是时候关注了?澳大利亚非正式老年照料者的健康状况及在健康相关活动上花费的时间:一项调查
Time to care? Health of informal older carers and time spent on health related activities: an Australian survey.
作者信息
Jowsey Tanisha, McRae Ian, Gillespie James, Banfield Michelle, Yen Laurann
机构信息
Australian Primary Health Care Research Institute, Australian National University, Canberra, ACT, 0200, Australia.
出版信息
BMC Public Health. 2013 Apr 22;13:374. doi: 10.1186/1471-2458-13-374.
BACKGROUND
Little is known about the time spent on specific health related activities by older adult informal carers who assist people with chronic illness. Research has not yet addressed the association between carer health status and their care demands. Such information could inform policy and health system efforts to manage chronic illness.
METHODS
We conducted an Australia wide survey using recall questionnaires to record time use. The study asked how much time is spent on "most days" for the most common activities like taking medication, self-treatment and testing, and how much time in the last month on less common activities like attending a physician or shopping associated with health needs. The survey was mailed to 5,000 members of National Seniors Australia; 2,500 registrants on the National Diabetes Services Scheme; and 3,100 members of the Australian Lung Foundation. A total of 2519 people responded, including 313 people who identified as informal carers. Statistical analysis was undertaken using Stata 11. Standard errors and confidence intervals were derived using bootstrapping techniques within Stata 11.
RESULTS
Most carers (96.2%) had chronic illness themselves, and those with greater numbers of chronic illnesses were those who faced the greatest overall time demands. The top decile of carers devoted between 8.5 and 10 hours a day to personal and caring health related activities. Informal carers with chronic illness spent more time managing their own health than people with chronic illness who were not informal carers. These carers spent more time on caring for others than on caring for their own health. High levels of caring responsibility were associated with poorer reported carer health.
CONCLUSIONS
Policy and health care services will need to adapt to recognise and reduce the time burden on carers who themselves have chronic illness. More carefully targeted investment in the social infrastructure of formal care would free up carers for other activities (including their own care) and holds the potential to improve the quality of life as well as the health outcomes of this population.
背景
对于协助慢性病患者的老年非正式照料者在特定健康相关活动上所花费的时间,我们了解甚少。研究尚未探讨照料者健康状况与其护理需求之间的关联。此类信息可为管理慢性病的政策和卫生系统工作提供参考。
方法
我们在澳大利亚全国范围内进行了一项调查,使用回忆问卷来记录时间使用情况。该研究询问了在“大多数日子”里用于诸如服药、自我治疗和检测等最常见活动的时间,以及在过去一个月里用于诸如看医生或与健康需求相关购物等不太常见活动的时间。调查问卷被邮寄给澳大利亚全国老年人协会的5000名成员、国家糖尿病服务计划的2500名登记者以及澳大利亚肺部基金会的3100名成员。共有2519人做出回应,其中包括313名自认为是非正式照料者的人。使用Stata 11进行统计分析。在Stata 11中使用自抽样技术得出标准误差和置信区间。
结果
大多数照料者(96.2%)自身患有慢性病,患有慢性病数量较多的照料者面临的总体时间需求最大。照料者中处于最高十分位数的人每天用于个人和与照料健康相关活动的时间在8.5至10小时之间。患有慢性病的非正式照料者在管理自身健康方面花费的时间比非非正式照料者的慢性病患者更多。这些照料者在照顾他人上花费的时间多于照顾自己的健康。高度的照料责任与照料者报告的较差健康状况相关。
结论
政策和医疗服务需要做出调整,以认识并减轻自身患有慢性病的照料者的时间负担。对正式护理社会基础设施进行更有针对性的投资,将使照料者有时间从事其他活动(包括他们自己的护理),并有可能改善这一人群的生活质量以及健康状况。