Centre for Health Services Research, University of Newcastle upon Tyne.
Psychol Med. 2000 Jul;30(4):943-55. doi: 10.1017/s0033291799002329.
It has long been assumed that mental frailty in older care-recipients results in a deterioration in family caregivers' psychological well-being. This hypothesis has not been tested in longitudinal studies. Research about the impact on families of supporting older people in institutions is limited. The present study examined psychological morbidity in informal caregivers of frail older people at home and in institutions. Caregivers were followed up over 2 years. Predictors of psychological morbidity in caregivers and factors related to deterioration in their well-being over time were identified.
Two-year panel survey of informal caregivers of older care-recipients, using semi-structured interview schedules and the 30-item GHQ. Care-recipients were those defined as physically or mentally frail after screening a stratified random sample of people aged > or = 65. Respondents were 276 caregivers of older people living at home at baseline and 47 visitors of those in long-term care at baseline.
There were no differences in GHQ scores between caregivers at home and visitors, and no changes in GHQ score over time. The strongest predictors of psychological morbidity at follow-up, and of change in GHQ scores over time, were baseline GHQ score and indicators of subjective well-being. Characteristics of care-recipients, including frailty type (mental or physical), were not significantly associated with changes in caregivers' psychological morbidity.
Mental frailty in care-recipients was not associated with deterioration over time in caregivers' psychological well-being. Caregiver characteristics were stronger than those of care-recipients in predicting psychological morbidity at follow-up and in predicting deteriorating well-being over time.
长期以来，人们一直认为老年受照料者的心理脆弱会导致家庭照料者的心理健康恶化。这一假设尚未在纵向研究中得到验证。关于在机构中照料老年人对家庭影响的研究有限。本研究调查了在家中和机构中照料体弱老年人的非正式照料者的心理疾病情况。对照料者进行了为期两年的随访。确定了照料者心理疾病的预测因素以及与其幸福感随时间恶化相关的因素。
对老年受照料者的非正式照料者进行为期两年的小组调查，使用半结构化访谈时间表和包含30个条目的一般健康问卷（GHQ）。受照料者是在对年龄≥65岁的人群进行分层随机抽样筛查后被定义为身体或精神虚弱的人。基线时，受访者为276名在家中照料老年人的照料者以及47名长期护理机构中老年人的探访者。
在家照料者和探访者的GHQ得分没有差异，且GHQ得分随时间没有变化。随访时心理疾病以及GHQ得分随时间变化的最强预测因素是基线GHQ得分和主观幸福感指标。受照料者的特征，包括虚弱类型（精神或身体），与照料者心理疾病的变化没有显著关联。
受照料者的心理脆弱与照料者心理健康随时间的恶化无关。在预测随访时的心理疾病以及随时间幸福感的恶化方面，照料者的特征比受照料者的特征影响更大。
