Hirst M
Social Policy Research Unit, University of York, YO 10 5DD, UK.
J Epidemiol Community Health. 2002 Aug;56(8):579-87. doi: 10.1136/jech.56.8.579.
To estimate annual changes and trends in the population of informal carers and to investigate transitions to caregiving by age, gender, locus of care, and level of involvement.
Longitudinal analysis of data from the British household panel survey, 1991 to 1998, an annual prospective survey of a nationally representative sample of more than 5000 private households in England, Scotland, and Wales.
Over 9000 adults over 16 years interviewed personally in successive waves of the survey, including around 1300 informal carers each year.
One third of co-resident carers and 40% of extra-resident carers start caregiving each year and similar proportions cease to provide care. Five year period rates are at least 75% higher than the one year prevalence estimates. Almost everyone is involved in caregiving at one time or another and over half are likely to provide 20 hours or more care per week at some point in their lives. Recent trends indicate that more adults are becoming heavily involved in providing longer episodes of care. Although the onset of caregiving peaks in late middle and early older age, above average incidences span three decades or more of adult life. Age variations in the start of caring relationships are driven by the changing demands for care within and between generations over the life course. There is no firm evidence that carers increase their involvement in caring activities over the first three years of a caring episode.
The population of carers is constantly changing as some people stop providing care and others take on a caring role or vary their level of involvement. Policy measures responsive to the diversity of caring roles, and geared around key transitions, are likely to be most effective in supporting carers through changing circumstances. Recognition and support for carers who are heavily involved in caring activities from the outset should be a priority.
评估非正式护理人员群体的年度变化及趋势,并按年龄、性别、护理地点和参与程度调查向护理角色的转变情况。
对1991年至1998年英国家庭调查面板数据进行纵向分析,该调查是对英格兰、苏格兰和威尔士5000多个私人家庭的全国代表性样本进行的年度前瞻性调查。
在连续几轮调查中亲自接受访谈的9000多名16岁以上成年人,每年约有1300名非正式护理人员。
每年有三分之一的同住护理人员和40%的非同住护理人员开始提供护理,停止护理的比例相似。五年期发生率比一年期患病率估计值至少高75%。几乎每个人都会在某个时候参与护理,超过一半的人在其生命中的某个阶段可能每周提供20小时或更多的护理。最近的趋势表明,越来越多的成年人深度参与提供更长时间的护理。虽然护理开始的高峰期在中年后期和老年早期,但高于平均水平的发生率涵盖了三十年或更长时间的成年生活。护理关系开始时的年龄差异是由一生中代际内部和代际之间不断变化的护理需求驱动的。没有确凿证据表明护理人员在护理事件的前三年中会增加对护理活动的参与度。
护理人员群体在不断变化,因为一些人停止提供护理,而另一些人承担起护理角色或改变其参与程度。针对护理角色多样性并围绕关键转变制定的政策措施,可能在支持护理人员应对不断变化的情况方面最有效。从一开始就对深度参与护理活动的护理人员给予认可和支持应成为优先事项。