Naef Rahel, Hediger Hannele, Imhof Lorenz, Mahrer-Imhof Romy
Institute of Nursing, Zurich University of Applied Sciences, Winterthur, Zurich, Switzerland.
Centre for Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland.
Int J Older People Nurs. 2017 Jun;12(2). doi: 10.1111/opn.12138. Epub 2016 Nov 10.
To determine subgroups of family carers based on family relational and caregiving variables and to explore group differences in relation to selected carer outcomes.
Family caregiving in later life holds a myriad of positive and negative outcomes for family members' well-being. However, factors that constitute family carers' experience and explain variances are less well understood.
A secondary data analysis using cross-sectional data from a controlled randomised trial with community-dwelling people 80 years or older and their families.
A total of 277 paired data sets of older persons and their family carers were included into the analysis. Data were collected via mailed questionnaires and a geriatric nursing assessment. A two-step cluster analysis was performed to determine subgroups. To discern group differences, appropriate tests for differences with Bonferroni correction were used.
Two family carer groups were identified. The low-intensity caregiver group (57% of carers) reported high relationship quality and self-perceived ease of caregiving. In contrast, the high-intensity caregiver group (43% of carers) experienced significantly lower relationship quality, felt less prepared and appraised caregiving as more difficult, time intensive and burdensome. The latter cared for older, frailer and more dependent octogenarians and had significantly lower levels of quality of life and self-perceived health compared to the low-intensity caregiver group.
A combination of family relational and caregiving variables differentiates those at risk for adverse outcomes. Family carers of frailer older people tend to experience higher strain, lower relationship quality and ability to work together as a family.
Nurses should explicitly assess family carer needs, in particular when older persons are frail. Family carer support interventions should address caregiving preparedness, demand and burden, as well as concerns situated in the relationship.
根据家庭关系和护理变量确定家庭照顾者的亚组，并探讨与选定的照顾者结果相关的组间差异。
晚年的家庭护理对家庭成员的幸福有着无数积极和消极的影响。然而，构成家庭照顾者经历并解释差异的因素却鲜为人知。
使用来自一项针对80岁及以上社区居住者及其家庭的对照随机试验的横断面数据进行二次数据分析。
共纳入277对老年人及其家庭照顾者的数据集进行分析。数据通过邮寄问卷和老年护理评估收集。进行两步聚类分析以确定亚组。为了辨别组间差异，使用了经Bonferroni校正的适当差异检验。
确定了两个家庭照顾者组。低强度照顾者组（占照顾者的57%）报告了高质量的关系和自我感觉轻松的护理。相比之下，高强度照顾者组（占照顾者的43%）经历的关系质量明显较低，感觉准备不足，并且认为护理更困难、耗时且负担重。后者照顾的是年龄更大、身体更虚弱且依赖性更强的八旬老人，与低强度照顾者组相比，其生活质量和自我感知健康水平明显更低。
家庭关系和护理变量的组合可区分有不良结果风险的人群。身体更虚弱的老年人的家庭照顾者往往经历更高的压力、更低的关系质量以及作为一个家庭共同协作的能力。
护士应明确评估家庭照顾者的需求，尤其是当老年人身体虚弱时。家庭照顾者支持干预措施应解决护理准备、需求和负担以及关系方面的问题。
Zotero 插件