Experiences of aging in place in the United States: protocol for a systematic review and meta-ethnography of qualitative studies

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Abstract

Background

By 2035, older adults will outnumber children for the first time in the United States (US). In light of its aging population, the US has supported services focused on enabling older adults to continue living in their current homes, a model commonly described as “aging in place.” The lived experience of aging in place is not well documented in existing systematic reviews. The aims of this systematic review are to synthesize and evaluate the existing qualitative evidence on experiences of aging in place in the US and identify knowledge gaps and directions for future studies.

Methods

Six electronic bibliographic databases (PubMed, PsycINFO, CINAHL, Web of Science, EMBASE, and Sociological Abstracts) will be searched. Studies presenting qualitative data on the experiences of older adults currently aging in place in the US will be included. Covidence software will be used to screen studies and extract data. The Joanna Briggs Institute checklist for qualitative research will be used to assess quality and risk of bias of included studies. We will use meta-ethnography, following the method described by Noblit and Hare, to synthesize and evaluate the results of the included studies.

Discussion

To the best of our knowledge, this is the first systematic review to integrate and synthesize the findings of qualitative studies of aging in place focusing on older adults in the US. The findings of this review will provide in-depth knowledge on lived experiences of aging in place and address important gaps in existing work.

Systematic review registration

International Prospective Register of Systematic Reviews (PROSPERO): CRD42018102847

Electronic supplementary material

The online version of this article (10.1186/s13643-018-0820-8) contains supplementary material, which is available to authorized users.

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Most cited references 9

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Factors influencing acceptance of technology for aging in place: a systematic review.

Sebastiaan T M Peek, Eveline Wouters, Joost van Hoof … (2014)

To provide an overview of factors influencing the acceptance of electronic technologies that support aging in place by community-dwelling older adults. Since technology acceptance factors fluctuate over time, a distinction was made between factors in the pre-implementation stage and factors in the post-implementation stage.

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"Medication career" or "moral career"? The two sides of managing antidepressants: a meta-ethnography of patients' experience of antidepressants.

Alice Malpass, Alison Shaw, Debbie Sharp … (2009)

The UK National Institute for Clinical Excellence (NICE) Clinical Guidelines recommend routine prescription of antidepressants for moderate to severe depression. While many patients accept a prescription, one in three do not complete treatment. We carried out a meta-ethnography of published qualitative papers since 1990 whose focus is patients' experience of antidepressant use for depression, in order to understand barriers and facilitators to concordance and inform a larger qualitative study investigating antidepressant use over time. A systematic search of five databases was carried out, supported by hand searches of key journals, writing to first authors and examining reference lists. After piloting three critical appraisal tools, a modified version of the CASP (Critical Appraisal Skills Programme) checklist was used to appraise potentially relevant and qualitative papers. We carried out a synthesis using techniques of meta-ethnography involving translation and re-interpretation. Sixteen papers were included in the meta-ethnography. The papers fall into two related groups: (1) Papers whose focus is the decision-making relationship and the ways patients manage their use of antidepressants, and (2) Papers whose focus is antidepressants' effect on self-concept, ideas of stigma and its management. We found that patients' experience of antidepressants is characterised by the decision-making process and the meaning-making process, conceptualised here as the 'medication career' and 'moral career'. Our synthesis indicates ways in which general practitioners (GPs) can facilitate concordant relationships with patients regarding antidepressant use. First, GPs can enhance the potential for shared decision-making by reviewing patients' changing preferences for involvement in decision-making regularly throughout the patient's 'medication career'. Second, if GPs familiarise themselves with the competing demands that patients may experience at each decision-making juncture, they will be better placed to explore their patients' preferences and concerns--i.e. their 'moral career' of medication use. This may lead to valuable discussion of what taking antidepressants means for patients' sense of self and how their treatment decisions may be influenced by a felt sense of stigma.

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A comparative analysis of three online appraisal instruments' ability to assess validity in qualitative research.

Alan Pearson, Karin Hannes, Craig Lockwood (2010)

The concept of validity has been a central component in critical appraisal exercises evaluating the methodological quality of quantitative studies. Reactions by qualitative researchers have been mixed in relation to whether or not validity should be applied to qualitative research and if so, what criteria should be used to distinguish high-quality articles from others. We compared three online critical appraisal instruments' ability to facilitate an assessment of validity. Many reviewers have used the critical appraisal skills program (CASP) tool to complete their critical appraisal exercise; however, CASP appears to be less sensitive to aspects of validity than the evaluation tool for qualitative studies (ETQS) and the Joanna Briggs Institute (JBI) tool. The ETQS provides detailed instructions on how to interpret criteria; however, it is the JBI tool, with its focus on congruity, that appears to be the most coherent.

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Author and article information

Contributors

Amy Rosenwohl-Mack:

ORCID: http://orcid.org/0000-0002-1961-4622

Amy.Rosenwohl-Mack@ucsf.edu

Karen Schumacher: Karen.Schumacher@ucsf.edu

Min-Lin Fang: Min-Lin.Fang@ucsf.edu

Yoshimi Fukuoka: Yoshimi.Fukuoka@ucsf.edu

Journal

Journal ID (nlm-ta): Syst Rev

Journal ID (iso-abbrev): Syst Rev

Title: Systematic Reviews

Publisher: BioMed Central (London )

ISSN (Electronic): 2046-4053

Publication date (Electronic): 6 October 2018

Publication date PMC-release: 6 October 2018

Publication date Collection: 2018

Volume: 7

Electronic Location Identifier: 155

Affiliations

[1 ]Department of Social & Behavioral Sciences, School of Nursing, University of California, San Francisco (UCSF), CA USA

[2 ]ISNI 0000 0001 2297 6811, GRID grid.266102.1, Department of Physiological Nursing, School of Nursing, , UCSF, ; CA, USA

[3 ]ISNI 0000 0001 2297 6811, GRID grid.266102.1, Education and Research Services, UCSF Library, , UCSF, ; CA, USA

[4 ]ISNI 0000 0001 2297 6811, GRID grid.266102.1, Institute for Health & Aging, School of Nursing, , UCSF, ; CA, USA

Author information

Amy Rosenwohl-Mack http://orcid.org/0000-0002-1961-4622

Article

Publisher ID: 820

DOI: 10.1186/s13643-018-0820-8

PMC ID: 6173904

PubMed ID: 30292236

SO-VID: 6e606e6b-b82a-4045-a80f-d8e812b9a813

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 5 July 2018

Date accepted : 17 September 2018

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100000056, National Institute of Nursing Research;

Award ID: K24NR015812

Award Recipient : Yoshimi Fukuoka

Funded by: UCSF Graduate Dean's Health Sciences Fellowship

Custom metadata

ScienceOpen disciplines: Public health

Keywords: aging in place,older adults,qualitative research,systematic review,meta-ethnography,living alone,staying at home,aging at home,aging in community,independent aging

Data availability:

ScienceOpen disciplines: Public health

Keywords: aging in place, older adults, qualitative research, systematic review, meta-ethnography, living alone, staying at home, aging at home, aging in community, independent aging

Experiences of aging in place in the United States: protocol for a systematic review and meta-ethnography of qualitative studies

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Abstract

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Most cited references 9

Factors influencing acceptance of technology for aging in place: a systematic review.

"Medication career" or "moral career"? The two sides of managing antidepressants: a meta-ethnography of patients' experience of antidepressants.

A comparative analysis of three online appraisal instruments' ability to assess validity in qualitative research.

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