Williams Allison M, Wang Li, Kitchen Peter
School of Geography and Earth Sciences, McMaster University, Hamilton, Ontario, Canada.
Health Soc Care Community. 2014 Mar;22(2):187-96. doi: 10.1111/hsc.12075. Epub 2013 Oct 31.
Using data from Statistic Canada's General Social Survey Cycle 21 (GSS 2007), this study explores whether differences exist in the impacts of care-giving among three groups of caregivers providing informal care either in the caregiver's or recipient's home, or in other locations within the community: (i) those providing end-of-life (EOL) care (n = 471); (ii) those providing long-term care (more than 2 years) for someone with a chronic condition or long-term illness (n = 2722); and (iii) those providing short-term care (less than 2 years) for someone with a chronic condition or long-term illness (n = 2381). This study lays out the variation in sociodemographic characteristics across the three caregiver groups while also building on our understanding of the differential impacts of care-giving through an analysis of determinants. All three groups of caregivers shared a number of sociodemographic characteristics, including being female, married, employed and living in a Census Metropolitan Area (CMA). With respect to health, EOL caregivers were found to have significantly higher levels of 'fair or poor' self-assessed health than the other two groups. Overall, the findings suggest that EOL caregivers are negatively impacted by the often additional role of care-giving, more so than both short-term and long-term caregivers. EOL caregivers experienced a higher proportion of negative impacts on their social and activity patterns. Furthermore, EOL caregivers incurred greater financial costs than the other two types of informal caregivers. The impacts of EOL care-giving also negatively influence employment for caregivers when compared with the other caregiver groups. Consequently, EOL caregivers, overall, experienced greater negative impacts, including negative health outcomes, than did long-term or short-term caregivers. This provides the evidence for the assertion that EOL care-giving is the most intense type of care-giving, potentially causing the greatest caregiver burden; this is shown through the greater negative impacts experienced by the EOL caregivers when compared with the short-term and long-term caregivers.
本研究使用加拿大统计局第21轮综合社会调查（2007年综合社会调查）的数据，探讨了三组在照顾者家中、受助者家中或社区内其他地点提供非正式照顾的照顾者在照顾影响方面是否存在差异：（i）提供临终关怀的照顾者（n = 471）；（ii）为患有慢性病或长期疾病的人提供长期照顾（超过2年）的照顾者（n = 2722）；以及（iii）为患有慢性病或长期疾病的人提供短期照顾（少于2年）的照顾者（n = 2381）。本研究阐述了三组照顾者在社会人口学特征方面的差异，同时通过对决定因素的分析，加深了我们对照顾差异影响的理解。所有三组照顾者都具有一些社会人口学特征，包括女性、已婚、就业且居住在人口普查大都会区（CMA）。在健康方面，发现临终关怀照顾者自我评估为“一般或较差”健康水平的比例显著高于其他两组。总体而言，研究结果表明，临终关怀照顾者往往因额外的照顾角色而受到负面影响，比短期和长期照顾者受到的影响更大。临终关怀照顾者在社交和活动模式方面受到负面影响的比例更高。此外，与其他两种类型的非正式照顾者相比，临终关怀照顾者承担的经济成本更高。与其他照顾者群体相比，临终关怀照顾对照顾者就业也有负面影响。因此，总体而言，临终关怀照顾者比长期或短期照顾者经历了更大的负面影响，包括负面健康结果。这为临终关怀照顾是最繁重的照顾类型、可能导致最大照顾负担这一论断提供了证据；与短期和长期照顾者相比，临终关怀照顾者所经历的更大负面影响就证明了这一点。
