Background

Community dwelling older adults who are care dependent are highly affected by incontinence, resulting in substantial informal caregiver burden. Understanding the experiences of these caregivers is needed to develop supportive programs that reduce caregiver burden and rates of institutionalization for care recipients.

Objectives

This systematic review aimed to critically appraise and synthesize the qualitative literature on the perceptions, experiences, and consequences of informal caregivers managing incontinence in community dwelling older adults.

Design

A qualitative evidence synthesis using meta-aggregation.

Data sources

CINAHL, Embase, Ovid Medline, PsycInfo, Scopus, and ProQuest Dissertations and Theses.

Review methods

A comprehensive search was conducted to identify qualitative studies of all designs, published in English from January 1970 to November 2020, reporting on the experiences of unpaid adult family members or friends providing care at home to an adult aged 60 or older with urinary and/or fecal incontinence. Screening, data extraction, and quality appraisal were conducted independently by two reviewers, with disagreements resolved by consensus with all team members. Joanna Briggs Institute (JBI) processes were used to assess study quality, and the dependability and credibility of both study findings and synthesized findings. All articles included met predetermined criteria.

Results

Database searches yielded 1165 references, of which 117 full-text documents were screened. Seven articles of moderate to high methodological quality met eligibility criteria and were included. Studies occurred in nine countries with 134 participants who were mostly female spouses of the care recipient. From these eligible studies, 49 findings were extracted with 35 equivocal or credible findings eligible for meta-aggregation. Findings were synthesized into the following four categories: 1) emotional responses, 2) physical, financial, and social consequences, 3) family roles and caregiver support, and 4) management and coping strategies.

Conclusions

Informal caregivers experience many physical, psychosocial, and financial challenges in caring for an older family member with incontinence. Educational and supportive programs for managing incontinence should be multi-component and tailored to meet the individual needs of informal caregivers. Future research should incorporate strategies to cope with emotional responses and offer practical strategies for managing incontinence.

PROSPERO registration

CRD42017069185

中文翻译：

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失禁导航：对家庭照顾者经历的定性系统评价和元聚合

背景

依赖照料的社区老年人受尿失禁的影响很大，导致非正式的照料者负担沉重。需要了解这些照顾者的经验，以制定支持性计划，以减少照顾者的负担和照顾接受者的住院率。

目标

本系统评价旨在批判性地评估和综合关于非正式护理人员管理社区老年人尿失禁的看法、经验和后果的定性文献。

设计

使用元聚合的定性证据合成。

数据源

CINAHL、Embase、Ovid Medline、PsycInfo、Scopus 和 ProQuest 论文和论文。

复习方法

进行了全面搜索，以确定所有设计的定性研究，这些研究于 1970 年 1 月至 2020 年 11 月以英文发表，报告了无偿成年家庭成员或朋友在家为 60 岁或以上患有泌尿系统和/或大便失禁。筛选、数据提取和质量评估由两名评价员独立进行，分歧由所有团队成员协商解决。Joanna Briggs Institute (JBI) 流程用于评估研究质量以及研究结果和综合结果的可靠性和可信度。纳入的所有文章均符合预定标准。

结果

数据库搜索产生了 1165 篇参考文献，其中筛选了 117 篇全文文件。七篇中等至高方法学质量的文章符合入选标准并被纳入。研究在九个国家进行，有 134 名参与者，其中大部分是护理接受者的女性配偶。从这些符合条件的研究中，提取了 49 项研究结果，其中 35 项模棱两可或可信的研究结果符合元聚合条件。调查结果综合为以下四类：1) 情绪反应，2) 身体、经济和社会后果，3) 家庭角色和照顾者支持，以及 4) 管理和应对策略。

结论

非正式照顾者在照顾患有尿失禁的年长家庭成员时会遇到许多身体、社会心理和经济方面的挑战。控制失禁的教育和支持计划应该是多组成部分的，并且可以满足非正式护理人员的个人需求。未来的研究应纳入应对情绪反应的策略，并提供管理尿失禁的实用策略。

PROSPERO注册

CRD42017069185