A new conceptual model of experiences of aging in place in the United States: Results of a systematic review and meta-ethnography of qualitative studies.
A new conceptual model of experiences of aging in place in the United States: Results of a systematic review and meta-ethnography of qualitative studies.
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DOI：
10.1016/j.ijnurstu.2019.103496
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发表时间：
2020-03
影响因子：
8.1
通讯作者：
Fukuoka Y
中科院分区：
文献类型：
--
作者：
Rosenwohl-Mack A;Schumacher K;Fang ML;Fukuoka Y
本系统综述的目的是综合美国老年人经验的证据。质性研究的系统回顾与元民族志。我们检索了6个文献数据库（PubMed、Embase、PsycINFO、CINAHL、Web of Science、Sociological Abstracts），对出版日期没有限制。符合条件的研究报告了关于美国老年人经验的同行评议定性研究，全文以英文提供。三名评审员独立使用Covidence软件筛选标题和摘要，然后筛选全文。我们使用乔安娜·布里格斯研究所定性研究检查表的修改版本评估了偏倚的质量和风险。采用元民族志进行定性数据分析，遵循Noblit和Hare的翻译和合成的七步法，以生成一个新的概念模型。在筛选的2659篇论文中，37项独特的研究符合纳入条件，在38篇出版物中报告。这些研究在16个州进行，并于1994年至2018年期间发表。纳入的样本共代表1199名参与者，平均年龄从48岁到91岁不等。样本的性别范围为20%至100%女性，中位数为77%。三分之一的纳入研究没有报告参与者的种族/民族，其余一半的研究样本至少90%是白色;然而，20%的研究专门关注种族/少数民族老年人的经历。使用元民族志，我们开发了一个新的概念模型的老化在美国的身份，连通性和地方的经验，作为一个动态的过程中平衡的威胁和机构。我们发现，居家养老的人通过改变他们的心态、调整他们的家庭环境以适应新的需求，以及寻找不同的方式与生活中的重要人物联系，来科普不可预测的需求和挑战。能动性受资源和选择限制的影响，当对衰老的威胁超过个人的能动性时，其后果包括不确定感、孤立感和错位感。据我们所知，这是第一次对定性研究进行系统回顾，以评估美国就地老龄化的经历。我们的元民族志综合的研究结果导致了一个新的概念模型的发展老龄化的地方，突出了动态的紧张局势，涉及平衡威胁和机构。
The purpose of this systematic review was to synthesize the evidence on experiences of aging in place in the United States. Systematic review and meta-ethnography of qualitative studies. We searched six bibliographic databases (PubMed, Embase, PsycINFO, CINAHL, Web of Science, Sociological Abstracts), with no limits on publication date. Eligible studies reported peer-reviewed qualitative research on experiences of aging in place in the United States with full-text available in English. Three reviewers independently used Covidence software to screen titles and abstracts followed by full texts. We assessed quality and risk of bias using a modified version of the Joanna Briggs Institute Checklist for Qualitative Research. Qualitative data analysis was conducted using meta-ethnography, following Noblit and Hare’s seven-step method of translation and synthesis to generate a novel conceptual model. Of 2659 papers screened, 37 unique studies were eligible for inclusion, reported in 38 publications. The studies were conducted in 16 states and published between 1994 and 2018. The included samples represented 1199 participants in total, with mean ages ranging from 48 to 91 years. The gender of the samples ranged from 20% to 100% female, with a median of 77%. One-third of the included studies did not report participants’ race/ethnicity, and half of the remaining study samples were at least 90% white; however, 20% of the studies focused exclusively on experiences of racial/ethnic minority older adults. Using meta-ethnography, we developed a new conceptual model of aging in place in the United States as a dynamic process of balancing threats and agency in relation to experiences of identity, connectedness, and place. We found that people aging in place were engaged in significant work to cope with unpredictable needs and challenges by changing their mindset, adapting their home environment to accommodate new needs, and finding different ways to connect with important people in their lives. Agency was shaped by resources and restrictions on choice, and where threats to aging in place outweighed an individual’s sense of agency, the consequences included feelings of uncertainty, isolation, and dislocation. To the best of our knowledge, this is the first systematic review of qualitative studies to evaluate experiences of aging in place in the United States. The findings of our meta-ethnographic synthesis led to development of a new conceptual model of aging in place highlighting the dynamic tensions involved in balancing threats and agency.
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