老年有功能障碍患者的配偶照顾者的多重慢性病：与照顾困难和获益的关联。
Multiple Chronic Conditions in Spousal Caregivers of Older Adults With Functional Disability: Associations With Caregiving Difficulties and Gains.
机构信息
Department of Psychiatry, University of Michigan, Ann Arbor.
Program for Positive Aging, University of Michigan, Ann Arbor.
出版信息
J Gerontol B Psychol Sci Soc Sci. 2020 Jan 1;75(1):160-172. doi: 10.1093/geronb/gbx118.
OBJECTIVES
Multiple chronic conditions (MCCs) are common and have harmful consequences in later life. Along with managing their own health, many aging adults care for an impaired partner. Spousal caregiving may be more stressful when caregivers have MCCs, particularly those involving complex management. Yet, little is known about combinations of conditions that are most consequential for caregiving outcomes.
METHOD
Using a U.S. sample of 359 spousal caregivers and care recipients from the 2011 National Aging Trends Study and National Study of Caregiving, we examined three categories of MCCs based on similarity of management strategies (concordant only, discordant only, and both concordant and discordant) and their associations with caregiving difficulties and gains. We also considered gender differences.
RESULTS
Relative to caregivers without MCCs, caregivers with discordant MCCs reported fewer gains, whereas caregivers with both concordant and discordant MCCs reported greater emotional and physical difficulties. Wives with discordant MCCs only reported a trend for greater physical difficulties. Caregivers with concordant MCCs did not report more difficulties or gains.
DISCUSSION
Spousal caregivers with MCCs involving discordant management strategies appear to be at risk for adverse care-related outcomes and may benefit from support in maintaining their own health as well as their caregiving responsibilities.
目的
多种慢性疾病（MCC）在晚年很常见，且会产生有害后果。许多老年患者在照顾自己健康的同时，还要照顾身体受损的伴侣。当照顾者患有 MCC 时，配偶护理可能会更具压力，特别是那些涉及复杂管理的疾病。然而，对于对护理结果最具影响的疾病组合知之甚少。
方法
本研究使用了来自 2011 年国家老龄化趋势研究和国家护理研究的 359 对配偶护理者和护理接受者的美国样本，根据管理策略的相似性（仅一致、仅不一致和一致与不一致），我们将 MCC 分为三类，并研究其与护理困难和收益的关系。我们还考虑了性别差异。
结果
与没有 MCC 的护理者相比，患有不一致 MCC 的护理者报告的收益较少，而同时患有一致和不一致 MCC 的护理者报告的情感和身体困难更大。只有患有不一致 MCC 的妻子报告了更大的身体困难的趋势。患有一致 MCC 的护理者并没有报告更多的困难或收益。
讨论
涉及不一致管理策略的 MCC 配偶护理者似乎面临不利的护理相关结果的风险，他们可能需要支持来维持自己的健康以及护理责任。
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