Gao Donna, Xu Angela, Yang Lixia
Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada.
Department of Epidemiology and Biostatistics, Western University, London, ON N6G 3K7, Canada.
Healthcare (Basel). 2025 Aug 7;13(15):1937. doi: 10.3390/healthcare13151937.
: Older adults (65+) are the fastest growing age group in Canada, comprising 18.8% of the country's population. During the COVID-19 pandemic, use of virtual care, including telehealth and tele-medicine, increased dramatically among older adults in Canada who often face higher health risks, mobility limitations, and many barriers to accessing healthcare. Despite the rapid expansion in virtual care, no systematic review has focused specifically on virtual care among older adults in Canada. This review aims to explore the factors influencing virtual care adoption and the experiences of older Canadians during the pandemic through a systematic review. : Conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, the review involved a comprehensive search of PubMed, Scopus, ESCBOHost, and Web of Science on 2 May 2025, yielding 281 unique citations. After screening and applying eligibility criteria, 15 studies employing quantitative, qualitative, or mixed-methods designs, with sample sizes ranging from 15 to 2,282,798, were included and appraised using the Mixed Methods Appraisal Tool (MMAT). : The review identified three domains of factors and the ways in which each factor shapes older adults' virtual care experiences: (1) personal factors influencing virtual care use and demand (e.g., age, education, language, income, immigration status, community sizes), (2) resource factors impacting virtual care adoption (e.g., technology access, support), and (3) varying virtual care experiences among older adults (e.g., in assessment and communication efficacy, privacy, care quality, convenience, safety, and costs). : This review highlights the complexities of virtual care engagement among older adults and underscores the need for inclusive, tailored strategies to improve the accessibility and effectiveness of virtual care delivery in both pandemic and post-pandemic contexts.
65岁及以上的老年人是加拿大增长最快的年龄组，占该国人口的18.8%。在新冠疫情期间，包括远程医疗和电子医疗在内的虚拟护理在加拿大老年人中的使用大幅增加，这些老年人往往面临更高的健康风险、行动不便以及获取医疗保健的诸多障碍。尽管虚拟护理迅速扩张，但尚无系统评价专门关注加拿大老年人的虚拟护理情况。本评价旨在通过系统评价探讨影响虚拟护理采用的因素以及疫情期间加拿大老年人的经历。：该评价按照系统评价与Meta分析的首选报告项目（PRISMA）指南进行，于2025年5月2日对PubMed、Scopus、ESCBOHost和科学网进行了全面检索，获得281条独特引文。在筛选并应用纳入标准后，纳入了15项采用定量、定性或混合方法设计的研究，样本量从15至2282798不等，并使用混合方法评价工具（MMAT）进行评价。：该评价确定了三个因素领域以及每个因素影响老年人虚拟护理体验的方式：（1）影响虚拟护理使用和需求的个人因素（如年龄、教育程度、语言、收入、移民身份、社区规模），（2）影响虚拟护理采用的资源因素（如技术获取、支持），以及（3）老年人不同的虚拟护理体验（如评估和沟通效果、隐私、护理质量、便利性、安全性和成本）。：本评价突出了老年人参与虚拟护理的复杂性，并强调需要制定包容性的、量身定制的策略，以提高在疫情期间和疫情后背景下虚拟护理服务的可及性和有效性。
