Alice Farrelly RN, BSc Nursing, MSc Advanced Practice, Louise Daly RN, RNT, PhD
{"title":"老年人的虚弱体验:系统综述。","authors":"Alice Farrelly RN, BSc Nursing, MSc Advanced Practice, Louise Daly RN, RNT, PhD","doi":"10.1111/opn.12611","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>The objective of this study was to synthesise the evidence of older persons’ experiences of frailty.</p>\n </section>\n \n <section>\n \n <h3> Background</h3>\n \n <p>The world's population is ageing with those aged over 60 years expected to total 2 billion by 2050. Although not exclusive to ageing, there is a higher prevalence of frailty in older adults, with corresponding demand for related healthcare. While definitions of frailty are debated, there is emerging consensus that sole reliance on biomedical conceptualisations is inadequate to capture the complex needs of older persons living with frailty. In addition, the voices of older persons have largely been excluded from frailty discourses. There is a consequent need for an expanded approach.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A meta-synthesis was conducted of the literature on older persons' experiences of frailty. CINAHL, Medline, Embase and ASSIA databases were systematically searched up to January 2024. Reference lists of retrieved sources and grey literature were also searched. Studies were independently evaluated for inclusion by two reviewers using predetermined inclusion criteria. Included studies were quality appraised using a standardised tool, and extracted data were thematically analysed and synthesised.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Eight hundred and thirteen studies were identified as potentially relevant. Following title and abstract review, 52 studies were selected for full-text review. Thirty-four studies were subsequently excluded as they did not address the systematic review question, leaving 17 included in the final review. An additional two studies were identified via grey literature sources. Older persons' experiences of frailty were synthesised with reference to three themes: (i) living with frailty: a multidimensional experience; (ii) living with frailty: acceptability and associations; and (iii) living with frailty: resisting and adapting and losing control.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Older persons' experiences of frailty revealed a resistance to the biomedical use of the term generally used in clinical practice. Instead, a more nuanced and multidimensional understanding of frailty was identified in the experiences of older persons.</p>\n </section>\n \n <section>\n \n <h3> Implications for Practice</h3>\n \n <p>Health and social care personnel should therefore consider an expanded approach in practice that incorporates the perspective of older people who strive to maintain independence and control when living with frailty. Doing so may enhance shared understanding and person-centred care planning between older persons and professionals.</p>\n </section>\n </div>","PeriodicalId":48651,"journal":{"name":"International Journal of Older People Nursing","volume":"19 3","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Older persons' experiences of frailty: A systematic review\",\"authors\":\"Alice Farrelly RN, BSc Nursing, MSc Advanced Practice, Louise Daly RN, RNT, PhD\",\"doi\":\"10.1111/opn.12611\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>The objective of this study was to synthesise the evidence of older persons’ experiences of frailty.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>The world's population is ageing with those aged over 60 years expected to total 2 billion by 2050. Although not exclusive to ageing, there is a higher prevalence of frailty in older adults, with corresponding demand for related healthcare. While definitions of frailty are debated, there is emerging consensus that sole reliance on biomedical conceptualisations is inadequate to capture the complex needs of older persons living with frailty. In addition, the voices of older persons have largely been excluded from frailty discourses. There is a consequent need for an expanded approach.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A meta-synthesis was conducted of the literature on older persons' experiences of frailty. CINAHL, Medline, Embase and ASSIA databases were systematically searched up to January 2024. Reference lists of retrieved sources and grey literature were also searched. Studies were independently evaluated for inclusion by two reviewers using predetermined inclusion criteria. Included studies were quality appraised using a standardised tool, and extracted data were thematically analysed and synthesised.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Eight hundred and thirteen studies were identified as potentially relevant. Following title and abstract review, 52 studies were selected for full-text review. Thirty-four studies were subsequently excluded as they did not address the systematic review question, leaving 17 included in the final review. An additional two studies were identified via grey literature sources. Older persons' experiences of frailty were synthesised with reference to three themes: (i) living with frailty: a multidimensional experience; (ii) living with frailty: acceptability and associations; and (iii) living with frailty: resisting and adapting and losing control.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Older persons' experiences of frailty revealed a resistance to the biomedical use of the term generally used in clinical practice. Instead, a more nuanced and multidimensional understanding of frailty was identified in the experiences of older persons.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Implications for Practice</h3>\\n \\n <p>Health and social care personnel should therefore consider an expanded approach in practice that incorporates the perspective of older people who strive to maintain independence and control when living with frailty. Doing so may enhance shared understanding and person-centred care planning between older persons and professionals.</p>\\n </section>\\n </div>\",\"PeriodicalId\":48651,\"journal\":{\"name\":\"International Journal of Older People Nursing\",\"volume\":\"19 3\",\"pages\":\"\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-05-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Older People Nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/opn.12611\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Older People Nursing","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/opn.12611","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
Older persons' experiences of frailty: A systematic review
Objectives
The objective of this study was to synthesise the evidence of older persons’ experiences of frailty.
Background
The world's population is ageing with those aged over 60 years expected to total 2 billion by 2050. Although not exclusive to ageing, there is a higher prevalence of frailty in older adults, with corresponding demand for related healthcare. While definitions of frailty are debated, there is emerging consensus that sole reliance on biomedical conceptualisations is inadequate to capture the complex needs of older persons living with frailty. In addition, the voices of older persons have largely been excluded from frailty discourses. There is a consequent need for an expanded approach.
Methods
A meta-synthesis was conducted of the literature on older persons' experiences of frailty. CINAHL, Medline, Embase and ASSIA databases were systematically searched up to January 2024. Reference lists of retrieved sources and grey literature were also searched. Studies were independently evaluated for inclusion by two reviewers using predetermined inclusion criteria. Included studies were quality appraised using a standardised tool, and extracted data were thematically analysed and synthesised.
Results
Eight hundred and thirteen studies were identified as potentially relevant. Following title and abstract review, 52 studies were selected for full-text review. Thirty-four studies were subsequently excluded as they did not address the systematic review question, leaving 17 included in the final review. An additional two studies were identified via grey literature sources. Older persons' experiences of frailty were synthesised with reference to three themes: (i) living with frailty: a multidimensional experience; (ii) living with frailty: acceptability and associations; and (iii) living with frailty: resisting and adapting and losing control.
Conclusions
Older persons' experiences of frailty revealed a resistance to the biomedical use of the term generally used in clinical practice. Instead, a more nuanced and multidimensional understanding of frailty was identified in the experiences of older persons.
Implications for Practice
Health and social care personnel should therefore consider an expanded approach in practice that incorporates the perspective of older people who strive to maintain independence and control when living with frailty. Doing so may enhance shared understanding and person-centred care planning between older persons and professionals.
期刊介绍:
International Journal of Older People Nursing welcomes scholarly papers on all aspects of older people nursing including research, practice, education, management, and policy. We publish manuscripts that further scholarly inquiry and improve practice through innovation and creativity in all aspects of gerontological nursing. We encourage submission of integrative and systematic reviews; original quantitative, qualitative, and mixed methods research; secondary analyses of existing data; historical works; theoretical and conceptual analyses; evidence based practice projects and other practice improvement reports; and policy analyses. All submissions must reflect consideration of IJOPN''s international readership and include explicit perspective on gerontological nursing. We particularly welcome submissions from regions of the world underrepresented in the gerontological nursing literature and from settings and situations not typically addressed in that literature. Editorial perspectives are published in each issue. Editorial perspectives are submitted by invitation only.