Smith Toby, Saunders Amanda, Heard Jay
Queen's Building, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK.
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK.
Geriatrics (Basel). 2020 Apr 27;5(2):26. doi: 10.3390/geriatrics5020026.
Informal caregivers provide vital support for older adults living in the community with chronic illnesses. The purpose of this study was to assess the psychosocial status of informal caregivers of community-dwelling adults over an eight-year period. Informal caregivers of adult care-recipients were identified from Wave 1 of the English Longitudinal Study of Ageing (ELSA) cohort. Multivariate regression analysis models were constructed to assess the association between participant's psychosocial characteristics and informal caregiving. Multilevel modelling explored the psychosocial changes between caregivers and non-caregivers over eight years. 1375 informal caregivers and 2750 age-matched non-caregivers were analyzed. Self-reported loneliness (Odd Ratio (OR): 0.26; 95% confidence intervals (CI): 0.01-0.51) and relationship status (OR: 0.36; 95% CI: 0.16-0.46) were independently associated with caregiving. Caregivers were more socially isolated with less holidaying abroad (OR: 0.51; 95% CI: 0.35-0.66), attendance to church (OR: 0.30; 95% CI: 0.11-0.49), or charity groups (OR: 0.35; 95% CI: 0.14-0.55). On multilevel analysis, over time (eight-years), caregivers reported greater loneliness ( < 0.01), change in relationship status ( = 0.01) and reduced control, autonomy, and pleasure ( ≤ 0.01) compared to non-caregivers. Given the deleterious effects caregiving can place on health and wellbeing, further interventions are required to improve these psychosocial factors.
非正式照料者为社区中患有慢性病的老年人提供至关重要的支持。本研究的目的是评估八年间社区居住成年人的非正式照料者的心理社会状况。从英国老龄化纵向研究（ELSA）队列的第1波中识别出成年受照料者的非正式照料者。构建多变量回归分析模型以评估参与者的心理社会特征与非正式照料之间的关联。多层次建模探讨了八年间照料者与非照料者之间的心理社会变化。对1375名非正式照料者和2750名年龄匹配的非照料者进行了分析。自我报告的孤独感（比值比（OR）：0.26；95%置信区间（CI）：0.01 - 0.51）和关系状况（OR：0.36；95%CI：0.16 - 0.46）与照料行为独立相关。照料者在社会上更加孤立，出国度假较少（OR：0.51；95%CI：0.35 - 0.66），参加教堂活动较少（OR：0.30；95%CI：0.11 - 0.49），或参加慈善团体较少（OR：0.35；95%CI：0.14 - 0.55）。在多层次分析中，随着时间推移（八年），与非照料者相比，照料者报告有更大的孤独感（P < 0.01）、关系状况变化（P = 0.01）以及控制感、自主性和愉悦感降低（P ≤ 0.01）。鉴于照料行为可能对健康和幸福产生有害影响，需要进一步的干预措施来改善这些心理社会因素。
