失能老人照护与支持需求质性研究的系统评价
摘要: 背景 老龄化背景下,失能老人照护需求不容忽视。全面了解失能老人照护与支持需求可为政府决策部门合理制定照护方案提供参考依据。 目的 系统评价失能老人照护与支持需求相关的质性研究。 方法 于2022-12-03—2023-02-26系统检索Web of Science、PubMed、Embase、Cochrane Library、中国知网、万方数据知识服务平台、中国生物医学文献服务系统从建库至2023-02-26相关的质性研究。采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准进行文献质量评价,通过汇集性整合方法对原始质性研究结果进行归纳整合。 结果 本研究共纳入33篇质性研究,提炼出7个主题,共18个类别:日常生活相关需求(基础性日常生活活动、家务活动、照护特征),功能独立性需求(身体功能独立、自主决策独立),卫生保健相关需求(卫生保健服务内容、卫生保健服务体验、卫生保健服务需求表达),环境支持需求(客观环境支持、政策支持),正性情绪支持需求(情感慰藉、精神关怀),社会支持需求(社区支持性服务、活动参与、人际链接、信息链接),卫生技术相关需求(照护辅助设备、技术服务)。 结论 失能老人照护与支持需求复杂且多样。政府需要整合"家庭-社区-机构"资源以应对失能老人"身-心-社-医-环境"需求,从群体角度关注失能老人照护资源的分配公平,给予失能老人更多的社会福利。
关键词: 老年人保健服务, 失能老人, 照护需求, 质性研究, 系统评价
Abstract:
Background
In the context of population aging, the care needs of the disabled elderly cannot be ignored. A comprehensive understanding of the care and support needs of the elderly with disabilities can provide basis for government policymakers in the development of rational care strategies.
Objective
To systematically review qualitative studies on the care and support needs of the disabled elderly.
Methods
In this study, a systematic search of Web of Science, PubMed, Embase, Cochrane Library, CNKI, Wanfang Data, and CBM for relevant qualitative studies was conducted from inception to February 26, 2023. The Joanna Briggs Institute's Critical Appraisal Tool for qualitative studies was performed to evaluate the quality of included qualitative studies. The results of the original qualitative studies were synthesized through a pooled integration approach.
Results
A total of 33 qualitative studies were finally included, and 7 themes with 18 categories were distilled, including daily activities-related needs (basic activities of daily living, household activities, and caregiving characteristics) , functional independence-related needs (independence in physical functioning, independence in autonomous decision-making) , health care-related needs (content of health care services, health care service experience, expression of needs for health care services) , contextual support-related needs (objective environmental support, policy support) , positive emotional support-related needs (psychological comfort, spiritual care) , social support-related needs (community support services, social engagement, relationship connection, information linkage) , health technology-related needs (care auxiliary equipment, technical services) .
Conclusion
The care and support needs of the disabled elderly are both complex and diverse. To meet the physical, psychological, social, healthy and environmental needs of the disabled elderly, it is essential for the government to integrate resources from family, community and institutions. Furthermore, attention should be given to the equitable of care resources from a group perspective, and additional social welfare should be provided to support the disabled elderly.
Key words: Health services for the aged, Disabled elderly, Care needs, Qualitative research, Systematic review
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