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照顾者个人支持网络的变化:性别差异及其对健康的影响(CUIDAR-SE 研究)。

Changes in Caregiver Personal Support Networks: Gender Differences and Effects on Health (CUIDAR-SE Study).

机构信息

Fundación para la Investigación Biosanitaria de Andalucía Oriental (FIBAO), 18012 Granada, Spain.

Escuela Andaluza de Salud Pública (EASP), 18080 Granada, Spain.

出版信息

Int J Environ Res Public Health. 2021 Nov 8;18(21):11723. doi: 10.3390/ijerph182111723.

Abstract

Technological changes have led to important advances in medical diagnoses and treatments that prolong the informal care process. Support from the personal network of informal caregivers is an undervalued resource and the changes that have occurred over time are unknown. The aim of this study was to analyze the changes in personal network support among informal caregivers and to examine the effect of these changes on self-perceived caregiver health, with a focus on differences between men and women and caregivers with high and low levels of burden We also investigated caregiver perceptions and explanations of changes to their support network (losses and additions and no change). Using a mixed-methods approach, data were obtained from 32 caregivers that were intentionally selected in Spain, who were interviewed twice with a one-year interval. In the quantitative phase, personal networks analysis was performed with Egonet software, which obtained data on the composition and functional content in social support from 1600 personal relationships (25 alters for each ego in the two waves). In the qualitative phase, semi-structured interviews were conducted in the two waves with a guide in order to explore the changes in informal support resources over time. The selected men with high levels of burden pointed out a loss of network support with more discouraging reports compared with the low-burden male caregivers. Furthermore, the selected women with low burden levels mentioned losses too; however, their reports were more positive. Women reported improved health, especially those with low burden scores in the first wave and those who did not lose support. Caregivers with a high initial burden and who lost support reported worse health, particularly men and women with a strong sense of duty toward care. Social support from personal networks is important for caregiver health and its effects are influenced by gender roles. Our findings could help by improving the relational and social capital of informal caregivers and adapting them to the new needs of formal home care systems.

摘要

技术变革推动了医学诊断和治疗的重要进步,延长了非正规护理过程。非正式照顾者的个人网络支持是一种被低估的资源,而且随着时间的推移,这种资源发生了变化,但人们对此并不了解。本研究旨在分析非正式照顾者个人网络支持的变化,并探讨这些变化对自我感知照顾者健康的影响,重点关注男女之间以及负担高低不同的照顾者之间的差异。我们还调查了照顾者对其支持网络变化(损失、增加和无变化)的看法和解释。本研究采用混合方法,从西班牙有目的地选择了 32 名照顾者,他们在一年的时间间隔内进行了两次访谈。在定量阶段,使用 Egonet 软件进行个人网络分析,该软件从 1600 个个人关系中获取了社会支持的组成和功能内容(两次波次中每个自我有 25 个改变者)。在定性阶段,两次波次均进行了半结构化访谈,采访指南旨在探讨随着时间的推移非正式支持资源的变化。选择的高负担男性照顾者指出网络支持的损失,与低负担男性照顾者相比,他们的报告更令人沮丧。此外,选择的低负担女性照顾者也提到了损失,但她们的报告更为积极。女性报告了健康状况的改善,尤其是那些在第一次波次负担水平低且没有失去支持的女性。那些初始负担高且失去支持的照顾者报告了更差的健康状况,尤其是那些责任感强的男性和女性照顾者。个人网络的社会支持对照顾者的健康很重要,其影响受到性别角色的影响。我们的研究结果可以通过提高非正式照顾者的关系和社会资本,并使其适应新的家庭护理系统的需求来提供帮助。

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