Program in Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore.
J Gerontol B Psychol Sci Soc Sci. 2013 Jul;68(4):609-21. doi: 10.1093/geronb/gbt042. Epub 2013 May 30.
To assess the instrumental support from a foreign domestic worker (FDW) as a moderator of the association of 4 types of impairments (physical function, memory, behavior, and mood) among older persons (OPs) with caregiving-related outcomes among their informal caregivers (CGs).
Data from a national survey of 1,190 Singaporeans aged 75 and older receiving human assistance for functional limitations and their CGs were used. Severity scores for the four OP impairments were calculated. A modified version of the Caregiver Reaction Assessment (CRA) assessed the impact of caregiving in four domains: disturbed schedule and poor health, lack of finances, lack of family support, and CG esteem. Linear regression models, one for each CRA domain, with interaction terms of the four impairment severity scores with FDW support, were developed.
FDW instrumental support, reported for 50% of the OPs, moderated the direct association of OP physical impairment with disturbed schedule and poor health (p = .009), OP memory impairment with disturbed schedule and poor health (p < .0001) and lack of finances (p = .02), and OP behavior impairment with lack of family support (p = .001). Although such support buffered the inverse association of OP behavior impairment with CG esteem (p = .01), it also buffered the positive association of OP mood impairment with CG esteem (p = .02).
FDW support is associated with better caregiving outcomes. Given its aging population, the number of FDWs in Singapore is likely to increase as families try to cope with caregiving for their older members. This has policy implications for (a) immigration patterns into Singapore and (b) training of and support networks for FDWs.
评估外籍家庭佣工（FDW）提供的工具支持，以调节 4 种老年人（OP）损伤类型（身体功能、记忆、行为和情绪）与他们的非正式照顾者（CG）的照顾相关结局之间的关系。
使用了来自新加坡全国性调查的数据，该调查涉及 1190 名 75 岁及以上的接受人力协助以缓解功能限制的新加坡人及其 CG。计算了四种 OP 损伤的严重程度评分。 caregiver reaction assessment（CRA）的一个改良版本评估了四个领域对 CG 的影响：日程紊乱和健康状况不佳、缺乏资金、缺乏家庭支持以及 CG 的自尊。开发了四个 CRA 领域的线性回归模型，每个模型都有四个损伤严重程度评分与 FDW 支持的交互项。
50%的 OP 报告了 FDW 的工具支持，该支持调节了 OP 身体损伤与日程紊乱和健康状况不佳（p =.009）、OP 记忆损伤与日程紊乱和健康状况不佳（p <.0001）和缺乏资金（p =.02）以及 OP 行为损伤与缺乏家庭支持（p =.001）之间的直接关联。尽管这种支持缓冲了 OP 行为损伤与 CG 自尊之间的负相关（p =.01），但它也缓冲了 OP 情绪损伤与 CG 自尊之间的正相关（p =.02）。
FDW 的支持与更好的照顾结局相关。鉴于新加坡人口老龄化，随着家庭试图照顾其年长成员，新加坡的 FDW 数量可能会增加。这对（a）新加坡的移民模式和（b）FDW 的培训和支持网络产生了政策影响。
