Older persons' experiences of frailty: A systematic review

IF 1.6 4区医学 Q4 GERIATRICS & GERONTOLOGY International Journal of Older People Nursing Pub Date : 2024-05-15 DOI:10.1111/opn.12611

Alice Farrelly RN, BSc Nursing, MSc Advanced Practice, Louise Daly RN, RNT, PhD

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Abstract

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.

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老年人的虚弱体验：系统综述。

研究目的本研究的目的是综合老年人对虚弱的体验的证据：背景：世界人口正在老龄化，预计到 2050 年，60 岁以上的人口总数将达到 20 亿。虽然老龄化并不是唯一的原因，但老年人体弱的发病率较高，对相关医疗保健的需求也相应增加。虽然对虚弱的定义还存在争议，但人们逐渐达成共识，即仅仅依靠生物医学概念不足以满足患有虚弱症的老年人的复杂需求。此外，老年人的声音在很大程度上被排除在体弱多病的讨论之外。因此，有必要扩展研究方法：方法：我们对有关老年人体弱经历的文献进行了元综合。系统检索了截至 2024 年 1 月的 CINAHL、Medline、Embase 和 ASSIA 数据库。此外，还检索了检索到的资料来源的参考文献目录和灰色文献。由两名审稿人使用预先确定的纳入标准对纳入的研究进行独立评估。使用标准化工具对纳入的研究进行质量评估，并对提取的数据进行专题分析和综合：结果：共确定了 813 项可能相关的研究。在对标题和摘要进行审查后，选出 52 项研究进行全文审查。有 34 项研究因未涉及系统性综述的问题而被排除，剩下 17 项纳入最终综述。另外还有两项研究是通过灰色文献来源确定的。我们根据以下三个主题对老年人的体弱经历进行了综合分析：(i) 体弱生活：多方面的经历；(ii) 体弱生活：可接受性和关联性；(iii) 体弱生活：抵制、适应和失去控制：老年人对虚弱的体验表明，他们抵制临床实践中通常使用的生物医学术语。相反，从老年人的经历中可以发现他们对虚弱的理解更加细微和多维：因此，医疗和社会护理人员应考虑在实践中扩展方法，纳入老年人的视角，让他们在体弱的情况下努力保持独立性和控制力。这样做可以加强老年人与专业人员之间的共同理解，并制定以人为本的护理计划。

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来源期刊

International Journal of Older People Nursing Nursing-Gerontology

CiteScore

3.60

自引率

9.10%

发文量

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.