Rural Health Research Center, Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota.
J Rural Health. 2019 Jan;35(1):49-57. doi: 10.1111/jrh.12309. Epub 2018 Jun 27.
This study examines rural-urban differences in employed caregivers' access to workplace supports, negative impacts of caregiving on work, and the association between work and caregiver strain, which can have negative impacts on health.
We used a cross-sectional analysis of employed caregivers (n = 635) from the 2015 Caregiving in the US survey, including bivariate comparisons of caregiver characteristics, access to workplace benefits, and workplace impacts by rural-urban location, as well as ordered logistic regression models to assess the relationship between workplace benefits and impacts and caregiver strain, stratified by rural-urban location.
Employed rural caregivers had significantly fewer workplace benefits available to them (1.3 out of 5 vs 1.9, P < .001), compared with urban caregivers. In particular, employed rural caregivers were less likely to have access to telecommuting, employee assistance programs, and paid leave. For the full sample, having more negative workplace impacts was associated with greater caregiver strain (adjusted odds ratio [AOR]: 1.65, P < .001); for employed rural caregivers, using paid help for caregiving was associated with more strain (AOR: 4.39, P < .05).
More should be done to support all employed caregivers, especially those in rural locations who have more limited access to workplace supports and who may be more negatively impacted by the financial toll of caregiving and of missing work because of caregiving responsibilities. Interventions could range from employer-initiated programs to local, state, or national policies to improve supports provided to employed caregivers in urban and rural areas.
本研究考察了城乡就业护工在获得工作场所支持、照顾对工作的负面影响，以及工作与护工压力之间的关系方面的差异，这些因素可能对健康产生负面影响。
我们使用了 2015 年美国护理调查中的就业护工（n=635）的横断面分析，包括根据城乡位置对护工特征、获得工作场所福利和工作场所影响进行的双变量比较，以及有序逻辑回归模型，以评估工作场所福利和影响与护工压力之间的关系，按城乡位置进行分层。
与城市护工相比，农村就业护工获得的工作场所福利明显较少（5 项中为 1.3 项，而城市为 1.9 项，P<0.001）。特别是，农村就业护工获得远程办公、员工援助计划和带薪休假的机会较少。对于整个样本，更多的负面工作场所影响与更大的护工压力相关（调整后的优势比 [AOR]：1.65，P<0.001）；对于农村就业护工，使用付费护理服务与更大的压力相关（AOR：4.39，P<0.05）。
应该采取更多措施来支持所有就业护工，特别是那些在农村地区的护工，他们获得工作场所支持的机会更为有限，而且可能因照顾带来的经济负担和因照顾责任而错过工作的负面影响更大。干预措施可以从雇主发起的计划到地方、州或国家政策，以改善城乡地区就业护工的支持。
