Zhao Xinyi, Zhang Quan, Xu Honghong, Li Xinxuan, Lou Vivian W Q, Liu Huiying
School of Health Humanities, Peking University, Beijing, China.
National School of Development, Peking University, Beijing, China.
Aging Ment Health. 2023 Sep-Oct;27(10):2027-2033. doi: 10.1080/13607863.2023.2194851. Epub 2023 Mar 30.
Previous research has identified that unmet needs are associated with adverse mental health outcomes in older adults. However, the unmet needs of older adults' spousal caregivers are unknown. The present study examined the association between unmet needs and depression among spousal caregivers, and whether marital satisfaction mediated this association.
We included 1,856 participants who provided care to their spouses with difficulties in activities of daily living (ADL) and instrumental activities of daily living (IADL) from the 2018 China Health and Retirement Longitudinal Survey. Unmet needs of spousal caregivers were assessed as the total number of ADL/IADL tasks with which respondents had unmet needs. Path models were conducted to evaluate the associations between unmet needs, marital satisfaction, and depression. Subgroup analyses by sex were conducted to examine the sex differences regarding the associations.
Spousal caregivers with more unmet ADL/IADL needs reported higher levels of depression ( < 0.001). Additionally, for wife caregivers, unmet ADL/IADL needs were associated with lower marital satisfaction, and lower marital satisfaction was associated with higher degrees of depression, indicating that marital satisfaction partially mediated the association between unmet needs and depression ( < 0.01). However, marital satisfaction did not mediate the association between unmet needs and depression among husband caregivers.
The mediating effect of marital satisfaction on the association between unmet needs and depression only existed in wife caregivers. Social services should be provided to meet the needs of caregivers with ADL/IADL difficulties, and interventions should be implemented to promote the marital satisfaction of wife caregivers.
先前的研究已经确定，未满足的需求与老年人不良的心理健康结果相关。然而，老年配偶照顾者的未满足需求尚不清楚。本研究探讨了配偶照顾者未满足的需求与抑郁之间的关联，以及婚姻满意度是否介导了这种关联。
我们纳入了来自2018年中国健康与养老追踪调查的1856名参与者，他们为日常生活活动（ADL）和工具性日常生活活动（IADL）有困难的配偶提供照顾。配偶照顾者未满足的需求被评估为受访者有未满足需求的ADL/IADL任务总数。采用路径模型来评估未满足的需求、婚姻满意度和抑郁之间的关联。进行了按性别分组的分析，以检验这些关联方面的性别差异。
ADL/IADL需求未得到满足的配偶照顾者报告的抑郁水平更高（<0.001）。此外，对于妻子照顾者来说，ADL/IADL需求未得到满足与较低的婚姻满意度相关，而较低的婚姻满意度与较高程度的抑郁相关，这表明婚姻满意度部分介导了未满足的需求与抑郁之间的关联（<0.01）。然而，婚姻满意度并未介导丈夫照顾者未满足的需求与抑郁之间的关联。
婚姻满意度对未满足的需求与抑郁之间关联的中介作用仅存在于妻子照顾者中。应提供社会服务以满足有ADL/IADL困难的照顾者的需求，并应实施干预措施以提高妻子照顾者的婚姻满意度。
