Shiu Chengshi, Muraco Anna, Fredriksen-Goldsen Karen
University of Washington.
Loyola Marymount University.
J Soc Social Work Res. 2016 Fall;7(3):527-546. doi: 10.1086/687325. Epub 2016 Jun 23.
Lesbian, gay, bisexual, and transgender (LGBT) older adult caregivers may encounter obstacles in obtaining health and aging services due to discrimination in service and legal systems. The caregiving relationships in LGBT communities also differ from the general population in that friends are providing a large portion of informal care. This article examines how the relational context of caregiving relates to caregiving demands and resources, which in turn, influence perceived stress and depressive symptomatology among older LGBT caregivers.
Using data from the National Health, Aging, and Sexuality Study: Caring and Aging with Pride, this study examines 451 participants who are providing caregiving to partners and friends. Structural equation modeling was applied to estimate the associations among the caregiver-care recipient relationship and caregiving demands, resources, perceived stress, and depressive symptomatology.
On average, as compared with those caring for partners, those who provided care to friends reported experiencing lower levels of caregiving demands and lower levels of social support. The lower caregiving demands correlated positively with both lower perceived stress and less severe depressive symptomatology; however, the lower levels of social support were related to higher perceived stress and higher depressive symptomatology.
Caregiving provided by friends, which has long been under recognized, plays an important role in the LGBT community. Because lower levels of caregiving demands are offset by less social support, LGBT friend-caregivers experience similar levels of perceived stress and depressive symptomatology to those providing care to spouses and partners. Policy and service reforms are needed to better acknowledge the continuum of informal caregiving relationships.
女同性恋、男同性恋、双性恋和跨性别（LGBT）老年照顾者可能会因服务和法律体系中的歧视而在获得健康与老龄服务方面遇到障碍。LGBT群体中的照顾关系也与普通人群不同，因为朋友提供了很大一部分非正式照顾。本文探讨照顾的关系背景如何与照顾需求和资源相关联，而这反过来又会影响LGBT老年照顾者的感知压力和抑郁症状。
利用“全国健康、老龄与性取向研究：自豪地照顾与变老”的数据，本研究调查了451名正在为伴侣和朋友提供照顾的参与者。应用结构方程模型来估计照顾者与受照顾者关系和照顾需求、资源、感知压力及抑郁症状之间的关联。
平均而言，与照顾伴侣的人相比，为朋友提供照顾的人报告的照顾需求水平较低，社会支持水平也较低。较低的照顾需求与较低的感知压力和不太严重的抑郁症状呈正相关；然而，较低的社会支持水平与较高的感知压力和较高的抑郁症状相关。
长期以来未得到充分认识的由朋友提供的照顾在LGBT群体中发挥着重要作用。由于较低的照顾需求被较少的社会支持所抵消，LGBT群体中由朋友担任照顾者的人所经历的感知压力和抑郁症状水平与照顾配偶和伴侣的人相似。需要进行政策和服务改革，以更好地认识非正式照顾关系的连续性。
