Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA.
Gerontologist. 2011 Feb;51(1):86-100. doi: 10.1093/geront/gnq061. Epub 2010 Aug 19.
Transitions in caregiving, such as becoming a primary caregiver to grandchildren or having adult children and grandchildren move in or out, may affect the well-being of the grandmother.
This report describes caregiving patterns at 3 time points over 24 months in a sample of 485 Ohio grandmothers and examines the effects of stability and change in grandmother caregiving roles (raising a grandchild, living in a multigenerational home, or not caregiving to grandchildren). Drawing on the Resiliency Model of Family Stress, the study examined caregiving stress and reward, intrafamily strain, social support, resourcefulness, depressive symptoms, mental and physical health, and perceived family functioning. Caregiver group, time of measurement, switching between caregiver groups, and baseline age, race, education, work status, and marital status were considered as independent variables within the context of a one-way treatment structure in a mixed-model multivariate analysis.
There were significant caregiver group effects for all variables, except mental health and resourcefulness. Grandmothers raising grandchildren reported the most stress, intrafamily strain, and perceived problems in family functioning, the worst physical health and more depressive symptoms, and the least reward and subjective support. Across groups, there were significant time effects, with worsening physical health and increased stress over time. Switching to higher levels of caregiving was associated with worsening physical health and increases in stress, intrafamily strain, and perceived problems in family functioning.
Recommendations for research and for practice, especially during times of caregiving transition or for grandmothers raising grandchildren, are discussed.
照顾孙辈的角色转变,如成为孙辈的主要照顾者,或让成年子女和孙辈搬入或搬出家庭,可能会影响祖母的幸福感。
本报告描述了在俄亥俄州 485 名祖母样本中,24 个月内 3 个时间点的照顾模式,并研究了祖母照顾角色(抚养孙辈、居住在多代同堂家庭或不照顾孙辈)的稳定性和变化对祖母的影响。本研究借鉴家庭压力适应模型,考察了照顾压力和回报、家庭内紧张、社会支持、应变能力、抑郁症状、心理健康和身体健康以及感知家庭功能。在混合模型多变量分析中,在单向处理结构的背景下,将照顾者群体、测量时间、在照顾者群体之间切换以及基线年龄、种族、教育程度、工作状况和婚姻状况视为独立变量。
除心理健康和应变能力外,所有变量均存在显著的照顾者群体效应。抚养孙辈的祖母报告的压力、家庭内紧张和感知到的家庭功能问题最多,身体健康最差,抑郁症状最多,回报和主观支持最少。在所有组中,均存在显著的时间效应,随着时间的推移,身体健康状况恶化,压力增加。向更高水平的照顾角色转变与身体健康状况恶化、压力、家庭内紧张和感知到的家庭功能问题增加有关。
讨论了研究和实践建议,特别是在照顾角色转变期间,或对于抚养孙辈的祖母而言。