School of Social Work, Columbia University, New York, NY, USA.
J Am Med Dir Assoc. 2021 Jul;22(7):1512-1517. doi: 10.1016/j.jamda.2020.12.012. Epub 2021 Jan 13.
Though many studies have explored differences between spouses and adult children in dementia care, empirical evidence is lacking on racial- and ethnic-minority populations. To fill this research gap, this study examined care tasks, caregiver burden, and depressive symptoms of Chinese spouse and adult-child caregivers in dementia care. Guided by the stress process model, this study asked 3 questions: Do spouse and adult-child caregivers take up different care tasks and experience different levels of caregiver burden and depressive symptoms? Does gender moderate the differences between spouse and adult-child caregivers? Whether care tasks and burden mediate the association between being a spouse/adult-child caregiver and depressive symptoms?
Data were collected from a questionnaire-based survey of Chinese Americans who provided care for their family members with dementia in New York City. The analytical sample included 126 Chinese spouse or adult-child caregivers.
Care tasks was indicated by intensity of 8 types of care tasks. Caregiver burden and depressive symptoms were measured by Zarit's Burden Interview and the 10-item Center for Epidemiologic Studies Depression Scale. Linear regression, interaction term (spouse/adult-child caregiver by gender), and path analysis were conducted to address the 3 questions.
The results of linear regression show no significant difference in care tasks between the 2 groups, but spouse caregivers had significantly higher levels of caregiver burden and depressive symptoms than adult children. Wives had higher levels of caregiver burden and depressive symptoms than husbands, daughters, and sons. Caregiver burden mediated the association between being a spouse caregiver and higher depressive symptoms, whereas care tasks did not shape such association.
This study highlighted the emotional stress of Chinese American older adults in providing care for their spouses. The findings indicate the necessity of developing culturally meaningful activities to support Chinese American spouse caregivers.
尽管许多研究探讨了配偶和成年子女在痴呆症护理方面的差异，但在少数族裔群体中缺乏实证证据。为了填补这一研究空白，本研究考察了中国配偶和成年子女照顾者在痴呆症护理中的照顾任务、照顾者负担和抑郁症状。本研究以压力过程模型为指导，提出了三个问题：配偶和成年子女照顾者承担的照顾任务是否不同，体验到的照顾者负担和抑郁症状是否不同？性别是否调节配偶和成年子女照顾者之间的差异？照顾任务和负担是否在配偶/成年子女照顾者与抑郁症状之间的关联中起中介作用？
数据来自于一项基于问卷的针对在纽约市为其家庭成员提供痴呆症护理的华裔美国人的调查。分析样本包括 126 名中国配偶或成年子女照顾者。
照顾任务由 8 种照顾任务的强度来表示。照顾者负担和抑郁症状由 Zarit 负担访谈和 10 项流行病学研究抑郁量表来衡量。线性回归、交互项（配偶/成年子女照顾者与性别）和路径分析用于解决三个问题。
线性回归的结果表明，两组之间的照顾任务没有显著差异，但配偶照顾者的照顾者负担和抑郁症状水平明显高于成年子女。妻子的照顾者负担和抑郁症状水平高于丈夫、女儿和儿子。照顾者负担在配偶照顾者与更高抑郁症状之间的关联中起中介作用，而照顾任务并没有塑造这种关联。
本研究强调了中国美籍老年人在照顾配偶方面的情感压力。研究结果表明，有必要制定具有文化意义的活动来支持中国美籍配偶照顾者。
