Haya Marinda Asiah Nuril, Ichikawa Shuhei, Wakabayashi Hideki, Takemura Yousuke
Department of Family Medicine, Mie University Graduate School of Medicine.
Department of Community Medicine, Faculty of Medicine Universitas Indonesia.
Tohoku J Exp Med. 2019 Mar;247(3):197-207. doi: 10.1620/tjem.247.197.
Japan has adopted community-based integrated long-term care, which has shifted the burden of care from institutions to the home. However, family caregivers have received less attention compared with care recipients. Many family caregivers are also older adults, and it is important that caregivers receive appropriate support to alleviate the burden of care. In rural and sub-urban area with limited resources compared to urban area, it is necessary to know which support to be prioritized. Therefore, this study aimed to understand family caregivers' perceptions of social support, the type and source of support which were considered important, and how it affected their caregiving burden and quality of life (QOL). We conducted a convergent mixed-method study with 174 primary family caregivers of older adults receiving home care in rural and suburb area of Central Japan. The mixed-method approach enabled qualitative data to complement quantitative results. Strong family support and higher education had positive effects on QOL, while higher caregiving burden and longer duration of care had negative effects on QOL. Provision of tangible support from family and healthcare professionals was central in reducing caregiving burden and improving caregivers' QOL. Support from distant relatives or neighbors, which was deemed inappropriate by caregivers, had a negative effect on caregivers' emotional status. In conclusion, family caregivers perceived support positively, but the effects depended on who provided support. While tangible support from close family and professionals was perceived positively, support from neighbors or distant relatives should consider caregivers' needs and condition to avoid a negative impact.
日本采用了基于社区的综合长期护理模式，将护理负担从机构转移到了家庭。然而，与受照顾者相比，家庭照顾者受到的关注较少。许多家庭照顾者也是老年人，照顾者获得适当支持以减轻护理负担非常重要。在资源比城市地区有限的农村和郊区，有必要了解应优先提供哪些支持。因此，本研究旨在了解家庭照顾者对社会支持的看法、他们认为重要的支持类型和来源，以及这如何影响他们的护理负担和生活质量（QOL）。我们对日本中部农村和郊区接受家庭护理的174名老年人的主要家庭照顾者进行了一项混合方法研究。这种混合方法使定性数据能够补充定量结果。强大的家庭支持和较高的教育水平对生活质量有积极影响，而较高的护理负担和较长的护理时间对生活质量有负面影响。来自家庭和医疗保健专业人员的实际支持在减轻护理负担和提高照顾者生活质量方面至关重要。照顾者认为来自远亲或邻居的支持不合适，这对照顾者的情绪状态有负面影响。总之，家庭照顾者对支持持积极看法，但效果取决于谁提供支持。虽然来自亲密家庭和专业人员的实际支持被视为积极的，但来自邻居或远亲的支持应考虑照顾者的需求和状况，以避免产生负面影响。
