洲文化价值观进行定制，使照顾者更有效地应对挑战。
本文是一篇综合综述，不包括患者或公众的贡献。
