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农村祖父母照顾孙辈的抑郁症状中的性别差异。

Gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren.

机构信息

School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 Xianning West Road, Xi'an, 710049, Shaanxi, China.

School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China.

出版信息

BMC Public Health. 2021 Oct 11;21(1):1838. doi: 10.1186/s12889-021-11886-3.

Abstract

BACKGROUND

Caring for grandchildren is regarded as one of the principle roles of middle- and old-aged adults, especially among rural Chinese grandparents. This study aims to examine the gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren, based on the gender differences in grandparental role engagement and the theories of role strain and role enhancement.

METHODS

A total of 4833 rural citizens with one or more grandchildren were selected from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015. Grandchild care was measured by continuous variable (duration) and categorical variable (no care, low intensity, moderate intensity, high intensity). Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale (CES-D). We used coarsened exact matching (CEM) to balance the covariates of caregivers and non-caregivers. Following CEM, 1975 non-caregivers and 2212 caregivers were identified (N = 4187). Multilevel linear regression was employed to examine the gender differences in depressive symptoms. We also tested for the moderating role of gender on the association between grandchild care and depressive symptoms.

RESULTS

Grandmothers were more likely to provide grandchild care (54.42% vs 51.43%) at high intensity (61.46% vs 51.01%), with longer duration (39.24 h vs 33.15 h) than that given by grandfathers. Grandmothers suffered more from depressive symptoms than grandfathers, and such gap increased when grandparents were involved in high-intensity care. Grandmothers providing grandchild care, particularly at moderate intensity, were associated with fewer depressive symptoms (Coef. = - 0.087, 95%CI: - 0.163, - 0.010; Coef. = - 0.291, 95%CI: - 0.435, - 0.147), compared with non-caregivers. Grandmothers giving moderate intensity of grandchild care were also associated with fewer depressive symptoms (Coef. = - 0.171, 95% CI: - 0.313, - 0.029), compared with those with low-intensity care. However, such associations were not significant among grandfathers.

CONCLUSIONS

Our findings highlight the gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren. Grandparents should be encouraged to engage in grandchild care, but at moderate intensity. The health status of middle- and old-aged adults, particularly females, should be monitored closely. Humanistic care, preventive care and curative treatment strategies focusing on such populations should be developed and refined.

摘要

背景

照顾孙辈被视为中老年人群的主要角色之一,尤其是在中国农村的祖父母中。本研究旨在基于祖辈角色投入的性别差异以及角色紧张和角色增强理论,探讨农村中国祖父母照顾孙辈时抑郁症状的性别差异。

方法

本研究共从 2015 年开展的中国健康与养老追踪调查(CHARLS)中选取了 4833 名有一个或多个孙辈的农村居民。孙辈照料通过连续变量(时长)和分类变量(无照料、低强度、中强度、高强度)进行测量。抑郁症状通过流行病学研究中心抑郁量表(CES-D)进行评估。我们使用粗化精确匹配(CEM)来平衡照料者和非照料者的协变量。在 CEM 之后,确定了 1975 名非照料者和 2212 名照料者(N=4187)。采用多水平线性回归来检验抑郁症状的性别差异。我们还检验了性别对孙辈照料与抑郁症状之间关系的调节作用。

结果

与祖父相比,祖母更有可能(54.42%比 51.43%)提供高强度(61.46%比 51.01%)、长时间(39.24 小时比 33.15 小时)的孙辈照料。与祖父相比,祖母的抑郁症状更为严重,而且当祖父母参与高强度照料时,这种差距会加大。与非照料者相比,提供孙辈照料(尤其是中强度)的祖母的抑郁症状更少(系数=−0.087,95%CI:−0.163,−0.010;系数=−0.291,95%CI:−0.435,−0.147)。与低强度照料相比,给予中强度孙辈照料的祖母的抑郁症状也更少(系数=−0.171,95%CI:−0.313,−0.029)。然而,这些关联在祖父中并不显著。

结论

本研究结果强调了农村中国祖父母照顾孙辈时抑郁症状的性别差异。应鼓励祖父母参与孙辈照料,但要适度。应密切监测中老年人、特别是女性的健康状况。应制定和完善针对此类人群的人文关怀、预防保健和治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2994/8507248/19c87c90be2e/12889_2021_11886_Fig1_HTML.jpg

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