Centre for Socio-Economic Research on Aging, IRCCS INRCA - National Institute of Health and Science on Aging, Ancona, Italy.
Scientific Direction, IRCCS INRCA - National Institute of Health and Science on Aging, Ancona, Italy.
Aging Ment Health. 2021 Jan;25(1):22-31. doi: 10.1080/13607863.2019.1667295. Epub 2019 Sep 23.
This longitudinal study explores whether the working situation (no change in working hours despite care, reduction of working hours due to care or not working) moderates mental and physical health of informal caregivers of older people with Alzheimer's disease (AD) in Italy.
Data from a sample of 146 caregivers of older people with moderate AD involved in the UP-TECH trial across three waves were analysed. Multivariate analyses were used to study the association between independent variables (caregivers' work situation) and dependent variables (caregivers' psycho-physical health). In a second model, elements relating to the caregiver, the cared-for individual and the caregiving situation were added as controls.
Being forced to reduce working hours due to care tasks or not being employed independently from care was negatively associated with informal caregiver's physical health, compared with working carers not experiencing reduction of working hours. In the extended model, this result was confirmed. In comparison with working carers not forced to reduce working hours, non-working carers experienced higher levels of caregiver burden and depression, however these results were not confirmed in the adjusted model. Other factors also emerged as important including weekly hours of care, the cared-for older individual's ADL/IADL scores and informal support network.
Given the positive effect of labour force participation on health of informal caregivers of older people with AD, policy makers should promote their employment avoiding their forced reduction of working hours, while also putting measures in place to decrease the intensity of informal care provision.
本纵向研究旨在探讨工作状况（尽管有照顾需求但工作时间无变化、因照顾需求减少工作时间或不工作）是否会对意大利老年阿尔茨海默病（AD）患者非正式照护者的身心健康产生影响。
对参与 UP-TECH 试验的 146 名中度 AD 老年患者照护者的样本数据进行了 3 个时间点的分析。采用多变量分析方法研究了自变量（照护者的工作状况）与因变量（照护者的心理生理健康）之间的关联。在第二个模型中，加入了与照护者、被照护者和照护情况有关的元素作为对照。
与没有减少工作时间的工作照护者相比，由于照顾任务而被迫减少工作时间或不工作与非正式照护者的身体健康呈负相关。在扩展模型中，这一结果得到了证实。与没有被迫减少工作时间的工作照护者相比，不工作的照护者的照护负担和抑郁程度更高，但在调整后的模型中，这些结果并不成立。其他因素也很重要，包括每周的照护时间、被照护者的 ADL/IADL 评分和非正式支持网络。
鉴于劳动力参与对老年 AD 患者非正式照护者健康的积极影响，政策制定者应鼓励他们就业，避免被迫减少工作时间，同时采取措施减少非正式照护的强度。
