残疾老年人中照料者态度和日常生活活动（ADL）援助未满足需求的性别差异。

Gender differences in caregiver attitudes and unmet needs for activities of daily living (ADL) assistance among older adults with disabilities.

机构信息

Department of Public Health Science, Graduate School and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul, South Korea.

School of Health Policy & Management, College of Public Health Science and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul, South Korea.

出版信息

BMC Geriatr. 2023 Oct 18;23(1):671. doi: 10.1186/s12877-023-04383-2.

DOI:10.1186/s12877-023-04383-2

PMID:37853319

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10583335/

Abstract

BACKGROUND

With a rapidly ageing population and a decline in the availability of family caregivers, the number of older adults with disabilities who have unmet long-term care needs is gradually increasing worldwide. However, whether there are gender differences in the association between primary caregivers or their attitudes and unmet needs for activities of daily living (ADL) assistance remains largely unknown.

METHODS

This study used the latest 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), containing the data of 1187 older adults with disabilities aged 65 and older, to identify gender differences in the attitudes of primary caregivers toward the unmet needs for ADL assistance among with disabilities adults in China. Binary logistic regression analysis was conducted to determine the effects of primary caregivers and their caregiving attitudes on the unmet care experiences of older adults with ADLs. In addition, a gender-stratified analysis was conducted to compare the differences based on older adults' gender.

RESULTS

The results revealed that the lack of positive attitudes from primary caregivers might create a situation of unmet needs for ADL assistance among older adults. When family members carry the main burden of care, older adults with disabilities, especially older women, have a lower level of unmet needs for ADL assistance. Therefore, it is important to consider gender-specific interventions to improve ADL assistance among older adults.

CONCLUSIONS

The findings suggest that the presence of a family member as a caregiver has a significant effect on unmet needs for ADL assistance in women, highlighting the importance of developing an emotional bond with the caregiver. Given that the availability of informal caregivers, such as family members, is declining, it is crucial to provide financial assistance and formal services, such as paid home services and community-based care services, and reduce the burden on family caregivers to address the unmet needs for ADL assistance among older adults with disabilities in China.

摘要

背景

随着人口老龄化的迅速发展和家庭护理人员的减少，全球范围内有残疾的老年人中未满足的长期护理需求人数逐渐增加。然而，主要照顾者及其对日常生活活动（ADL）援助的态度与未满足需求之间的关系是否存在性别差异，在很大程度上仍不清楚。

方法

本研究使用最新的 2018 年中国长寿纵向研究（CLHLS）的波次数据，该数据包含了 1187 名 65 岁及以上有残疾的老年人，以确定中国残疾成年人中主要照顾者对 ADL 援助未满足需求的态度方面的性别差异。采用二元逻辑回归分析确定主要照顾者及其照顾态度对有 ADL 老年人未满足照顾需求的影响。此外，还进行了性别分层分析，以比较基于老年人性别的差异。

结果

结果表明，主要照顾者缺乏积极的态度可能导致老年人 ADL 援助的未满足需求。当家庭成员承担主要的照顾负担时，有残疾的老年人，特别是老年女性，其 ADL 援助的未满足需求水平较低。因此，考虑针对老年人的性别特异性干预措施以改善 ADL 援助是很重要的。

结论

研究结果表明，家庭成员作为照顾者的存在对女性 ADL 援助的未满足需求有显著影响，这突出了与照顾者建立情感联系的重要性。鉴于非正式照顾者（如家庭成员）的可用性正在下降，提供经济援助和正式服务（如付费家庭服务和社区护理服务）以及减轻家庭照顾者的负担对于解决中国有残疾的老年人的 ADL 援助未满足需求至关重要。