School of Nursing, UT Health San Antonio, San Antonio, TX, USA.
Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA.
Aging Ment Health. 2021 Oct;25(10):1830-1838. doi: 10.1080/13607863.2020.1836474. Epub 2020 Oct 22.
Caregiving within a spousal partnership marks a novel relationship stage for couples. Caregiving introduces new stressors and affects couples' ability to cope, and potentially alters perceptions of emotional support. Prior research on older married couples illustrates how perceived support not only affects an individual's mental health, but also that of their partner. To date, the dyadic relationship between emotional support and mental health is largely unexamined among caregiving partners, where support expectations may differ.
Actor partner interdependence models using linear mixed modeling were applied to data from spouses where one partner received caregiving within the 2014 and 2016 waves of the Health and Retirement Study. We examined the cross-sectional and lagged associations between perceived emotional support and strain from a spouse on actor and partner depression scores, as well as whether one was the caregiver or the care recipient moderated associations.
More positive perceptions of support were associated with lower depression scores for oneself (= -0.55, < 0.001) and one's partner (= -0.24, < 0.001). Actor effects-how one's own perceptions of support associate with one's own depressive symptomology-were stronger for care recipients than for caregivers (= -0.83, < 0.001 v. = -0.26, < 0.05). Higher perceptions of strain were also associated with higher depression scores for oneself ( = 0.57, < 0.001) and one's partner ( = 0.39, < 0.001), associations that remained even in lagged models.
The observation of both actor and partner effects in this study suggests opportunities to improve care recipient outcomes through intervention with caregivers or both members of the care dyad.
在配偶关系中进行护理标志着夫妻关系的一个新阶段。护理会带来新的压力源,并影响夫妻应对的能力,还可能改变对情感支持的看法。先前关于老年已婚夫妇的研究说明了感知到的支持不仅会影响个人的心理健康,还会影响其伴侣的心理健康。迄今为止,在护理伴侣中,情感支持和心理健康之间的对偶关系在很大程度上尚未得到研究,在这种关系中,支持期望可能会有所不同。
使用线性混合模型对健康与退休研究 2014 年和 2016 年的配偶数据进行了演员-伴侣相互依存模型分析。我们检验了来自配偶的情感支持和配偶压力对演员和伴侣抑郁评分的横断面和滞后关联,以及其中一个人是护理者还是护理接受者是否调节了关联。
对支持的更积极看法与自己(=-0.55,<0.001)和伴侣(=-0.24,<0.001)的抑郁评分较低有关。与护理接受者相比,护理者自身对支持的感知与其自身抑郁症状的关联更强(=-0.83,<0.001 与=-0.26,<0.05)。对压力的更高感知也与自己(=0.57,<0.001)和伴侣(=0.39,<0.001)的抑郁评分较高有关,即使在滞后模型中也是如此。
在这项研究中观察到演员和伴侣的影响,这表明通过对护理者或护理双体的干预,有机会改善护理接受者的结果。