Duan Haoshu, Chen Feinian
Department of Sociology, University of Maryland, College Park, Maryland, USA.
Aging Ment Health. 2023 Jan;27(1):124-132. doi: 10.1080/13607863.2022.2032596. Epub 2022 Feb 2.
This study aims to examine the impacts of spousal caregiving on caregivers' depressive symptoms, and how work status and gender mitigate the relationship.
We used four waves' data from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2018, = 20,213) with linear mixed-effect models to investigate the association between providing instrumental activities of daily living (IADL) and activities of daily living (ADL) assistance to a spouse and spouse caregivers' depressive symptoms. We further examined the moderating effect of work status. Analyses were stratified by gender.
As main effects, respondents who provided ADL assistance to their spouse had significantly higher depressive symptoms than non-spousal caregivers, and the association was particularly stronger for women than for men. However, we did not find significant difference of depressive symptoms between IADL spousal caregiver and non-spousal caregivers. Working while ADL spousal care further exacerbated caregivers' depressive symptoms for both genders, whereas working full-time while providing IADL spousal care is only associated with elevated depressive symptoms for women. Interestingly, we found that providing IADL assistance is associated with lower depressive symptoms while they were not working.
The relationship between spousal caregiving and depressive symptoms differed significantly by the type of care and was also moderated by work status, and female caregivers on average have worsened depressive symptoms than male caregivers. Future research on caregiving needs to consider the types of care and other social roles that caregivers also take on. Lastly, more affordable eldercare facilitates need to be built to alleviate the burden among spousal caregivers, especially when they are working.
本研究旨在探讨配偶照料对照料者抑郁症状的影响，以及工作状态和性别如何缓和这种关系。
我们使用了中国健康与养老追踪调查（CHARLS，2011 - 2018年，样本量n = 20213）的四轮数据，采用线性混合效应模型来研究为配偶提供日常生活工具性活动（IADL）和日常生活活动（ADL）协助与配偶照料者抑郁症状之间的关联。我们进一步考察了工作状态的调节作用。分析按性别分层。
作为主要效应，为配偶提供ADL协助的受访者的抑郁症状显著高于非配偶照料者，且这种关联在女性中比在男性中更强。然而，我们未发现IADL配偶照料者与非配偶照料者在抑郁症状上有显著差异。在提供ADL配偶照料时工作会进一步加剧两性照料者的抑郁症状，而在提供IADL配偶照料时全职工作仅与女性抑郁症状升高有关。有趣的是，我们发现他们不工作时提供IADL协助与较低的抑郁症状相关。
配偶照料与抑郁症状之间的关系因照料类型不同而有显著差异，并且也受到工作状态的调节，女性照料者的抑郁症状平均比男性照料者更严重。未来关于照料的研究需要考虑照料类型以及照料者承担的其他社会角色。最后，需要建立更多负担得起的老年护理设施，以减轻配偶照料者的负担，尤其是当他们工作时。
