Kelly Christine, Dansereau Lisette, Jack Ellie, Pirzada Salina, Oh Yuns, Bhushan Pranav, Pelly Lorine, Linton Janice, McCarthy Carey, Cometto Giorgio
Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, R3E 0W3, Canada.
Institute for Global Public Health, University of Manitoba, Winnipeg, MB, R3E 0T6, Canada.
Health Aff Sch. 2025 Jun 28;3(7):qxaf128. doi: 10.1093/haschl/qxaf128. eCollection 2025 Jul.
Health systems depend on care workers to provide "hands-on" direct care with eating, dressing, and other needs, as well as indirect care with household tasks, meals, and transport. Care workers are in high demand to support growing populations who need help in daily life, yet they often fall outside of health human resource planning. Recruiting, supporting, and retaining the care workforce are urgent priorities for health workforce planners.
This realist synthesis review asks: Which interventions strengthen the care workforce? We systematically identified 7396 peer-reviewed sources and 481 gray literature sources, with 151 included in the review.
The sources document a variety of interventions that strengthen the care workforce, with an emphasis on pre-service and ongoing training for care workers. There were ambitious interventions that aimed to support the care workforce on multiple fronts.
Policy makers and researchers are encouraged to implement complex interventions that cover multiple factors simultaneously. We recommend focusing on legislative structures, educational oversight, and material working conditions, such as scheduling and pay, as highly promising avenues for strengthening the care workforce across multiple contexts.
卫生系统依赖护理人员提供与饮食、穿衣及其他需求相关的“亲身”直接护理，以及与家务、膳食和交通相关的间接护理。为支持日常生活需要帮助的不断增长的人口，对护理人员的需求很大，但他们往往不在卫生人力资源规划范围内。招聘、支持和留住护理人员队伍是卫生人力规划者的紧迫优先事项。
本实证综合评价研究提出的问题是：哪些干预措施能加强护理人员队伍？我们系统地识别了7396篇同行评审文献和481篇灰色文献，其中151篇纳入了本评价。
这些文献记录了多种加强护理人员队伍的干预措施，重点是护理人员的岗前培训和在职培训。有一些雄心勃勃的干预措施旨在从多个方面支持护理人员队伍。
鼓励政策制定者和研究人员实施同时涵盖多个因素的复杂干预措施。我们建议将重点放在立法结构、教育监督以及物质工作条件（如排班和薪酬）上，因为这些是在多种情况下加强护理人员队伍的极有前景的途径。
