Moon Heehyul E, Haley William E, Rote Sunshine M, Sears Jeanelle S
Kent School of Social Work, University of Louisville, Kentucky.
School of Aging Studies, College of Behavioral and Community Science, University of South Florida, Tampa.
Innov Aging. 2020 Sep 15;4(6):igaa045. doi: 10.1093/geroni/igaa045. eCollection 2020.
Despite growing diversity among the aging population and extensive previous research on racial/ethnic minority caregivers, little research has been conducted on the potentially unique experiences and outcomes of informal caregivers of foreign-born care recipients. Using nationally representative data and the Stress Process Model, the current study examined the differences in caregiver outcomes (care burden, psychological well-being, and self-rated health) by care recipient nativity status (U.S.-born vs. foreign-born) and the extent to which caregiver outcomes vary by care recipient nativity status and caregiver race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, and Others).
The current study used Round 5 of the National Health and Aging Trends Study and the National Study of Caregiving ( = 1,436). We conducted ordinary least squares regression to analyze the differences in caregiver's outcomes by care recipient nativity status and caregiver race/ethnicity and to investigate the impacts of the inclusion of caregiving factors (background factors, primary stressors, secondary stressors, and resources).
Regression analyses showed that only care burden significantly varied by care recipient nativity status after controlling for covariates. Caregivers of foreign-born care recipients reported a higher burden. However, when interactions of care recipient nativity status × caregiver race/ethnicity were introduced, non-Hispanic black and Hispanic caregivers of foreign-born care recipients were more likely to report better psychological well-being and self-rated health compared to their counterparts. Across caregiver groups, better caregiver-care recipient relationship quality and less caregiver chronic conditions were associated with less burden and better caregiver psychological well-being and self-rated health.
Care recipient nativity status and caregiver race/ethnicity may have complex effects on caregiving experiences. Given the observed significant interaction effects for caregiver psychological well-being and self-rated health, cultural factors may affect the extent to which these caregivers appraise their caregiving. Future research should delve into the appropriate ways to assess care stress as well as resilience among each caregiver group. Our results indicate the need for research, education, and practice that assess cultural and within-group differences among caregivers and inform needed changes to structural barriers.
尽管老年人口日益多样化，且此前已有大量关于少数族裔照料者的研究，但针对照料外国出生受照料者的非正式照料者可能具有的独特经历和结果的研究却很少。本研究利用具有全国代表性的数据和压力过程模型，考察了照料者结果（照料负担、心理健康和自评健康）在受照料者出生状态（美国出生与外国出生）方面的差异，以及照料者结果因受照料者出生状态和照料者种族/族裔（非西班牙裔白人、非西班牙裔黑人、西班牙裔和其他）而变化的程度。
本研究使用了《美国国家健康与老龄化趋势研究》第5轮以及《全国照料研究》（n = 1436）的数据。我们进行了普通最小二乘法回归分析，以考察照料者结果在受照料者出生状态和照料者种族/族裔方面的差异，并研究纳入照料因素（背景因素、主要压力源、次要压力源和资源）的影响。
回归分析表明，在控制协变量后，仅照料负担在受照料者出生状态方面存在显著差异。照料外国出生受照料者的照料者报告的负担更高。然而，当引入受照料者出生状态×照料者种族/族裔的交互项时，与照料美国出生受照料者的对应群体相比，照料外国出生受照料者的非西班牙裔黑人和西班牙裔照料者更有可能报告更好的心理健康和自评健康。在所有照料者群体中，更好的照料者 - 受照料者关系质量以及照料者较少的慢性病与较轻的负担、更好的照料者心理健康和自评健康相关。
受照料者出生状态和照料者种族/族裔可能对照料经历产生复杂影响。鉴于观察到照料者心理健康和自评健康存在显著的交互作用效应，文化因素可能会影响这些照料者评估其照料行为的程度。未来的研究应深入探讨评估每个照料者群体的照料压力以及恢复力的适当方法。我们的结果表明，需要开展研究、教育和实践，以评估照料者之间的文化差异和群体内部差异，并为改变结构性障碍提供所需信息。
