{"title":"社区居住体弱老年人照护者的经验与需求：一项混合方法的系统回顾。","authors":"Wendie Zhou, Qigao Liang, Yanhui Bian, Qinqin Liu, Yanyan Li, Jiaqi Yu, Hejing Chen, Cuili Wang","doi":"10.1111/jocn.17799","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>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.</p><p><strong>Design: </strong>This was a mixed methods systematic review using the convergent integrated analysis framework.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Relevance to clinical practice: </strong>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.</p><p><strong>Reporting method: </strong>This review followed the PRISMA 2020 guidelines.</p><p><strong>Patient or public contribution: </strong>No patient or public contribution due to design.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Experiences and Needs of Caregivers of Community-Dwelling Frail Older Adults: A Mixed Methods Systematic Review.\",\"authors\":\"Wendie Zhou, Qigao Liang, Yanhui Bian, Qinqin Liu, Yanyan Li, Jiaqi Yu, Hejing Chen, Cuili Wang\",\"doi\":\"10.1111/jocn.17799\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>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.</p><p><strong>Design: </strong>This was a mixed methods systematic review using the convergent integrated analysis framework.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Relevance to clinical practice: </strong>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.</p><p><strong>Reporting method: </strong>This review followed the PRISMA 2020 guidelines.</p><p><strong>Patient or public contribution: </strong>No patient or public contribution due to design.</p>\",\"PeriodicalId\":50236,\"journal\":{\"name\":\"Journal of Clinical Nursing\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-04-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/jocn.17799\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/jocn.17799","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
摘要
目的：本研究旨在综合目前关于社区居住的体弱老年人的非正式照顾者的经验和需求的证据，以告知有针对性的干预措施，以改善他们的照顾情况。设计：这是一个使用聚合综合分析框架的混合方法系统评价。方法：系统检索2000年1月1日至2025年3月12日期间发表的研究文献，检索范围包括CINAHL、CNKI、EMBASE、OpenGrey、ProQuest、PsycINFO、PubMed、SinoMed、VIP、万方、Web of Science等11个数据库及参考文献列表。采用混合方法评价工具进行质量评价。研究结果采用叙述方法进行综合。结果：在5297篇引文中，筛选了2905篇标题和摘要，进一步筛选了176篇全文，并纳入了8项研究(n = 6定量研究，n = 2定性研究；1949照顾者)。照顾经验的主题与(1)影响消极、(2)或积极照顾者结果的影响因素相关；(3)照护者应对照护情境的策略或资源；照料可能产生(4)消极、(5)或积极影响的结果；(6)他们遇到的与照顾体弱多病的老年人有关的困难。照顾者表示需要心理支持、现有资源的详细信息、以家庭为中心的综合公共服务以及自我宣传和协调员。结论：本综述强调了需要更多关注的广泛领域，以提高这些护理人员的福祉。需要对照顾者的经历、需求和干预措施，特别是他们的支持需求进行更多的研究。建议在未来的研究和实践中建立一个理论框架，对儿童照顾者和配偶照顾者进行比较分析，并强调掌握和能力。与临床实践的相关性：我们的研究结果有可能指导需求导向和循证干预措施的发展，以适应护理人员面临的独特挑战，从而支持他们发挥护理作用。报告方法：本综述遵循PRISMA 2020指南。患者或公众贡献：由于设计原因，没有患者或公众贡献。
Experiences and Needs of Caregivers of Community-Dwelling Frail Older Adults: A Mixed Methods Systematic Review.
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.
期刊介绍：
The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice.
JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice.
We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.
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