Lyons Jennifer G, Cauley Jane A, Fredman Lisa
Epidemiology Department, Boston University School of Public Health, Massachusetts.
Epidemiology Department, University of Pittsburgh, Pennsylvania.
J Gerontol A Biol Sci Med Sci. 2015 Aug;70(8):1018-23. doi: 10.1093/gerona/glv001. Epub 2015 Mar 20.
Informal caregiving, a chronic stressor, is also a dynamic experience, as caregivers may repeatedly enter and exit the role and alter the amount of care they provide. Changes in caregiving status and intensity influence stress, but few studies have evaluated the simultaneous impact of these changes on perceived stress.
A total of 1,027 female caregivers and noncaregivers (mean age = 81.7), of which 992 were included in the final sample, were followed for at least two consecutive annual interviews (ie, one interval) and up to five interviews over a 9-year period. Caregiving status was measured by self-report of whether the respondent assisted someone with at least one basic or instrumental activity of daily living; caregiving intensity was dichotomized at the median number of basic or instrumental activity of daily living tasks caregivers performed. The associations between changes in caregiving status and intensity level with Perceived Stress Scale (PSS) score at the end of an interval were estimated using mixed-effects regression models.
Respondents contributed 2,832 intervals. High-intensity caregivers reported the highest stress at the end of an interval, whereas noncaregivers reported the lowest (mean PSS = 18.97 vs 15.73, p < .01). Low-intensity caregivers, whose intensity increased, had higher stress than continuing high-intensity caregivers. Those who stopped caregiving, regardless of intensity level, reported the same amount of stress as noncaregivers.
Transitions in caregiving status and intensity affect caregiver perceived stress. Continuing high-intensity caregivers and those who transition from low- to high-intensity caregiving report the highest stress of all transition groups, suggesting that stress-reduction interventions should target high-intensity caregivers.
非正式照护作为一种慢性应激源，也是一种动态体验，因为照护者可能会反复进入和退出该角色，并改变他们提供的照护量。照护状态和强度的变化会影响压力，但很少有研究评估这些变化对感知压力的同时影响。
共有1027名女性照护者和非照护者（平均年龄 = 81.7岁），其中992人纳入最终样本，接受了至少连续两次年度访谈（即一个间隔期），并在9年期间接受了多达五次访谈。照护状态通过自我报告来衡量，即受访者是否协助他人进行至少一项基本或工具性日常生活活动；照护强度在照护者执行的基本或工具性日常生活任务数量的中位数处进行二分法划分。使用混合效应回归模型估计间隔期末照护状态和强度水平变化与感知压力量表（PSS）得分之间的关联。
受访者提供了2832个间隔期数据。高强度照护者在间隔期末报告的压力最高，而非照护者报告的压力最低（平均PSS = 18.97对15.73，p <.01）。强度增加的低强度照护者比持续的高强度照护者压力更大。那些停止照护的人，无论强度水平如何，报告的压力与非照护者相同。
照护状态和强度的转变会影响照护者的感知压力。持续的高强度照护者以及那些从低强度转变为高强度照护的人在所有转变组中报告的压力最高，这表明压力减轻干预措施应针对高强度照护者。
