Vellone Ercole, Fida Roberta, Cocchieri Antonello, Sili Alessandro, Piras Giovanni, Alvaro Rosaria
University Tor Vergata, School of Nursing, Rome, Italy.
Prof Inferm. 2011 Oct-Dec;64(4):237-48.
Caregivers represent an important source of care for older adults. Many studies focused on the negative aspects of elder caregiving but few studies have analyzed also the positive effects. In addition, no studies have considered contemporarily the positive and the negative impact of caregiving to elderly people on the same people using a structural equation modeling. The purpose of this study was to examine the contribution of elder care recipient factors, caregiver factors and caregiving factors in determining the positive and negative impact of informal caregiving to older adults using a structural equation model. A cross-sectional design was used to study eighty caregivers of older people. Several instruments were used to measure elder care recipient factors (functionality, cognition, behavior); caregiver factors (socio-demographics, depression, stress, quality of life, and perceived health); caregiving factors (time from caregiving, time of care, social restriction, place of living, expenses, and living with the elder care recipient); and the positive and the negative impact of caregiving. Caregivers were 59.7 years old while elderly people were 84.0. Several factors were significantly correlated with the positive and negative impact of caregiving. However, when these factors were entered in a structural equation model, only female gender and social restriction predicted the negative impact, while caregiver's quality of life and caregiving expenses predicted both the positive and the negative impact. The results of this study suggest a new framework of caregiving to older adults where the outcomes depend more on caregiver and caregiving factors than on older person characteristics. More research is needed with a larger sample to test further the model outlined in this study.
照顾者是老年人重要的护理来源。许多研究聚焦于老年护理的消极方面,但很少有研究分析其积极影响。此外,尚无研究同时使用结构方程模型来考量照顾老年人对照顾者自身产生的积极和消极影响。本研究的目的是使用结构方程模型,检验老年受照顾者因素、照顾者因素和护理因素在确定非正式照顾对老年人的积极和消极影响方面的作用。采用横断面设计对80名老年人的照顾者进行研究。使用了多种工具来测量老年受照顾者因素(功能、认知、行为);照顾者因素(社会人口统计学特征、抑郁、压力、生活质量和自我感知健康状况);护理因素(护理时长、护理时间、社会限制、居住地点、费用以及与老年受照顾者同住情况);以及护理的积极和消极影响。照顾者的年龄为59.7岁,而老年人的年龄为84.0岁。几个因素与护理的积极和消极影响显著相关。然而,当将这些因素纳入结构方程模型时,只有女性性别和社会限制预测了消极影响,而照顾者的生活质量和护理费用则同时预测了积极和消极影响。本研究结果提出了一个针对老年人护理的新框架,其中护理结果更多地取决于照顾者和护理因素,而非老年人的特征。需要用更大的样本进行更多研究,以进一步检验本研究中概述的模型。