Invisible no more: a scoping review of the health care aide workforce literature.
Invisible no more: a scoping review of the health care aide workforce literature.
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DOI：
10.1186/s12912-015-0090-x
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发表时间：
2015
期刊：
影响因子：
3.2
通讯作者：
Cummings GG
中科院分区：
文献类型：
--
作者：
Hewko SJ;Cooper SL;Huynh H;Spiwek TL;Carleton HL;Reid S;Cummings GG
保健助理是弱势老年人的主要照顾者。他们有许多头衔，基本上不受管制，这导致他们相对不为人所知。本次范围审查的目的是评估HCA劳动力文献的广度和深度。我们对七个在线书目数据库进行了搜索。如果研究自1995年以来在英文同行评审期刊上发表，则纳入研究。结果在以下五个类别内和之间反复综合：教育、供应、使用、需求以及伤害和疾病。在筛选的5，045篇引文中，82篇研究符合纳入标准。很少有人研究HCA教育;特别是受训者的特点，计划的位置，长度和内容。结果表明，平均HCA是女性，36-45岁，具有高中或更低的教育水平。家庭健康HCA，平均年龄较大，更有可能是移民比那些在其他环境中工作。对探索HCA使用的研究进行的审查表明，HCA的作用不明确-职责、自主程度和工作环境的变化使描述HCA的”作用“几乎不可能。预计对HCA的需求将增加，而且专业和设施层面的人员流动率都很高，这引发了对未来HCA短缺的预测。家庭健康HCA经历了相对较低的工作稳定性，收入较少，工作时间最少，不太可能有额外的福利比HCA在医院和疗养院。回顾与HCA疾病和损伤相关的研究发现，他们比注册护士和执业护士的损伤风险相对较高。这是迄今为止对HCA劳动力文献进行的最大、最全面的范围审查。我们的研究结果表明，HCA劳动力是无形的和无处不在的;只要是这种情况下，政府和医疗机构将在他们的能力有限，制定和实施可行的，有效的HCA劳动力计划。HCA的持续低估对护理提供者、他们为之工作的机构和依赖他们护理的人产生了不利影响。未来的劳动力规划和研究需要国家HCA登记册，或至少是目录。本文的在线版本（doi：10.1186/s12912-015-0090-x）包含补充材料，可供授权用户使用。
Healthcare aides (HCAs) are the primary caregivers for vulnerable older persons. They have many titles and are largely unregulated, which contributes to their relative invisibility. The objective of this scoping review was to evaluate the breadth and depth of the HCA workforce literature. We conducted a search of seven online bibliographic databases. Studies were included if published since 1995 in English, peer-reviewed journals. Results were iteratively synthesized within and across the following five categories: education, supply, use, demand and injury and illness. Of 5,045 citations screened, 82 studies met inclusion criteria. Few examined HCA education; particularly trainee characteristics, program location, length and content. Results in supply indicated that the average HCA was female, 36–45 years and had an education level of high school or less. Home health HCAs were, on average, older and were more likely to be immigrants than those working in other settings. The review of studies exploring HCA use revealed that their role was unclear – variation in duties, level of autonomy and work setting make describing “the” role of an HCA near impossible. Projected increased demand for HCAs and high rates of turnover, both at the profession and facility-level, elicit predictions of future HCA shortages. Home health HCAs experienced comparatively lower job stability, earned less, worked the fewest hours and were less likely to have fringe benefits than HCAs employed in hospitals and nursing homes. The review of studies related to HCA illness and injury revealed that they were at comparatively higher risk of injury than registered nurses and licensed practical nurses. This is the largest, most comprehensive scoping review of HCA workforce literature to date. Our results indicate that the HCA workforce is both invisible and ubiquitous; as long as this is the case, governments and healthcare organizations will be limited in their ability to develop and implement feasible, effective HCA workforce plans. The continued undervaluation of HCAs adversely impacts care providers, the institutions they work for and those who depend on their care. Future workforce planning and research necessitates national HCA registries, or at minimum, directories. The online version of this article (doi:10.1186/s12912-015-0090-x) contains supplementary material, which is available to authorized users.