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照顾者在突发事件和长期照顾中的积极方面:社会参与和痛苦的作用。

Positive aspects of caregiving in incident and long-term caregivers: Role of social engagement and distress.

机构信息

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

School of Aging Studies, University of South Florida, Tampa, FL, USA.

出版信息

Aging Ment Health. 2023 Jan;27(1):87-93. doi: 10.1080/13607863.2021.2000935. Epub 2021 Nov 9.

Abstract

OBJECTIVES

Positive caregiver adaptation over time may be associated with reports of positive aspects of caregiving (PAC). We examined differences in PAC by caregiving duration and social engagement, controlling for measures of distress.

METHODS

Participants included 283 African American or White caregivers from the Caregiving Transitions Study with a wide range of caregiving durations. PAC are defined as positive appraisals that caregivers report about their role, such as feeling appreciated or confident. We fit multivariable linear models with the total PAC score as the outcome to assess its association with years of caregiving and social engagement (social network, monthly social contact). Models were adjusted for age, sex, race, marital status, relationship to care recipient, care recipient's dementia status, perceived stress and caregiving strain.

RESULTS

Caregivers with higher social engagement reported significantly higher PAC. A non-significant trend was found in most analytic models for caregivers with longer duration of care to report higher PAC. African American caregivers reported higher PAC compared to White caregivers. Dementia caregivers reported lower PAC than non-dementia caregivers in models adjusting for demographics and social network size, but the association was attenuated with the addition of caregiving strain.

DISCUSSION

Higher social engagement and longer duration of care tend to be associated with higher PAC after adjusting for demographics and measures of distress. Future studies should aim to leverage longitudinal data to understand whether caregivers shift appraisal to positive aspects of their role and explore implementation of caregiving interventions targeting PAC in order to improve the caregiving experience.

摘要

目的

随着时间的推移,积极的照顾者适应可能与照顾的积极方面(PAC)的报告有关。我们通过照顾时间和社会参与度来检查 PAC 的差异,同时控制了压力和照顾压力的措施。

方法

参与者包括来自照顾过渡期研究的 283 名非裔美国或白人照顾者,他们的照顾时间长短不一。PAC 是指照顾者对自己角色的积极评价,例如感到受到赞赏或自信。我们使用多元线性模型来评估 PAC 总分与照顾年限和社会参与度(社交网络、每月社交接触)之间的关系。模型调整了年龄、性别、种族、婚姻状况、与照顾对象的关系、照顾对象的痴呆症状况、感知压力和照顾压力。

结果

社会参与度较高的照顾者报告的 PAC 显著较高。在大多数分析模型中,照顾时间较长的照顾者报告 PAC 较高的趋势不明显。与白人照顾者相比,非裔美国照顾者报告的 PAC 较高。在调整人口统计学和社交网络规模的模型中,痴呆症照顾者报告的 PAC 低于非痴呆症照顾者,但随着照顾压力的增加,这种关联减弱。

讨论

在调整人口统计学和压力措施后,较高的社会参与度和较长的照顾时间往往与较高的 PAC 相关。未来的研究应该旨在利用纵向数据来了解照顾者是否将评估转向角色的积极方面,并探索针对 PAC 的照顾干预措施的实施,以改善照顾体验。

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