Institute for Global Health, University College London, Rowland Hill Street, London, NW3 2PF, UK.
Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa.
J Cross Cult Gerontol. 2023 Jun;38(2):155-171. doi: 10.1007/s10823-023-09482-6. Epub 2023 May 27.
Caregiving by older adults is a common phenomenon, enhanced in the era of HIV infection. This longitudinal study was set up to examine the effect of caregiver age, relationship and mental wellbeing on child (4-13 years) outcomes (psychosocial and cognitive) in a sample of 808 caregiver- child dyads in South Africa and Malawi. Respondents were drawn from consecutive attenders at Community Based Organisations (CBOs) and interviewed with standardised inventories at baseline and followed up 12-15 months later. Analysis focused on three separate aspects of the caregiver; age, relationship to the child, and mental wellbeing, results are stratified with regard to these factors. Results showed that compared to younger caregivers, over 50 years were carrying a heavy load of childcare, but caregiver age for the most part was not associated with child outcomes. Being biologically related to the child (such as biological grandparenting) was also not a significant factor in child outcomes measured. However, irrespective of age and relationship, caregiver mental health was associated with differences in child outcome - those children of caregivers with a greater mental health burden were found to report experiencing more physical and psychologically violent discipline. Over time, the use of violent discipline was found to reduce. These data suggest that older caregivers and grandparents are providing comparable care to younger caregivers, for young children in the face of the HIV epidemic and that interventions should focus on mental health support for all caregivers, irrespective of age or relationship to the child.
老年人照顾者是一种常见现象，在 HIV 感染时代更为突出。本纵向研究旨在考察南非和马拉维 808 对照顾者-儿童对中照顾者的年龄、关系和心理健康状况对儿童（4-13 岁）结局（心理社会和认知）的影响。受访者来自社区组织（CBO）的连续就诊者，并在基线时接受标准化清单访谈，随后在 12-15 个月后进行随访。分析侧重于照顾者的三个不同方面：年龄、与孩子的关系和心理健康状况，结果按这些因素进行分层。结果表明，与年轻的照顾者相比，50 岁以上的照顾者承担了沉重的儿童保育负担，但照顾者年龄在大多数情况下与儿童结局无关。与孩子有生物学关系（如生物学上的祖孙关系）也不是儿童结局的重要因素。然而，无论年龄和关系如何，照顾者的心理健康状况都与儿童结局的差异有关——那些照顾者心理健康负担较重的孩子报告说经历了更多的身体和心理上的暴力管教。随着时间的推移，发现使用暴力管教的情况有所减少。这些数据表明，在 HIV 流行的情况下，老年照顾者和祖父母为年幼的孩子提供了与年轻照顾者相当的照顾，干预措施应侧重于为所有照顾者提供心理健康支持，无论其年龄或与孩子的关系如何。
