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在不断变化的社会中提供非正式护理。

Providing informal care in a changing society.

作者信息

Broese van Groenou Marjolein I, De Boer Alice

机构信息

VU University, Amsterdam, The Netherlands.

VU University, Amsterdam, The Netherlands ; The National Institute for Social Research, The Hague, The Netherlands.

出版信息

Eur J Ageing. 2016;13(3):271-279. doi: 10.1007/s10433-016-0370-7. Epub 2016 Apr 15.

Abstract

The ageing of society is leading to significant reforms in long-term care policy and systems in many European countries. The cutbacks in professional care are increasing demand for informal care considerably, from both kin and non-kin. At the same time, demographic and societal developments such as changing family structures and later retirement may limit the supply of informal care. This raises the question as to whether the volume of informal care (in people) will increase in the years ahead. This paper aims to provide a theoretical answer to this question in two steps. First, based on different care models and empirical literature, we develop a behavioural model on individual caregiving, the Informal Care Model. The model states that, in response to the care recipient's need for care, the intention to provide care is based on general attitudes, quality of the relationship, normative beliefs, and perceived barriers. Whether one actually provides care also depends on the care potential of the social context, being the family, the social network, and the community. Second, we discuss how current policy and societal developments may negatively or positively impact on these mechanisms underlying the provision of informal care. Given the increased need for care among home-dwelling individuals, the model suggests that more people will take up the caregiver role in the years ahead contributing to larger and more diverse care networks. It is concluded that long-term informal care provision is a complex phenomenon including multiple actors in various contexts. More research is needed to test the Informal Care Model empirically, preferably using information on care recipients, informal caregivers and community care in a dynamic design and in different countries. Such information will increase insight in the developments in informal care provision in retrenching welfare states.

摘要

社会老龄化正促使许多欧洲国家在长期护理政策和体系方面进行重大改革。专业护理的削减使得亲属和非亲属对非正式护理的需求大幅增加。与此同时,诸如家庭结构变化和退休年龄延迟等人口和社会发展因素可能会限制非正式护理的供给。这就引发了一个问题:未来几年非正式护理的人力规模是否会增加。本文旨在分两步为这个问题提供一个理论答案。首先,基于不同的护理模式和实证文献,我们构建了一个关于个体护理行为的模型——非正式护理模型。该模型表明,为回应受护理者的护理需求,提供护理的意愿基于总体态度、关系质量、规范信念和感知到的障碍。一个人是否实际提供护理还取决于社会环境的护理潜力,即家庭、社会网络和社区。其次,我们讨论当前的政策和社会发展如何可能对提供非正式护理的这些机制产生负面或正面影响。鉴于居家个体对护理的需求增加,该模型表明未来几年会有更多人承担起护理者的角色,从而形成更大且更多样化的护理网络。结论是,长期的非正式护理供给是一个复杂现象,涉及不同背景下的多个行为主体。需要更多研究来实证检验非正式护理模型,最好在动态设计中并针对不同国家,使用关于受护理者、非正式护理者和社区护理的信息。此类信息将增进对福利国家收缩背景下非正式护理供给发展情况的了解。

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