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加拿大 COVID-19 大流行期间的家庭护理:中介分析。

Family Caregiving during the COVID-19 Pandemic in Canada: A Mediation Analysis.

机构信息

Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T5G 2T4, Canada.

Medically At-Risk Driver Centre, University of Alberta, Edmonton, AB T5G 2T4, Canada.

出版信息

Int J Environ Res Public Health. 2022 Jul 15;19(14):8636. doi: 10.3390/ijerph19148636.

Abstract

Family caregiving is a public health issue because of caregivers' significant contribution to the health and social care systems, as well as the substantial impact that giving and receiving care has on the health and quality of life of care receivers and caregivers. While there have been many studies that associate caregivers' care work, financial difficulty, navigation, and other caregiving factors with family caregivers' psychological distress, we were interested not only in the factors related to family caregiver anxiety but also in hypothesizing how those effects occur. In this study, we used Andrew Hayes' PROCESS moderation analysis to explore the link between caregiver frailty, weekly care hours, and perceptions of financial difficulty, social support, and anxiety. In this analysis, we included 474 caregivers with relatively complete data on all of the variables. In regression analysis after controlling for gender and age, social loneliness (β = 0.245), frailty (β = 0.199), financial difficulty (β = 0.196), care time (β = 0.143), and navigation confidence (β = 0.131) were all significant. We then used PROCESS Model 6 to determine the significance of the direct, indirect, and total effects through the serial mediation model. The model pathway from frailty to care time to financial difficulty to social loneliness to anxiety was significant. The proportions of family caregivers who were moderately frail, anxious, and experiencing social loneliness after eighteen months of the COVID-19 pandemic found in this survey should be of concern to policymakers and healthcare providers.

摘要

家庭护理是一个公共卫生问题,因为护理人员对医疗保健系统做出了重大贡献,而且他们提供和接受护理对护理接受者和护理人员的健康和生活质量有重大影响。虽然有很多研究将护理人员的护理工作、经济困难、导航以及其他护理因素与家庭护理人员的心理困扰联系起来,但我们不仅对与家庭护理人员焦虑相关的因素感兴趣,而且还假设这些影响是如何发生的。在这项研究中,我们使用安德鲁·海斯(Andrew Hayes)的 PROCESS 调节分析来探索护理人员脆弱性、每周护理时间以及对经济困难、社会支持和焦虑的感知之间的联系。在这项分析中,我们纳入了 474 名护理人员,他们在所有变量上的数据相对完整。在控制了性别和年龄后,回归分析发现社会孤独感(β=0.245)、脆弱性(β=0.199)、经济困难(β=0.196)、护理时间(β=0.143)和导航信心(β=0.131)都具有显著意义。然后,我们使用 PROCESS 模型 6 通过序列中介模型来确定直接、间接和总效应的显著性。从脆弱性到护理时间,再到经济困难,再到社会孤独感,最后到焦虑的模型路径是显著的。在这项调查中,我们发现,在 COVID-19 大流行 18 个月后,中度脆弱、焦虑和经历社会孤独的家庭护理人员的比例应该引起政策制定者和医疗保健提供者的关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f281/9317413/f56262e9fb74/ijerph-19-08636-g001.jpg

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