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英国智障人士的非正式照料者:健康、生活质量及照料影响

Informal caregivers of people with an intellectual disability in England: health, quality of life and impact of caring.

作者信息

Totsika Vasiliki, Hastings Richard P, Vagenas Dimitrios

机构信息

Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK.

Institute of Health and Biomedical Innovation, Queensland Institute of Technology, Brisbane, Queensland, Australia.

出版信息

Health Soc Care Community. 2017 May;25(3):951-961. doi: 10.1111/hsc.12393. Epub 2016 Sep 22.

Abstract

There is wide variation in reported impact of caring on caregiver well-being, and often a negative appraisal of caregiving. Researchers are beginning to question the robustness of the evidence base on which negative appraisals are based. The present study aimed to draw on data from a population-representative sample to describe the health, quality of life and impact of caring of informal caregivers of people with an intellectual disability. Informal carers of people with intellectual disability (N = 260) were identified among 2199 carers in the English Survey of Carers in Households 2009/10. Generalised estimating equations explored the association between socio-demographic and caring profile with quality of life, physical health status, and impact on psychological health and personal life. Compared to other caregivers, providing care to a person with intellectual disability was not associated with reduced quality of life. There was an 82% increased risk of reporting poorer health status, even though poorer health was not likely to be attributed to care-giving. A higher risk of negative impact on personal life was seen in comparison with the wider group of caregivers, but not in comparison with more similar-sized caregiver groups (mental health or dementia). Carers of people with intellectual disability were more likely to be struggling financially and have a high caring load. These factors were systematically related to lower well-being. A uniformly negative appraisal of caring for people with intellectual disability was not supported by these English population-representative data. Poverty and long care-giving hours may make caregivers more susceptible to negative well-being. Support for caregivers of people with intellectual disability should focus on alleviating those two factors.

摘要

关于照料对照料者幸福感的影响,报告结果差异很大,而且对照料的评价往往是负面的。研究人员开始质疑那些负面评价所依据的证据基础是否可靠。本研究旨在利用来自具有人口代表性样本的数据,描述智障人士非正式照料者的健康状况、生活质量以及照料的影响。在2009/10年英国家庭照料者调查的2199名照料者中,识别出了智障人士的非正式照料者(N = 260)。广义估计方程探讨了社会人口统计学和照料情况与生活质量、身体健康状况以及对心理健康和个人生活的影响之间的关联。与其他照料者相比,照料智障人士与生活质量下降并无关联。报告健康状况较差的风险增加了82%,尽管健康状况较差不太可能归因于照料。与更广泛的照料者群体相比,对个人生活产生负面影响的风险更高,但与规模更相近的照料者群体(心理健康或痴呆症照料者)相比则不然。智障人士的照料者在经济上更可能陷入困境,且照料负担较重。这些因素与幸福感较低有系统性关联。这些具有英国人口代表性的数据并不支持对照料智障人士的一致负面评价。贫困和长时间的照料可能使照料者更容易出现负面的幸福感。对智障人士照料者的支持应侧重于缓解这两个因素。

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