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《加拿大老龄化纵向研究中非正式照料者的心理健康状况:照料地点为何重要》

Psychological Well-Being Among Informal Caregivers in the Canadian Longitudinal Study on Aging: Why the Location of Care Matters.

机构信息

Faculty of Social Work, University of Calgary, Alberta, Canada.

Department of Sociology, University of Calgary, Alberta, Canada.

出版信息

J Gerontol B Psychol Sci Soc Sci. 2020 Nov 13;75(10):2207-2218. doi: 10.1093/geronb/gbaa159.

Abstract

OBJECTIVES

A caregiving stress perspective suggests that caregiving harms psychological well-being in informal caregivers, whereas a caregiving rewards perspective suggests that provision of care benefits psychological well-being. This research examines whether both perspectives apply to caregiving experiences, but differently by the primary location of caregiving (i.e., in-home, other residence, and institution), as well as by gender.

METHODS

We analyzed depression and life satisfaction in the nationally representative Canadian Longitudinal Study on Aging (N = 48,648), first comparing noncaregivers (N = 27,699) to a combined caregiver group (N = 20,949) and then stratifying caregivers by the primary location of care.

RESULTS

When considered as a single group, caregivers suffered relative to noncaregivers in terms of life satisfaction and depression. When stratified by the location of care, only in-home caregivers reported both greater depression and lower life satisfaction. Nonresidential caregivers did not differ significantly in levels of depression from noncaregivers and reported higher life satisfaction. Institutional caregivers reported greater depression than noncaregivers, but did not differ significantly in life satisfaction. These patterns were stronger among women than men.

DISCUSSION

Both the caregiving stress and caregiving rewards perspectives are applicable to the caregiving experience, with the stress perspective more applicable to in-home caregivers and the rewards perspective more relevant to nonresidential caregivers. Recommendations include targeted practice focused on the location of care as well as the gender of the caregiver. Given that nonresidential caregivers actually benefit from providing care, interventions need to focus on identifying and bolstering positive aspects of the caregiving experience.

摘要

目的

从照顾者压力和照顾者回报两个角度来看,照顾者会对非正式照顾者的心理健康造成伤害,但提供照顾也会对心理健康有益。本研究考察了这两个角度是否适用于照顾者的经历,但因照顾的主要地点(即家庭、其他住所和机构)以及性别而异。

方法

我们分析了全国代表性的加拿大老龄化纵向研究(N=48648)中的抑郁和生活满意度,首先将非照顾者(N=27699)与综合照顾者群体(N=20949)进行比较,然后按照顾的主要地点对照顾者进行分层。

结果

当作为一个整体来看时,与非照顾者相比,照顾者在生活满意度和抑郁方面表现较差。按照顾地点分层时,只有家庭照顾者报告抑郁程度更高且生活满意度更低。非居住照顾者在抑郁水平上与非照顾者无显著差异,报告的生活满意度更高。机构照顾者的抑郁程度高于非照顾者,但生活满意度无显著差异。这些模式在女性中比男性中更为明显。

讨论

照顾者压力和照顾者回报这两个角度都适用于照顾经历,压力角度更适用于家庭照顾者,回报角度更适用于非居住照顾者。建议包括以照顾地点和照顾者性别为重点的有针对性的实践。鉴于非居住照顾者实际上从提供照顾中受益,干预措施需要侧重于确定和增强照顾经历的积极方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63fd/7664311/9998fa94ba0b/gbaa159_fig1.jpg

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