Schofield Deborah, Cunich Michelle, Shrestha Rupendra, Passey Megan, Kelly Simon, Tanton Robert, Veerman Lennert
NHMRC Clinical Trials Centre and School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia.
BMC Public Health. 2014 Jun 5;14:561. doi: 10.1186/1471-2458-14-561.
Little is known about the effects of personal and other characteristics of care recipients on the behaviour of carers. The aim of this study is to examine the association between the main chronic (disabling) condition of care recipients and the likelihood of their (matched) primary carers aged 15-64 years being out of the labour force.
We conducted a retrospective analysis of cross-sectional data from the Australian Bureau of Statistics 2009 Survey of Disability, Ageing and Carers (SDAC) for people aged 15-64 years. We estimated the rates of exit from the labour force for primary carers and non-carers; rates of chronic disease occurrence for care recipients living with their main carers; odds ratios of primary carers being out of the labour force associated with the main chronic condition of their care recipient who lives with them.
From the 2009 SDAC, we identified 1,268 out of 37,186 eligible participants who were primary carers of a care recipient who lived with them. Of these, 628 (49.5%) were out of the labour force. Most common diseases of care recipients were: back problems (12%); arthritis and related disorders (10%); diseases of the nervous system (such as multiple sclerosis, epilepsy, cerebral palsy) (7.4%); and conditions originating in the perinatal period or congenital malformations, deformations and chromosomal abnormalities (5.1%). When adjusted for age, sex, education and whether have a long term chronic condition of informal carers, the five conditions of care recipients associated with the highest odds of their carers being out of the labour force were: head injury/acquired brain damage; neoplasms, blood diseases, disorders of the immune system; leg/knee/foot/hip damage from injury/accident; dementia, Parkinson's disease, Alzheimer's disease; and diseases of the musculoskeletal system and connective tissue (osteoporosis).
This study identifies the type of conditions that have the greatest impact on the labour force participation of informal carers - previously unavailable information for Australia. Australia, like most developed countries, is facing several skills shortages and an ageing population. These governments will need to adopt novel and more wholistic approaches to increase the labour force participation of diverse groups. Informal carers are one such group.
关于受护理者的个人特征及其他特征对护理者行为的影响，我们知之甚少。本研究旨在探讨受护理者的主要慢性（致残）疾病与年龄在15 - 64岁的（匹配的）主要护理者脱离劳动力队伍可能性之间的关联。
我们对澳大利亚统计局2009年残疾、老龄化与护理者调查（SDAC）中15 - 64岁人群的横断面数据进行了回顾性分析。我们估计了主要护理者和非护理者的劳动力退出率；与主要护理者共同生活的受护理者的慢性病发生率；主要护理者脱离劳动力队伍的比值比，该比值比与与其共同生活的受护理者的主要慢性病相关。
从2009年SDAC中，我们在37186名符合条件的参与者中确定了1268名是与其共同生活的受护理者的主要护理者。其中，628名（49.5%）脱离了劳动力队伍。受护理者最常见的疾病有：背部问题（12%）；关节炎及相关疾病（10%）；神经系统疾病（如多发性硬化症、癫痫、脑瘫）（7.4%）；围产期起源的疾病或先天性畸形、变形及染色体异常（5.1%）。在对年龄、性别、教育程度以及非正式护理者是否患有长期慢性病进行调整后，与护理者脱离劳动力队伍可能性最高相关的受护理者的五种疾病情况为：头部受伤/后天性脑损伤；肿瘤、血液疾病、免疫系统疾病；因受伤/事故导致的腿部/膝盖/足部/髋部损伤；痴呆、帕金森病、阿尔茨海默病；肌肉骨骼系统和结缔组织疾病（骨质疏松症）。
本研究确定了对非正式护理者劳动力参与影响最大的疾病类型——这是澳大利亚此前没有的信息。澳大利亚与大多数发达国家一样，正面临多种技能短缺和人口老龄化问题。这些政府将需要采取新颖且更全面的方法来提高不同群体的劳动力参与率。非正式护理者就是这样一个群体。
