Department of Psychiatry, University of Michigan, Ann Arbor.
Program for Positive Aging, University of Michigan, Ann Arbor.
Gerontologist. 2020 Jan 24;60(1):165-173. doi: 10.1093/geront/gny130.
Managing medications can be stressful for spousal caregivers, but little is known about particular aspects of medication management that are most consequential for caregiving outcomes. We examined care stressors and resources related to medication management, their associations with role overload among spousal caregivers, and whether these links vary by care recipients' number of chronic health conditions and dementia status.
This cross-sectional study included 377 spousal caregivers of adults aged 65 and older from the 2011 National Health and Aging Trends Study and National Study of Caregiving. Linear regressions were estimated to evaluate how medication-related stressors (ordering medication, keeping track of medications, giving injections) and resources (medication reminder systems, shared medication management within the spousal dyad) are associated with caregivers' role overload. Care recipients' number of chronic health conditions and dementia status were considered as moderators. Models controlled for caregivers' sociodemographic characteristics, chronic health conditions, and other care tasks.
Caregivers who administered injections reported more role overload, whereas those who worked with care recipients to jointly manage medications reported less role overload. Keeping track of medications was linked to caregivers' greater role overload when care recipients had 5 or more chronic health conditions. Finally, care recipients' use of medication reminder systems was linked to less role overload for caregivers of a partner with dementia.
Devising strategies to assist spousal caregivers in the more onerous components of medication management and promote resources that mitigate medication-related stress may improve caregiver well-being.
管理药物对配偶照顾者来说可能是有压力的,但对于对照顾结果最有影响的药物管理的特定方面,我们知之甚少。我们研究了与药物管理相关的照顾压力源和资源,它们与配偶照顾者的角色超载之间的关联,以及这些关联是否因照顾对象的慢性病数量和痴呆症状况而有所不同。
这项横断面研究包括来自 2011 年国家健康与老龄化趋势研究和国家照顾研究的 377 名 65 岁及以上成年人的配偶照顾者。线性回归用于评估与药物相关的压力源(订购药物、跟踪药物、注射)和资源(药物提醒系统、配偶对之间共同管理药物)与照顾者角色超载的关系。考虑了照顾对象的慢性病数量和痴呆症状况作为调节因素。模型控制了照顾者的社会人口统计学特征、慢性病和其他照顾任务。
给予注射的照顾者报告的角色超载更多,而与照顾对象合作共同管理药物的照顾者报告的角色超载更少。当照顾对象有 5 种或更多慢性病时,跟踪药物与照顾者更大的角色超载有关。最后,当照顾对象使用药物提醒系统时,配偶痴呆症患者的照顾者的角色超载程度较低。
制定策略来帮助配偶照顾者处理药物管理中更繁重的部分,并促进减轻药物相关压力的资源,可能会改善照顾者的幸福感。