Understanding Nurses’ Experiences of Fragmented Care in Aging Populations: A Meta-Synthesis

BACKGROUND: Despite global population aging, fragmented care remains a significant obstacle to the provision of effective health care, particularly to older adults with complex health needs. PURPOSE: This study was designed to synthesize current qualitative research on nurses' experiences with care fragmentation in caring for aging populations. METHODS: A comprehensive search of two electronic databases was conducted to identify relevant literature published in English. A total of 20 articles covering a total of 296 nurse participants were included in this synthesis. The extracted data were thematically synthesized. RESULTS: Four main themes and 10 subthemes were identified in the synthesis. The themes included (1) challenges in accessing and delivering health care services, (2) challenges in communications and coordination, (3) the need to advance nurses' roles and recognize their contributions, and (4) the importance of providing patient-centred care. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The findings of this study highlight the complexities and challenges of providing care to aging populations within fragmented health care systems. The difficulties faced by nurses in accessing resources, coupled with communication and coordination barriers, underscore the need for systemic improvements to facilitate effective care delivery. The theme related to nurse recognition highlights the need for greater support and acknowledgement of the contributions of nurses, which is essential to ensuring care quality and patient outcomes. Moreover, the emphasis on patient-centered care reinforces the importance of adopting individualized care strategies that cater to the unique needs of older adults. Health care systems should prioritize initiatives aimed at improving communication and coordination among health care providers, supporting nursing staff, and implementing patient-centered care practices. These efforts are crucial to overcoming the challenges of fragmented care and ensuring older populations receive the comprehensive and effective care they deserve.