Demography and Ageing Unit,Melbourne School of Population and Global Health,University of Melbourne,Melbourne,Victoria,Australia.
Int Psychogeriatr. 2018 Dec;30(12):1849-1860. doi: 10.1017/S104161021800042X. Epub 2018 May 25.
ABSTRACTBackground:Population aging places greater demands on the supply of informal carers. The aims of this study were to examine (1) the types of unmet support needs of carers of older Australians and (2) the association of unmet needs with mental health.
Utilizing new data from the 2015 Australian Bureau of Statistics (ABS) Survey of Disability, Ageing and Carers, we calculated the prevalence of carers experiencing specific and multiple unmet needs for support, using single and multiple item measures. Logistic regression models were fitted to examine the association between unmet needs and psychological distress (using the Kessler psychological distress scale), once demographic and health factors were controlled for.
In 2015, 35% of carers of older Australians cited at least one unmet need for support. Among this group, almost two-thirds cited multiple unmet support needs (64.7%). The most prevalent types of unmet needs included financial (18%), physical (13%), and emotional support (12%), as well as additional respite care and support to improve carer health (12%). After controlling for demographic and health characteristics of the carer, having any unmet need for support increased the odds of psychological distress by twofold (OR = 2.20, 95% CI = 1.65, 2.94). With each successive unmet need for support, the odds of psychological distress increased 1.37 times (OR = 1.36, 95% CI = 1.22, 1.54). Those who had received assistance with care, but required further support were 1.95 times more likely (OR = 1.95, 95% CI = 1.17, 3.24) to be in distress and those who had not received care assistance were about 2.4 times more likely (OR = 2.38 95% OR = 1.56, 3.62) to be in distress relative to those with no unmet need.
Addressing unmet support needs of carers is important, not only for the planning of services for carers in an aging population, but also because of the association between unmet support needs and carers mental health.
摘要背景：人口老龄化对非正式照顾者的供给提出了更高的要求。本研究的目的是检验：（1）澳大利亚老年照顾者的未满足支持需求的类型；（2）未满足需求与心理健康之间的关系。方法：利用澳大利亚统计局（ABS）2015 年残疾、老龄化和照顾者调查的新数据，我们使用单一和多项指标计算了照顾者在支持方面经历特定和多项未满足需求的比例。在控制了人口统计学和健康因素后，使用凯斯勒心理困扰量表（Kessler psychological distress scale）的逻辑回归模型来检验未满足需求与心理困扰之间的关联。结果：2015 年，35%的澳大利亚老年照顾者表示至少有一项支持需求未得到满足。在这一群体中，近三分之二的人表示有多项未满足的支持需求（64.7%）。最常见的未满足需求类型包括经济支持（18%）、身体支持（13%）、情感支持（12%），以及额外的临时护理和改善照顾者健康的支持（12%）。在控制了照顾者的人口统计学和健康特征后，有任何未满足的支持需求都会使心理困扰的几率增加两倍（OR=2.20，95%CI=1.65，2.94）。每增加一项未满足的支持需求，心理困扰的几率就会增加 1.37 倍（OR=1.36，95%CI=1.22，1.54）。那些已经接受过护理协助，但仍需要进一步支持的人，其处于困境中的可能性要高出 1.95 倍（OR=1.95，95%CI=1.17，3.24）；那些没有接受过护理协助的人，其处于困境中的可能性则要高出 2.4 倍（OR=2.38，95%CI=1.56，3.62）。结论：解决照顾者的未满足支持需求不仅对规划老龄化人口中的照顾者服务很重要，而且还因为未满足的支持需求与照顾者的心理健康之间存在关联。
