Structural marginalization of older adults within health care settings: a concept analysis
Notice bibliographique
Résumé
BACKGROUND AND OBJECTIVES: Ageing populations present new challenges for society, governments and for health systems. To accommodate the global demographic shift towards older populations, healthcare systems preparedness is of paramount importance. To prepare and equip health systems to best support older adults' health and well-being over the long-term it is necessary to understand how current systems may unintentionally marginalize older adults. Therefore, the purpose of this review and analysis of the literature was to develop an operational definition of structural marginalization of older adults within healthcare settings. RESEARCH DESIGN AND METHODS: A concept analysis approach, which is a specialized type of literature review used to guide an in-depth examination of a word(s) to understand its importance, application and meaning, was used to review the literature published between January 2000 and December 2024. Eligible articles included those published in English, in peer-reviewed journals or grey literature, with a focus on how older adults experienced structural marginalization within health care settings. Older adults were defined as study participants who were identified as older adults by the study authors, where the lower age limit for inclusion was 60 years or where the study participants or population of interest had an average age of at least 60 years. Studies with participants who had conditions frequently associated with ageing such as dementia were also eligible for inclusion. RESULTS: The following defining attributes of structural marginalization of older adults within health care settings were determined through analysis of the 36 included articles: (a) health system actions bias and disadvantage accessibility to care, (b) insufficient organizational structure, composition, activities, and actions undermine older adults' health, (c) policies fail to protect or support, (d) care is reduced or compromised, and (e) the social determinants of health influence access and experience with healthcare organizations. DISCUSSION AND IMPLICATIONS: The contributors to structural marginalization of older adults within healthcare are complex and multifaceted. Successful resolution of this widespread concern requires a collaborative approach that includes recognition of the issue, targeted education, financial resources, and action towards resolution across all levels within healthcare systems.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».