Department of Sociology, Rutgers, The State University of New Jersey, New Brunswick.
Gerontologist. 2019 Nov 16;59(6):1078-1091. doi: 10.1093/geront/gny022.
Informal caregiving to older adults is a key part of the U.S. long-term care system. Caregivers' experiences consist of burden and benefits, but traditional analytic approaches typically consider dimensions independently, or cannot account for burden and benefit levels and combinations that co-occur. This study explores how benefits and burden simultaneously shape experiences of caregiving to older adults, and factors associated with experience types.
2015 National Health and Aging Trends Study (NHATS) and National Study of Caregiving (NSOC) data were linked to obtain reports from caregivers and recipients. Latent class and regression analysis were conducted on a nationally representative sample of U.S. informal caregivers to older persons.
Five distinguishable caregiving experiences types and their population prevalence were identified. Subjective burden and benefits level and combination uniquely characterize each group. Primary stressors (recipient depression, medical diagnoses), primary appraisal (activities of daily living, instrumental activities of daily living, medical task assistance, hours caregiving), and background/contextual factors (caregiver age, race, relationship to recipient, mental health, coresidence, long-term caregiving) are associated with experience types.
Findings highlight caregivers' experience multiplicity and ambivalence, and identify groups that may benefit most from support services. In cases where it is not possible to reduce burden, assistance programs may focus on increasing the benefits perceptions.
为老年人提供非正式护理是美国长期护理系统的重要组成部分。照顾者的体验包括负担和益处,但传统的分析方法通常独立考虑各个维度,或者无法解释同时存在的负担和益处水平及其组合。本研究探讨了益处和负担如何同时塑造对老年人的护理体验,以及与体验类型相关的因素。
2015 年国家健康与老龄化趋势研究(NHATS)和国家护理研究(NSOC)的数据被链接起来,以获取照顾者和接受者的报告。对美国老年人非正式照顾者的全国代表性样本进行了潜在类别和回归分析。
确定了五种可区分的护理体验类型及其人群患病率。主观负担和益处水平及其组合独特地描述了每个群体。主要应激源(受者抑郁、医学诊断)、主要评价(日常生活活动、工具性日常生活活动、医疗任务协助、护理时间)和背景/情境因素(照顾者年龄、种族、与受者的关系、心理健康、共同居住、长期护理)与体验类型相关。
研究结果突出了照顾者体验的多样性和矛盾性,并确定了可能最受益于支持服务的群体。在无法减轻负担的情况下,援助计划可能会侧重于增加对益处的感知。