残疾丈夫和妻子接受护理的纵向变化。
Longitudinal changes in disabled husbands' and wives' receipt of care.
机构信息
Center for the Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI 53706, USA.
出版信息
Gerontologist. 2010 Oct;50(5):681-93. doi: 10.1093/geront/gnq028. Epub 2010 Apr 9.
PURPOSE OF THE STUDY
This study contrasts 2-year adjustments in disabled husbands' and wives' amount of received care following both worsening and recovery in personal (activities of daily living [ADLs]) and routine care (instrumental activities of daily living [IADLs]) disability.
DESIGN AND METHODS
Using longitudinal data on 789 husbands and 778 wives from the Health and Retirement Study (2000 and 2002), changes in marital partners' monthly hours of spousal and nonspousal care were jointly modeled using bivariate Tobit models. In addition, asymmetry in the magnitude of responses to worsening and improvement of function was examined.
RESULTS
Disabled husbands receive more hours of spousal and nonspousal care following worsening in ADL function than wives. Conversely, disabled wives lose more spousal and nonspousal care hours following improvements in ADL disability than husbands. Moreover, wives recovering in ADL function lose more hours of spousal care than they receive following worsening in personal care disability. There is no evidence of corresponding gender differences in the dynamics of assistance received following changes in IADL function.
IMPLICATIONS
Compared with husbands, disabled wives are disadvantaged in the adjustment of their personal care hours. Although disabled married community residents receive more hours of care than their unmarried counterparts, there are important gender differences in the advantages offered by marriage.
研究目的
本研究对比了个人(日常生活活动 [ADL])和常规护理(工具性日常生活活动 [IADL])功能恶化和恢复后,残疾丈夫和妻子在接受护理量方面 2 年的调整情况。
设计和方法
利用来自健康与退休研究(2000 年和 2002 年)的 789 名丈夫和 778 名妻子的纵向数据,使用二元 Tobit 模型联合建模了配偶和非配偶护理的每月时间变化。此外,还检查了功能恶化和改善的响应幅度不对称性。
结果
ADL 功能恶化后,残疾丈夫接受的配偶和非配偶护理时间比妻子多。相反,ADL 残疾改善后,残疾妻子失去的配偶和非配偶护理时间比丈夫多。此外,ADL 功能恢复的妻子比个人护理残疾恶化时失去的配偶护理时间多。在 IADL 功能变化后的援助动态方面,没有证据表明存在相应的性别差异。
意义
与丈夫相比,残疾妻子在个人护理时间的调整方面处于不利地位。尽管残疾已婚社区居民比未婚居民接受更多的护理时间,但婚姻带来的优势存在重要的性别差异。