School of Medicine, Oregon Health and Science University, Oregon, USA.
Mov Disord. 2010 Apr 30;25(6):724-30. doi: 10.1002/mds.22888.
Family care research has identified negative outcomes of providing care to a spouse with Parkinson's disease (PD), such as declining physical and mental health. Research has also identified protective variables that decrease negative outcomes such as high mutuality and rewards of meaning. It is important for clinicians to identify "at risk" family caregivers and provide earlier interventions. Despite the importance of age and developmental stage there is a paucity of research comparing young versus older spouse caregivers. This study compared the difference in negative aspects of strain and modulators of strain in young and older PD spouse caregivers. A series of hierarchical multiple regressions were used to examine the contribution of age on both positive and negative aspects of the care situation for 65 (37 young, 28 old) PD spouse caregivers. Negative variables included 3 dimensions of strain; strain from lack of personal resources, strain from worry, and global strain. Positive or protective variables included mutuality, preparedness, and rewards of meaning. Even in early stage disease before significant care is required, young spouses (40-55) were found to be at greater risk for negative consequences of the care situation reporting significantly more strain from lack of personal resources, and lower levels of mutuality and rewards of meaning than older (greater than 70) spouses. As expected, young spouses were more likely to be working, caring for children in the home, and in better physical health than older spouses. Clinicians are well-situated to identify the unique needs of young spouses and intervene early in the caregiving trajectory. These findings provide ideas for targeted interventions. Future larger studies that compare young and older spouses should include later stage disease to more fully understand the developmental differences raised by the present findings.
家庭护理研究已经确定了为帕金森病（PD）配偶提供护理的负面后果，例如身心健康下降。研究还确定了一些保护变量，可以减少消极后果，例如高度的相互性和有意义的回报。临床医生识别“有风险”的家庭照顾者并提供早期干预非常重要。尽管年龄和发育阶段很重要，但比较年轻和年长配偶照顾者的研究很少。本研究比较了年轻和年长 PD 配偶照顾者在压力的负面方面和压力调节因素方面的差异。使用一系列分层多元回归来检查年龄对 65 名（37 名年轻，28 名年长）PD 配偶照顾者的护理情况的积极和消极方面的贡献。负面变量包括缺乏个人资源的压力、担心的压力和整体压力的 3 个维度。积极或保护变量包括相互性、准备程度和有意义的回报。即使在疾病早期，在需要大量护理之前，年轻配偶（40-55 岁）就被发现面临更大的风险，他们报告缺乏个人资源的压力更大，相互性和有意义的回报更低，而年长配偶（70 岁以上）则没有。正如预期的那样，年轻配偶更有可能工作，在家照顾孩子，身体更健康。临床医生非常适合识别年轻配偶的独特需求，并在照顾轨迹的早期进行干预。这些发现为有针对性的干预提供了思路。未来更大规模的比较年轻和年长配偶的研究应包括疾病的后期阶段，以更全面地了解本研究结果提出的发展差异。
