Tran Jessica T, Theng Bunnarin, Tzeng Huey-Ming, Raji Mukaila, Serag Hani, Shih Miaolung, Lee Wei-Chen Miso
John Sealy School of Medicine, University of Texas Medical Branch, Galveston, USA.
School of Nursing, University of Texas Medical Branch, Galveston, USA.
Cureus. 2023 Oct 5;15(10):e46537. doi: 10.7759/cureus.46537. eCollection 2023 Oct.
Background Many Americans are informal caregivers providing unpaid care for their loved ones living with chronic conditions, such as dementia and heart failure. As the US population continues to age and live longer with more complex chronic conditions, informal caregivers play an increasingly important role in the care of older adults with functional impairment and multiple comorbidities. Caregivers face many challenges in managing the health of themselves and their loved ones, including physical, emotional, and financial burdens, which may potentially vary by race and ethnicity. Therefore, it is critical to develop culturally tailored solutions, such as smart technology, aimed at improving the quality of life of informal caregivers and care recipients from diverse backgrounds. Methods Data were collected from a convenient sample of 69 informal caregivers in Texas who were members or volunteers for either the International Buddhist Progress Society-Dallas (IBPS Dallas) or University of Texas Medical Branch (UTMB). Caregivers answered questions about their caregiving experiences, including the type of care they provided, challenges they faced, and lessons learned. Responses were stratified by race/ethnicity (White, Hispanic, or Asian American) to assess for potential cultural differences in caregiving experiences. A chi-squared test and one-way analysis of variance (ANOVA) were conducted. Results White, Hispanic, and Asian American caregivers all reported high non-medical related needs. White, Hispanic, and Asian American care recipients all had a high degree of neurological disease and functional impairment. White and Hispanic caregivers were also more likely to offer emotional support (=0.007) and financial support (=0.025) than Asian American caregivers. Asian American caregivers reported greater worry about the health-related knowledge of their family members (=0.040) than White and Hispanic caregivers. Hispanic (18.8%) and Asian American caregivers (12.5%) reported the least knowledge of caregiving-related government policies than White caregivers (43.2%) (=0.025). Hispanic (18.8%) and Asian American caregivers (18.8%) also reported the least knowledge of available support programs and services for care recipients (=0.001). Conclusions White, Hispanic, and Asian American informal caregivers vary in their types of worries, care provided, and challenges faced. Our study found that Asian American caregivers reported greater worry about the health-related knowledge of their family members than White and Hispanic caregivers. White caregivers were better at navigating government resources and caregiver support programs than Hispanic and Asian American caregivers. While race and ethnicity are potential factors for these observed differences, several other factors may have played a role, including age, gender, income, education, patient diagnosis, and disease severity. Future research should consider these factors and evaluate a larger and more diverse sample for more definitive racial and ethnic comparisons. Understanding disparities in caregiving experiences is a critical initial step to developing culturally appropriate interventions to reduce caregiving burden and promote the health and well-being of both patients and their informal caregivers from diverse backgrounds.
许多美国人是无偿照顾患有慢性病(如痴呆症和心力衰竭)亲人的非正式护理人员。随着美国人口持续老龄化,患有更复杂慢性病的人群寿命延长,非正式护理人员在照顾功能受损和患有多种合并症的老年人方面发挥着越来越重要的作用。护理人员在管理自己和亲人的健康方面面临许多挑战,包括身体、情感和经济负担,这些负担可能因种族和民族而异。因此,开发针对不同文化背景的解决方案,如智能技术,对于提高来自不同背景的非正式护理人员及其护理对象的生活质量至关重要。
从得克萨斯州69名非正式护理人员的便利样本中收集数据,这些护理人员是达拉斯国际佛教进步协会(IBPS达拉斯)或德克萨斯大学医学分校(UTMB)的成员或志愿者。护理人员回答了有关其护理经历的问题,包括他们提供的护理类型、面临的挑战和学到的经验教训。按种族/民族(白人、西班牙裔或亚裔美国人)对回答进行分层,以评估护理经历中潜在的文化差异。进行了卡方检验和单因素方差分析(ANOVA)。
白人、西班牙裔和亚裔美国护理人员均报告有较高的非医疗相关需求。白人、西班牙裔和亚裔美国护理对象都患有高度的神经系统疾病和功能障碍。与亚裔美国护理人员相比,白人和西班牙裔护理人员也更有可能提供情感支持(P=0.007)和经济支持(P=0.025)。与白人和西班牙裔护理人员相比,亚裔美国护理人员报告对其家庭成员的健康相关知识更为担忧(P=0.040)。与白人护理人员(43.2%)相比,西班牙裔(18.8%)和亚裔美国护理人员(12.5%)报告对与护理相关的政府政策了解最少(P=0.025)。西班牙裔(18.8%)和亚裔美国护理人员(18.8%)也报告对护理对象可用的支持计划和服务了解最少(P=0.001)。
白人、西班牙裔和亚裔美国非正式护理人员在担忧类型、提供的护理和面临的挑战方面存在差异。我们的研究发现,与白人和西班牙裔护理人员相比,亚裔美国护理人员报告对其家庭成员的健康相关知识更为担忧。白人护理人员在利用政府资源和护理人员支持计划方面比西班牙裔和亚裔美国护理人员更有优势。虽然种族和民族是这些观察到的差异的潜在因素,但其他几个因素可能也起到了作用,包括年龄、性别、收入、教育程度、患者诊断和疾病严重程度。未来的研究应考虑这些因素,并评估更大、更多样化的样本,以进行更明确的种族和民族比较。了解护理经历中的差异是制定符合文化背景的干预措施以减轻护理负担、促进来自不同背景的患者及其非正式护理人员的健康和福祉的关键第一步。