School of Social Work, University of Michigan, Ann Arbor, Michigan, USA.
Research Center for Group Dynamics, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.
J Gerontol B Psychol Sci Soc Sci. 2023 Mar 13;78(Suppl 1):S27-S37. doi: 10.1093/geronb/gbac139.
In many families, multiple caregivers support older adults living with dementia. Studying collaboration among caregivers requires consideration of conceptual and methodological issues that have not been fully explored. This study presents a framework for conceptualizing caregiver collaboration and an index that captures variation in collaboration among multiple caregivers within care networks.
We used data from the 2015 waves of the National Health and Aging Trends Study and National Study of Caregiving (NSOC) to operationalize collaboration among multiple caregivers (N = 1,298) of 552 care recipients (Mage = 83.69, SD = 7.73; 71.6% women; 47.9% possible/probable dementia; 38.9% people of color).
The care collaboration index considered individual and overlapping contributions while controlling for the size of the care network (caregivers in network responding to NSOC survey) and total network size (number of caregivers in network) in the statistical model. Larger care networks enabled more collaboration, both in general and across most types of tasks (βs > 0.38). Collaboration was greater among those caring for a Black or Hispanic care recipient, both in general and for household and medical/health tasks specifically (βs > 0.11). Collaboration was also greater among those caring for recipients with probable dementia, both in general and for most tasks (βs > 0.11) but not transportation-related tasks (p = .219).
Results are examined in the context of care network dynamics and proposed mechanisms linking care collaboration to outcomes for caregivers and recipients. Strengths and limitations of our conceptualization and operationalization of collaboration are discussed.
在许多家庭中,多个照顾者共同照顾患有痴呆症的老年人。研究照顾者之间的协作需要考虑到尚未充分探讨的概念和方法问题。本研究提出了一个概念化照顾者协作的框架和一个指数,用于捕捉照护网络中多个照顾者之间协作的变化。
我们使用了来自 2015 年全国健康老龄化趋势研究和全国照护研究(NSOC)的数据,对 552 名照护者(Mage = 83.69,SD = 7.73;71.6%为女性;47.9%可能/可能患有痴呆症;38.9%为有色人种)的多个照顾者之间的协作进行了操作化。
在统计模型中,照护协作指数考虑了个体和重叠的贡献,同时控制了照护网络的大小(对 NSOC 调查做出回应的网络中的照顾者)和总网络大小(网络中的照顾者人数)。更大的照护网络使更多的协作成为可能,无论是一般情况下还是在大多数类型的任务中(βs > 0.38)。在照顾黑人或西班牙裔照护者的情况下,无论是一般情况下还是在照顾家庭和医疗/健康任务方面,协作都更为普遍(βs > 0.11)。在照顾有疑似痴呆症的照护者的情况下,协作也更为普遍,无论是一般情况下还是在大多数任务中(βs > 0.11),但在与交通相关的任务中并非如此(p =.219)。
在照护网络动态和将照护协作与照顾者和照护对象的结果联系起来的拟议机制的背景下,对结果进行了检验。讨论了我们对协作的概念化和操作化的优势和局限性。