Abstract:

Objective To identify the barriers to respite services use for older adults with dementia living at home and their family caregivers，so as to provide references for optimizing respite service delivery strategies. Methods Totally 8 Chinese and English databases were searched to select qualitative and mixed-method studies published between January 2011 and September 2025 on the barriers to respite service use among home-dwelling older adults with dementia and their family caregivers. The mixed methods appraisal tool was used for literature quality assessment，and the results were synthesized using the service accessibility theory as the framework. Results A total of 34 articles were included，from which 150 research findings were extracted. These were synthesized into 25 barrier factors，which were categorized into 5 dimensions：accessibility and ability to perceive（5 factors），acceptability and ability to seek（6 factors），availability and ability to reach（5 factors），affordability and ability to pay（3 factors），and appropriateness and ability to engage（6 factors）. Conclusion The utilization of respite services is constrained by multiple barrier factors. It is recommended that relevant departments adopt comprehensive strategies across multiple dimensions，such as information dissemination，knowledge popularization，cultural adaptation，renewal of elderly care concepts，resource optimization，economic support，and service quality improvement，to enhance the quality of life for the target population.

Key words: Dementia, Caregivers, Respite Care, Barriers, Meta-Synthesis, Nursing Care

摘要：

目的 系统识别失智老年人及其照顾者使用喘息服务的障碍因素，为优化喘息服务供给策略提供参考。 方法 检索国内外8个中英文数据库，筛选2011年1月—2025年9月发表的关于失智老年人及照顾者使用喘息服务障碍因素的质性研究及混合研究。采用混合方法评价工具进行文献质量评价，并以Levesque服务可及性理论为框架，对结果进行整合。 结果 共纳入34篇文献，提取出150个研究结果，归纳形成25个障碍因素，被归纳至可接近性与感知能力（5个因素）、可接受性与寻找能力（6个因素）、可获得性与到达能力（5个因素）、可负担性与支付能力（3个因素）、适宜性与参与能力（6个因素）5个维度中。 结论 喘息服务的使用受多重障碍因素的制约，建议相关部门从信息传播、知识普及、文化适配、观念更新、资源优化、经济支持与服务品质提升等多方面综合施策，进而提高目标人群的生活质量。

关键词: 失智, 照顾者, 喘息服务, 障碍因素, Meta整合, 护理