Garms-Homolová Vjenka, Declercq Anja, Finne-Soveri Harriet, Notthoff Nanna, van der Roest Henriëtte G, van Hout Hein P J
Hochschule für Technik und Wirtschaft Berlin, University of Applied Sciences, Berlin, Germany.
Lucas KU, Leuven, Belgium.
Front Med (Lausanne). 2021 Mar 5;8:522410. doi: 10.3389/fmed.2021.522410. eCollection 2021.
Research on life stressors and adverse life events has a long tradition. Few studies have addressed this topic in connection to very old people. Life stressors, especially major life stressors (MLSs) experienced by clients of home care services in the community have rarely been the subject of studies. Considering this gap, we investigated the prevalence of MLSs in home care clients. We examined the effects that MLSs have on their mood and health status as well as the impact of clients' social resources on MLSs and their outcomes. We used assessment data from 2,884 home care clients in six European countries. The methodological basis was the comprehensive and standardized interRAI Home Care Assessment (interRAI HC). Fifteen point four percent of the sample-that consisted of women and men with an average age of 82.89 years-experienced an MLS in the last 6 months before the assessment. They were more depressed than persons without these experiences, and their health status indicated a higher level of instability and deterioration. At reassessment after 6 months, the situation changed. Despite the fact that both outcomes of the MLSs, depression and health status became worse in the reassessment-sample, home care clients without MLS were more affected by the worsening, especially that of depression. The expected buffering impact of social resources was low. Although this study worked with limited information on MLSs, it could contribute to closing various knowledge gaps. The study shows that the MLSs represent a prevalent problem in a population of home care clients and that this problem has negative consequences for their mood and the stability of their health status. Furthermore, this research took up the situation of very old and vulnerable adults, who have previously rarely been considered in studies on major critical life events and stressors. Future research on MLSs has to take up the issue of the time passage between the MLS and the impact on health and well-being of individuals dependent on care. It has to determine immediate as well as later consequences and identify those factors that are appropriate to reduce the MLS-effects on very old people dependent on care.
关于生活压力源和不良生活事件的研究有着悠久的传统。很少有研究针对非常年长的人群探讨这个话题。生活压力源，尤其是社区居家护理服务对象所经历的重大生活压力源，很少成为研究的主题。考虑到这一空白，我们调查了居家护理对象中重大生活压力源的患病率。我们研究了重大生活压力源对他们情绪和健康状况的影响，以及服务对象的社会资源对重大生活压力源及其结果的影响。我们使用了来自六个欧洲国家的2884名居家护理对象的评估数据。方法学基础是全面且标准化的居家护理机构间居民评估（interRAI HC）。在评估前的最后6个月里，样本中15.4%的人经历了重大生活压力源，样本包括平均年龄为82.89岁的男性和女性。他们比没有这些经历的人更抑郁，并且他们的健康状况显示出更高程度的不稳定和恶化。在6个月后的重新评估中，情况发生了变化。尽管在重新评估样本中，重大生活压力源的两个结果，即抑郁和健康状况都变得更糟，但没有经历重大生活压力源的居家护理对象受恶化情况的影响更大，尤其是抑郁方面。社会资源预期的缓冲作用较低。尽管这项研究使用的关于重大生活压力源的信息有限，但它有助于填补各种知识空白。该研究表明，重大生活压力源在居家护理对象群体中是一个普遍存在的问题，并且这个问题对他们的情绪和健康状况的稳定性有负面影响。此外，这项研究关注了非常年长且脆弱的成年人的情况，他们在之前关于重大关键生活事件和压力源的研究中很少被考虑。未来关于重大生活压力源的研究必须关注重大生活压力源与对依赖护理的个体的健康和幸福产生影响之间的时间间隔问题。它必须确定即时和后续的后果，并找出那些适合减轻重大生活压力源对依赖护理的非常年长的人的影响的因素。
