Dowdell Elizabeth Burgess
College of Nursing, Villanova University, Villanova, PA, USA.
MCN Am J Matern Child Nurs. 2004 Sep-Oct;29(5):299-304. doi: 10.1097/00005721-200409000-00007.
To describe the experience of grandmothers who are parenting their grandchildren, and determine the amount of caregiver burden felt by the grandmothers.
This descriptive correlational study had a sample of 104 grandmothers, reporting on 249 custodial grandchildren. Grandmothers completed the Caregiver Reactions Assessment to determine perceived physical health, family support, financial status, and caregiver burden.
Overall, grandmothers perceived the health of their grandchildren as excellent. Of the grandchildren who had been born prematurely (30%), the primary health problems were hyperactivity and asthma. Parental drug use was reported as the reason for child placement with the grandmother in 80% of the cases. The range of time grandchildren had been living with the grandmother was 6 months to 15 years. Low ratings of grandchild physical health correlated with low ratings of grandmother physical health, which correlated strongly with low levels of self-esteem, a strong perception of poor family support, and poor financial status, all of which represent measures of caregiver burden.
This study demonstrated that the well being of the grandmother and grandchild are both linked to good physical health. Thus, indicators of poor health for both grandchild and grandmother must be identified early. Grandmothers in this study were surprised at how much had changed in every aspect of child health since they had raised their own children. Nurses working with grandmothers who have custody of grandchildren should understand the dynamics of the relationship, the possibility of caregiver burden, provide anticipatory guidance about the changes in child care and child healthcare in the 21st century, and help link grandmothers who have little support to community programs.
描述抚养孙辈的祖母们的经历，并确定祖母们感受到的照顾者负担程度。
这项描述性相关性研究以104位祖母为样本，她们负责照顾249名孙辈。祖母们完成了照顾者反应评估，以确定她们对自身健康状况、家庭支持、经济状况和照顾者负担的认知。
总体而言，祖母们认为孙辈的健康状况极佳。在早产的孙辈中（占30%），主要健康问题是多动和哮喘。在80%的案例中，据报告孙辈被安置到祖母身边的原因是父母吸毒。孙辈与祖母一起生活的时间跨度为6个月至15年。孙辈身体健康状况评分低与祖母身体健康状况评分低相关，而这又与低自尊水平、强烈的家庭支持感缺失以及经济状况不佳密切相关，所有这些都是照顾者负担的衡量指标。
本研究表明，祖母和孙辈的幸福都与良好的身体健康相关。因此，必须尽早识别出孙辈和祖母健康状况不佳的指标。本研究中的祖母们惊讶地发现，自她们养育自己的孩子以来，儿童健康的各个方面发生了如此大的变化。与照顾孙辈的祖母们打交道的护士应该了解这种关系的动态、照顾者负担的可能性，提供关于21世纪儿童护理和儿童医疗保健变化的预期指导，并帮助将缺乏支持的祖母们与社区项目联系起来。
