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大流行中的照护工作:COVID-19 大流行早期女性照护者的与健康相关的社会经济脆弱性。

Caregiving in a Pandemic: Health-Related Socioeconomic Vulnerabilities Among Women Caregivers Early in the COVID-19 Pandemic.

机构信息

The University of Chicago, Department of Obstetrics and Gynecology, Chicago, Illinois.

University of Southern California Keck School of Medicine, Department of Family Medicine, Los Angeles, California.

出版信息

Ann Fam Med. 2022 Sep-Oct;20(5):406-413. doi: 10.1370/afm.2845. Epub 2022 Sep 2.

Abstract

PURPOSE

Family and friends who provide regular care for a sick or dependent individual ("caregivers") are at increased risk of health-related socioeconomic vulnerabilities (HRSVs). This study examined pre-pandemic prevalence of and early pandemic changes in HRSVs among women caregivers compared with non-caregivers.

METHODS

A cross-sectional survey was conducted in April 2020 (early pandemic) with 3,200 English-speaking US women aged 18 years or older, 30% of whom identified as caregivers. We modeled adjusted odds of self-reported HRSVs (financial strain, food/housing insecurity, interpersonal violence, transportation/utilities difficulties) before and changes during the early pandemic by caregiving status. Models were adjusted for age, race/ethnicity, marital status, education, income, number of people in household, number of children in household, physical and mental health, and number of comorbidities.

RESULTS

Pre-pandemic, 63% of caregivers and 47% of non-caregivers reported 1 or more vulnerability ( <.01); food insecurity was most prevalent (48% of caregivers vs 33% of non-caregivers, <.01). In the early pandemic, caregivers had higher odds than non-caregivers of financial strain, both incident (adjusted odds ratio [AOR] = 2.1; 95% CI, 1.6-2.7) and worsening (AOR = 2.0; 95% CI, 1.4-2.8); incident interpersonal violence (AOR = 2.0; 95% CI, 1.5-2.7); incident food insecurity (AOR = 1.6; 95% CI, 1.2-2.1); incident transportation difficulties (AOR = 1.9; 95% CI, 1.3-2.6); and incident housing insecurity (AOR = 1.6; 95% CI, 1.1-2.3).

CONCLUSION

The coronavirus disease 2019 (COVID-19) pandemic increased risk of incident and worsening HRSVs for caregivers more than for non-caregivers. COVID-19 response and recovery efforts should target caregivers to reduce modifiable HRSVs and promote the health of caregivers and those who depend on them. Online First article.

摘要

目的

为患病或依赖他人的个体提供定期护理的家庭成员和朋友(“护理人员”)面临与健康相关的社会经济脆弱性(HRSV)的风险增加。本研究比较了女性护理人员与非护理人员在大流行前和大流行早期 HRSV 的流行情况和变化。

方法

2020 年 4 月(大流行早期)进行了一项横断面调查,调查对象为 3200 名年龄在 18 岁或以上的讲英语的美国女性,其中 30%的女性自我报告为护理人员。我们通过护理人员状况对报告的 HRSV(经济压力、食物/住房不安全、人际暴力、交通/公用事业困难)进行了调整。模型调整了年龄、种族/族裔、婚姻状况、教育程度、收入、家庭人口数、家庭儿童人数、身心健康以及合并症数量。

结果

大流行前,63%的护理人员和 47%的非护理人员报告存在 1 种或多种脆弱性(<.01);食物不安全最为普遍(48%的护理人员 vs 33%的非护理人员,<.01)。在大流行早期,护理人员与非护理人员相比,财务压力的发生率(调整后的优势比[OR]为 2.1;95%CI,1.6-2.7)和恶化率(OR=2.0;95%CI,1.4-2.8)均更高;人际暴力发生率(OR=2.0;95%CI,1.5-2.7);食物不安全发生率(OR=1.6;95%CI,1.2-2.1);交通困难发生率(OR=1.9;95%CI,1.3-2.6);住房不安全发生率(OR=1.6;95%CI,1.1-2.3)。

结论

COVID-19 大流行增加了护理人员发生和恶化 HRSV 的风险,高于非护理人员。COVID-19 应对和恢复工作应针对护理人员,以减少可改变的 HRSV,并促进护理人员及其所依赖人员的健康。在线首发文章。

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