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老年人对非正式和正式护理的使用存在脆弱性差异。

Frailty differences in older adults' use of informal and formal care.

机构信息

Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.

Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium; Faculty of Education, Health and Social Work, College University Ghent, Geraard de Duivelstraat 5, 9000, Gent, Belgium.

出版信息

Arch Gerontol Geriatr. 2018 Nov-Dec;79:69-77. doi: 10.1016/j.archger.2018.05.018. Epub 2018 Jun 2.

Abstract

OBJECTIVES

This study examines different combinations of informal and formal care use of older adults and investigates whether these combinations differ in terms of need for care (physical and psychological frailty) and enabling factors for informal and formal care use (social and environmental frailty).

METHODS

Using cross-sectional data from the Belgian Ageing Studies (survey, N = 38,066 community-dwelling older adults), Latent Class Analysis (LCA) is used to identify combinations of informal and formal care use. Bivariate analyses are used to explore the relationship between the different combinations of care use and frailty.

RESULTS

Latent Class Analysis (LCA) identified 8 different types of care use, which vary in combinations of informal and formal caregivers. Older adults who are more likely to combine care from family and care from all types of formal caregivers are more physically, psychologically and environmentally frail than expected. Older adults who are more likely to receive care only from nuclear family, or only from formal caregivers are more socially frail than expected.

CONCLUSIONS

Older adults with a higher need for care are more likely to receive care from different types of informal and formal caregivers. High environmental frailty and low social frailty are related with the use of care from different types of informal and formal caregivers. This study confirms that informal care can act as substitute for formal care. However, this substitute relationship becomes a complementary relationship in frail older adults. Policymakers should take into account that frailty in older adults affects the use of informal and formal care.

摘要

目的

本研究考察了老年人非正式和正式护理的不同组合,并调查了这些组合在护理需求(身体和心理脆弱)和非正式和正式护理使用的促进因素(社会和环境脆弱)方面是否存在差异。

方法

使用来自比利时老龄化研究的横断面数据(调查,N=38066 名居住在社区的老年人),使用潜在类别分析(LCA)来识别非正式和正式护理使用的组合。使用双变量分析来探索不同护理使用组合与脆弱性之间的关系。

结果

潜在类别分析(LCA)确定了 8 种不同类型的护理使用组合,这些组合在家庭和各种类型的正式护理提供者的护理组合上有所不同。与预期相比,更有可能将家庭和所有类型的正式护理提供者的护理结合起来的老年人在身体、心理和环境方面更加脆弱。与预期相比,更有可能仅从核心家庭或仅从正式护理提供者那里获得护理的老年人在社会方面更加脆弱。

结论

需要更多护理的老年人更有可能从不同类型的非正式和正式护理提供者那里获得护理。较高的环境脆弱性和较低的社会脆弱性与从不同类型的非正式和正式护理提供者那里获得护理有关。本研究证实,非正式护理可以替代正式护理。然而,在脆弱的老年人中,这种替代关系变成了互补关系。政策制定者应考虑到老年人的脆弱性会影响非正式和正式护理的使用。

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