老年夫妇日常生活活动能力照料者网络在婚姻二元组之外的扩展。
Expansion of elderly couples' IADL caregiver networks beyond the marital dyad.
作者信息
Feld Sheila, Dunkle Ruth E, Schroepfer Tracy, Shen Huei-Wern
机构信息
University of Michigan, School of Social Work, Ann Arbor, MI 48109-1109, USA.
出版信息
Int J Aging Hum Dev. 2006;63(2):95-113. doi: 10.2190/CW8G-PB6B-NCGH-HT1M.
Factors influencing expansion of instrumental activities of daily living (IADL) caregiver networks beyond the spouse/partner were studied, using data from the Asset and Health Dynamics among the Oldest Old (AHEAD) nationally representative sample of American elders (ages 70 and older). Analyses were based on 427 Black and White couples in which one partner regularly received IADL assistance; nearly 20% had expanded networks. Logistic regression showed expanded networks were significantly more likely when spouses had IADL or basic personal activity of everyday living (ADL) limitations and help recipients were wives or had numerous IADL or ADL limitations; they also tended to be more common (p <.10) for couples with numerous nearby daughters and help recipients with proxies and those without serious cognitive problems. Network expansion was unrelated to recipients' number of health conditions and Medicaid coverage or couples' ages, marital duration, income, and number of proximate sons. Implications for service programs and caregiving theories of the circumstances linked to IADL assistance from outside the marital dyad are discussed.
利用来自“全美最年长者资产与健康动态研究”(AHEAD)中具有全国代表性的美国老年人(70岁及以上)样本数据,对影响日常生活工具性活动(IADL)照料者网络超出配偶/伴侣范围进行扩展的因素进行了研究。分析基于427对黑白夫妇,其中一方配偶定期接受IADL协助;近20%的夫妇有扩展后的照料者网络。逻辑回归分析表明,当配偶存在IADL或基本日常生活活动(ADL)受限情况,且受助者为妻子或有大量IADL或ADL受限情况时,照料者网络扩展的可能性显著更高;对于有众多住得近的女儿的夫妇、有代理人的受助者以及没有严重认知问题的夫妇,网络扩展也往往更为常见(p<.10)。网络扩展与受助者的健康状况数量、医疗补助覆盖情况或夫妇的年龄、婚姻持续时间、收入以及住得近的儿子数量无关。文中讨论了这些结果对服务项目以及与婚姻二元组之外提供IADL协助相关情况的照料理论的启示。