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评估照顾老年父母对照顾者健康的影响:英国照顾父母和公婆的中年照顾者的初始健康状况和身心健康轨迹。

Assessing the impact of caregiving for older parents on caregivers' health: Initial health status and trajectories of physical and mental health among midlife caregivers for parents and parents-in-law in Britain.

机构信息

Institute for Social and Economic Research, University of Essex, Wivenhoe Park, CO4 3SQ, UK.

出版信息

Soc Sci Med. 2024 Feb;342:116537. doi: 10.1016/j.socscimed.2023.116537. Epub 2023 Dec 26.

Abstract

Assessing the impact of caregiving for older parents on caregivers' health is increasingly important in the context of population changes and curtailment of state provided services. This has been extensively studied but results are inconsistent, possibly reflecting a lack of attention to health-related selection into the caregiver role. We use data from a nationally representative UK longitudinal study to analyse differences in the health of people aged 40-69 at baseline by whether they were 'eligible' to provide parent care (with a living parent/parent-in-law) and by whether they subsequently assumed a caregiver role. We measured initial health status using a latent variable derived from three observer-recorded indicators as well as self-reported health. We analysed trajectories of physical and mental health over a seven-year follow-up for those providing intensive care (20+ hours per week) to a parent or parent-in-law, providers of lesser amounts of care, and non-caregivers. Outcomes were measured using the SF-12 indicators of mental and physical health. RESULTS: showed that those with a living parent or parent-in-law had better health than those lacking these relatives. However, among potential caregivers for a parent or parent-in-law, those assuming intensive caregiving had poorer initial health than non-caregivers or those who became providers of less intensive care. Fixed effects analyses of follow-up data showed that the mental health of intensive caregivers deteriorated. However, the physical health of intensive caregivers with low levels of education improved. RESULTS: show the importance of taking account of whether people are at risk of providing parental care and initial health status when assessing impacts of caregiving on health. They also indicate differential effects of caregiving on health depending on socio-demographic characteristics and reaffirm the need for greater supports for those providing substantial amounts of care to older parents.

摘要

评估照顾老年父母对照顾者健康的影响在人口变化和国家提供服务减少的背景下变得越来越重要。这已经得到了广泛的研究,但结果不一致,这可能反映了对健康相关的照顾者角色选择的关注不足。我们使用来自英国全国代表性纵向研究的数据,通过分析基线时是否有资格为父母提供照顾(有健在的父母/公婆)以及是否随后承担照顾者角色,来分析 40-69 岁人群健康状况的差异。我们使用从三个观察者记录的指标以及自我报告的健康状况得出的潜在变量来衡量初始健康状况。我们分析了在七年的随访期间为父母或公婆提供密集护理(每周 20 小时以上)、提供较少护理的提供者和非护理者的身体和心理健康轨迹。使用 SF-12 心理健康和身体两个指标来衡量结果。结果表明,有健在的父母或公婆的人比没有这些亲戚的人健康状况更好。然而,在有父母或公婆潜在照顾者中,那些承担密集照顾者的初始健康状况比非照顾者或那些成为较少密集照顾提供者的人差。对随访数据的固定效应分析表明,密集照顾者的心理健康恶化了。然而,教育程度低的密集照顾者的身体健康状况有所改善。结果表明,在评估照顾对健康的影响时,考虑人们是否有提供父母照顾的风险和初始健康状况非常重要。它们还表明,照顾对健康的影响取决于社会人口特征,并且需要为那些为年长父母提供大量照顾的人提供更多支持。

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