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社区居家体弱老年人照料者的经历与需求:一项混合方法系统评价

Experiences and Needs of Caregivers of Community-Dwelling Frail Older Adults: A Mixed Methods Systematic Review.

作者信息

Zhou Wendie, Liang Qigao, Bian Yanhui, Liu Qinqin, Li Yanyan, Yu Jiaqi, Chen Hejing, Wang Cuili

机构信息

School of Nursing, Peking University, Beijing, China.

出版信息

J Clin Nurs. 2025 Sep;34(9):3519-3538. doi: 10.1111/jocn.17799. Epub 2025 Apr 28.

Abstract

AIM

This study aimed to synthesise current evidence about the experiences and needs of informal caregivers of community-dwelling frail older adults to inform targeted interventions for improving their caregiving situations.

DESIGN

This was a mixed methods systematic review using the convergent integrated analysis framework.

METHODS

We conducted systematic searches across 11 databases, including CINAHL, CNKI, EMBASE, OpenGrey, ProQuest, PsycINFO, PubMed, SinoMed, VIP, WanFang and Web of Science, as well as reference lists, for studies published between January 1, 2000 and March 12, 2025. Quality appraisal was performed using the Mixed Methods Appraisal Tool. Findings were synthesised using a narrative approach.

RESULTS

Of the 5297 citations, 2905 were screened for titles and abstracts, 176 were further screened for full-texts and eight studies were included (n = 6 quantitative, n = 2 qualitative; 1949 caregivers). The themes of caregiving experiences related to (1) influential factors contributing to negative, (2) or positive caregiver outcomes; (3) coping strategies or resources that caregivers employed to address caregiving situations; the outcomes that could be (4) negatively, (5) or positively impacted by caregiving; and (6) difficulties they encountered related to caring for frail older adults. Caregivers expressed needs for psychological support, detailed information on available resources, and family-centred and integrated public services with self-advocacy and coordinators.

CONCLUSIONS

This review highlights broad areas that require more attention for enhancing the well-being of these caregivers. More research is warranted on caregivers' experiences, needs, and interventions, especially their support needs. A theoretical framework, comparative analyses between child caregivers and spousal caregivers, as well as emphasising both mastery and competence, is recommended for future research and practice.

RELEVANCE TO CLINICAL PRACTICE

Our findings hold the potential to guide the development of needs-oriented and evidence-based interventions tailored to the unique challenges faced by caregivers, thereby supporting them in their caregiving roles.

REPORTING METHOD

This review followed the PRISMA 2020 guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution due to design.

摘要

目的

本研究旨在综合有关社区居住体弱老年人非正式照料者的经历和需求的现有证据,为改善其照料状况的针对性干预措施提供依据。

设计

这是一项采用收敛性综合分析框架的混合方法系统评价。

方法

我们在11个数据库中进行了系统检索,包括CINAHL、CNKI、EMBASE、OpenGrey、ProQuest、PsycINFO、PubMed、SinoMed、VIP、万方和Web of Science,以及参考文献列表,以查找2000年1月1日至2025年3月12日期间发表的研究。使用混合方法评估工具进行质量评估。研究结果采用叙述性方法进行综合。

结果

在5297条引用文献中,筛选了2905篇文献的标题和摘要,进一步筛选了176篇文献的全文,纳入了8项研究(n = 6项定量研究,n = 2项定性研究;1949名照料者)。照料经历的主题涉及:(1)导致负面或正面照料结果的影响因素;(2)照料者用于应对照料状况的应对策略或资源;(3)可能受到照料负面、正面或影响的结果;(4)他们在照料体弱老年人方面遇到的困难。照料者表示需要心理支持、有关可用资源的详细信息,以及以家庭为中心的综合公共服务,包括自我倡导和协调人员。

结论

本综述突出了为提高这些照料者的福祉而需要更多关注的广泛领域。有必要对照料者的经历、需求和干预措施,尤其是他们的支持需求进行更多研究。建议在未来的研究和实践中采用一个理论框架,对儿童照料者和配偶照料者进行比较分析,并强调掌握程度和能力。

与临床实践的相关性

我们的研究结果有可能指导针对照料者所面临的独特挑战制定以需求为导向的循证干预措施,从而支持他们履行照料职责。

报告方法

本综述遵循PRISMA 2020指南。

患者或公众参与

由于研究设计,未涉及患者或公众参与。

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