Liu Jinyu, Bern-Klug Mercedes
School of Social Work,Columbia University,1255 Amsterdam Ave,New York,USA.
School of Social Work,The University of Iowa,Room 308 North Hall,Iowa City,Iowa,USA.
Int Psychogeriatr. 2016 Feb;28(2):303-15. doi: 10.1017/S1041610215001726. Epub 2015 Oct 22.
In China, as is the case in most of the world, family is the largest source of support for frail older adults. Confucian filial piety expectations hold children-in particular sons-responsible for the care of aging parents in China. During the course of caregiving, in addition to positive feelings, the caregiver may feel overwhelmed, entrapped, and worried about their performance, which can have negative health consequences. The purpose of this exploratory study is to examine one dimension of caregiver burden "worry about performance" (WaP) and investigate whether variables inspired by Pearlin's Stress Process Model help to explain the variation of WaP, so that at-risk caregivers can be identified and supported.
Multiple regression was used to analyze CLHLS data from 895 Chinese adult children providing care for their oldest old parent in eight coastal provinces in China. WaP was measured by two items from the Zarit Burden Inventory. Independent variables representing concepts from Pearlin's Stress Process Model and control variables were included in the models.
Compared to a model of control variables only, using independent variables inspired by Pearlin's Stress Process Model increased the ability to explain the variation in WaP by three fold to 14%. The following variables increased WaP: parent's IADL level, the amount of time spent caregiving, being a daughter, reporting an emotionally close relationship with the parent, sharing a residence with the parent.
Despite not being able to fully operationalize Pearlin's Model with this dataset, analyzing variables that represent concepts from the model was useful in increasing the ability to explain the variation in WaP. Results suggest that caregiver support directed at daughters may be particularly beneficial.
在中国,如同世界上大多数地方一样,家庭是体弱老年人最大的支持来源。在中国,儒家的孝道观念要求子女,尤其是儿子,负责照顾年迈的父母。在照顾过程中,照顾者除了会有积极的感受外,还可能会感到不堪重负、陷入困境,并担心自己的表现,而这可能会对健康产生负面影响。这项探索性研究的目的是检验照顾者负担的一个维度“对表现的担忧”(WaP),并调查受佩林压力过程模型启发的变量是否有助于解释WaP的变化,以便识别并支持有风险的照顾者。
采用多元回归分析来自中国八个沿海省份的895名成年子女为其高龄父母提供照料的中国老年健康影响因素跟踪调查(CLHLS)数据。WaP通过Zarit负担量表中的两个项目来衡量。模型中纳入了代表佩林压力过程模型概念的自变量和控制变量。
与仅包含控制变量的模型相比,使用受佩林压力过程模型启发的自变量将解释WaP变化的能力提高了两倍,达到14%。以下变量增加了WaP:父母日常生活活动能力水平、照顾所花费的时间、身为女儿、报告与父母情感亲密、与父母同住。
尽管无法用该数据集完全实施佩林模型,但分析代表该模型概念的变量有助于提高解释WaP变化的能力。结果表明,针对女儿的照顾者支持可能特别有益。