University Center for Social and Urban Research, University of Pittsburgh, Pennsylvania, USA.
School of Nursing, University of Pittsburgh, Pennsylvania, USA.
Gerontologist. 2021 Jul 13;61(5):650-660. doi: 10.1093/geront/gnab049.
The coronavirus disease 2019 (COVID-19) pandemic has negatively affected persons with existing chronic health conditions. The pandemic also has the potential to exacerbate the stresses of family caregiving. We compare family caregivers with noncaregivers on physical, psychosocial, and financial well-being outcomes during the pandemic and determine family caregivers most at risk for adverse outcomes.
We conducted a cross-sectional online survey of 576 family caregivers and 2,933 noncaregivers from April to May 2020 in Pittsburgh, PA region with a national supplement. Outcome measures included concurrent anxiety, depression, fatigue, sleep disturbance, social participation, and financial well-being and perceived changes due to COVID-19 (loneliness, financial well-being, food security). We also measured sociodemographic, caregiving contextual variables, and COVID-19-related caregiver stressors (COVID Caregiver Risk Index).
Controlling for sociodemographics, family caregivers reported higher anxiety, depression, fatigue, sleep disturbance, lower social participation, lower financial well-being, increased food insecurity (all p < .01), and increased financial worries (p = .01). Caregivers who reported more COVID-19-related caregiver stressors and disruptions reported more adverse outcomes (all p < .01). In addition, caregivers who were female, younger, lower income, providing both personal/medical care, and providing care for cognitive/behavioral/emotional problems reported more adverse outcomes.
Challenges of caregiving are exacerbated by the COVID-19 pandemic. Family caregivers reported increased duties, burdens, and resulting adverse health, psychosocial, and financial outcomes. Results were generally consistent with caregiver stress-health process models. Family caregivers should receive increased support during this serious public health crisis.
2019 年冠状病毒病（COVID-19）大流行对患有现有慢性健康状况的人产生了负面影响。大流行还有可能加剧家庭护理的压力。我们将在大流行期间比较有和没有照顾者的家庭照顾者在身体、心理社会和经济福祉方面的结果，并确定最有可能出现不良结果的家庭照顾者。
我们于 2020 年 4 月至 5 月在宾夕法尼亚州匹兹堡地区进行了一项横断面在线调查，调查对象为 576 名家庭照顾者和 2933 名非照顾者，并进行了全国补充调查。结果指标包括同时出现的焦虑、抑郁、疲劳、睡眠障碍、社会参与和经济福祉以及由于 COVID-19 而产生的变化（孤独感、经济福祉、食品安全）。我们还测量了社会人口统计学、照顾者背景变量以及与 COVID-19 相关的照顾者压力源（COVID 照顾者风险指数）。
控制了社会人口统计学因素后，照顾者报告了更高的焦虑、抑郁、疲劳、睡眠障碍、更低的社会参与、更低的经济福祉、更高的食物不安全感（均 p <.01）和更高的经济担忧（p =.01）。报告与 COVID-19 相关的照顾者压力源和干扰源更多的照顾者报告了更多的不良结果（均 p <.01）。此外，女性、年轻、低收入、同时提供个人/医疗护理以及提供认知/行为/情绪问题护理的照顾者报告了更多的不良结果。
COVID-19 大流行使照顾者的挑战更加严峻。家庭照顾者报告了工作量增加、负担加重以及由此导致的健康、心理社会和经济不良后果。结果总体上与照顾者压力-健康过程模型一致。在这场严重的公共卫生危机中，家庭照顾者应获得更多支持。
