Abernethy A, Burns C, Wheeler J, Currow D
Department of Medicine, Division of Medical Oncology, Duke University Medical Centre, Durham, North Carolina 27710, USA.
Palliat Med. 2009 Jan;23(1):66-79. doi: 10.1177/0269216308098793. Epub 2008 Nov 7.
Interventions designed to assist informal caregivers who serve individuals at or near the end of life have predominantly focused on caregiving spouses. Can we define other caregiver subpopulations--by intensity of care provided--so as to enable better a) identification of caregiver needs and b) targeting of support to caregivers? The Health Omnibus Survey, an annual face-to-face survey in South Australia, collects health-related data from a representative sample of 4400 households. Piloted questions included in the 2001-2005 Health Omnibus surveys addressed death of a loved one, caregiving provided, impact of caregiving and caregiver characteristics. Of 18,224 respondents, 5302 reported a loved one's death due to terminal illness in the previous 5 years. In all, 502 (10%) provided daily care [5-7 days/week], 619 (12%) provided intermittent care [2-4 days/week] and 425 (8%) provided rare care. Active (daily plus intermittent) caregivers, compared with non-active (rare) caregivers, were more often women (63% vs 50%; P < 0.0001). Daily caregivers were distinguishable from intermittent; daily caregivers were more often widowed (95% vs 7%; P < 0.0001) and >or=60 years (80% vs 64%; P < 0.0001); intermittent caregivers were more commonly children/parents (35%), other relatives (33%), or friends (26%; P < 0.0001) and were better educated, more active in paid work and wealthier. Financial burden, experience at time of death, ability to move on after the death and need for grief support also differed by intensity of caregiving. Caregiver subpopulations can be defined according to intensity of caregiving with distinct demographic features helping to distinguish them.
旨在帮助照顾临终或接近临终者的非正式照料者的干预措施主要集中在照料配偶身上。我们能否根据所提供照料的强度来界定其他照料者亚群体,以便更好地:a)确定照料者的需求;b)针对照料者提供支持?《健康综合调查》是南澳大利亚州的一项年度面对面调查,从4400户家庭的代表性样本中收集与健康相关的数据。2001 - 2005年《健康综合调查》中试点的问题涉及亲人的死亡、提供的照料、照料的影响以及照料者的特征。在18224名受访者中,5302人报告在过去5年中有亲人因绝症去世。其中,502人(10%)提供日常照料(每周5 - 7天),619人(12%)提供间歇性照料(每周2 - 4天),425人(8%)提供偶尔照料。与非活跃(偶尔)照料者相比,活跃(日常加间歇性)照料者女性更多(63%对50%;P < 0.0001)。日常照料者与间歇性照料者有区别;日常照料者更多是寡妇(95%对7%;P < 0.0001)且年龄≥60岁(80%对64%;P < 0.0001);间歇性照料者更常见的是子女/父母(35%)、其他亲属(33%)或朋友(26%;P < 0.0001),并且受教育程度更高,从事有偿工作更积极,也更富有。经济负担、亲人去世时的经历、亲人去世后继续生活的能力以及对悲伤支持的需求也因照料强度不同而有所差异。照料者亚群体可以根据照料强度来界定,不同的人口特征有助于区分这些亚群体。