Institute for Diabetes, Obesity and Metabolism, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Clin Nurs Res. 2024 Jun;33(5):334-343. doi: 10.1177/10547738231223790. Epub 2024 Jan 30.
We explored the influence of social determinants of health (SDH) risk on stress and coping style in heart failure (HF) caregivers. In this cross-sectional study, data from 250 caregivers were analyzed. Multivariable linear regression analyses were performed to determine the extent to which SDH risk (measured using a modified PRAPARE tool (National Association of Community Health Centers), range 0-22) predicted stress (Perceived Stress Scale, 0-56) and coping style (active (0-45), avoidance (0-30), and minimization (0-30)) while accounting for caregiver burden (HF Caregiver Questionnaire (HF-CQ) 0-100). Multivariable regression analysis with backwards elimination variable selection approach was used to identify which SDH risk factors best predicted coping styles. SDH risk was significantly associated with avoidance and minimization coping styles. Each unit increase in SDH risk was associated with an increase of 0.6 ± 0.2 units ( = .0008) in avoidance and 0.7 ± 0.2 units ( < .0001) in minimization coping style. Race and "supporting others" significantly predicted avoidance coping style; scores were 3.3 ± 0.8 units greater for caregivers who were not White ( < .0001) and 1.4 ± 0.5 units greater ( < .01) for each additional person whom they supported. Race significantly predicted minimization coping style; scores were 4.4 ± 0.7 units greater for caregivers who were not White ( < .0001). Caregivers with higher SDH risk may avoid and minimize to cope with caregiving challenges.
我们探讨了社会决定因素(SDH)风险对心力衰竭(HF)照顾者压力和应对方式的影响。在这项横断面研究中,分析了 250 名照顾者的数据。进行多变量线性回归分析,以确定 SDH 风险(使用改良的 PRAPARE 工具(国家社区卫生中心协会)测量,范围 0-22)在多大程度上预测压力(感知压力量表,0-56)和应对方式(积极(0-45)、回避(0-30)和最小化(0-30)),同时考虑照顾者负担(HF 照顾者问卷(HF-CQ)0-100)。采用向后消除变量选择方法的多变量回归分析用于确定哪些 SDH 风险因素最能预测应对方式。SDH 风险与回避和最小化应对方式显著相关。SDH 风险每增加一个单位,回避应对方式增加 0.6±0.2 个单位( = .0008),最小化应对方式增加 0.7±0.2 个单位( < .0001)。种族和“支持他人”显著预测回避应对方式;对于不是白人的照顾者,评分增加 3.3±0.8 个单位( < .0001),每增加一个支持的人,评分增加 1.4±0.5 个单位( < .01)。种族显著预测最小化应对方式;对于不是白人的照顾者,评分增加 4.4±0.7 个单位( < .0001)。SDH 风险较高的照顾者可能会回避和最小化以应对照顾挑战。
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