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照料、志愿活动还是两者兼有?利用近 25 万 65 岁及以上人群的人口普查记录比较对健康和死亡率的影响。

Caregiving, volunteering or both? Comparing effects on health and mortality using census-based records from almost 250,000 people aged 65 and over.

机构信息

Queen's University Belfast - Centre for Public Health, Belfast, UK.

Ulster University - Bamford Centre for Mental Health and Wellbeing, Derry, UK.

出版信息

Age Ageing. 2017 Sep 1;46(5):821-826. doi: 10.1093/ageing/afx017.

DOI:10.1093/ageing/afx017
PMID:28338778
Abstract

BACKGROUND

the health impacts of caregiving and volunteering are rarely studied concurrently, despite the potential for both synergies and conflicts. This population-based study examines the association of these activities on health and subsequent mortality.

METHOD

a census-based record-linkage study of 244,429 people aged 65 and over, with cohort characteristics, caregiving and volunteering status, and presence of chronic health conditions derived from the Census returns. Mortality risk was assessed over the following 45 months with adjustment for baseline characteristics.

RESULTS

caregivers and volunteers were individually more mobile than those undertaking neither activity; caregivers who also volunteered were more mobile than those who did not volunteer, but no less likely to suffer from poor mental health. Both caregiving and volunteering were separately associated with reduced mortality risk (HR = 0.74: 95% confidence intervals (CIs) = 0.71, 0.77 and HR = 0.76: 0.73, 0.81, respectively); the lowest mortality was found amongst light caregivers who also volunteered (HR = 0.53: 95% CIs = 0.45, 0.62), compared to those engaged in neither. There was no evidence of a multiplicative effect of caregiving and volunteering at more intense levels of caregiving.

CONCLUSION

there is a large overlap in caregiving and volunteering activities with complex associations with health status. There is some evidence that combining caregiving and volunteering activities, for those involved in less intense levels of caregiving, maybe associated with lower mortality risk than associated with either activity alone. Further research is needed to understand which aspects of caregiving and volunteering are best and for whom and in which circumstances.

摘要

背景

尽管照料和志愿服务可能存在协同作用和冲突,但很少同时研究这两种活动对健康的影响及其后续死亡率。本基于人群的研究调查了这些活动对健康和随后死亡率的关联。

方法

对 244,429 名 65 岁及以上的人群进行了基于普查的记录链接研究,队列特征、照料和志愿服务状况以及从普查中得出的慢性健康状况。在接下来的 45 个月中,通过调整基线特征来评估死亡率风险。

结果

与未从事这两种活动的人相比,单独从事照料或志愿服务的人行动能力更强;同时从事照料和志愿服务的人比未从事志愿服务的人行动能力更强,但心理健康状况不佳的可能性较小。照料和志愿服务都与降低死亡率风险相关(HR=0.74:95%置信区间(CI)=0.71,0.77 和 HR=0.76:0.73,0.81);与未从事这两种活动的人相比,轻度照料者同时从事志愿服务的人死亡率最低(HR=0.53:95%CI=0.45,0.62)。没有证据表明在更强烈的照料水平上,照料和志愿服务存在相乘效应。

结论

照料和志愿服务活动之间存在很大的重叠,并且与健康状况之间存在复杂的关联。有一些证据表明,对于那些参与照料程度较低的人来说,将照料和志愿服务结合起来,可能与单独从事任何一种活动相比,与较低的死亡率风险相关。需要进一步研究以了解哪些方面的照料和志愿服务最好,以及适合哪些人、在哪些情况下。

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