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中国多代同堂家庭中慢性病老年人及其主要照顾者的家庭复原力和社会支持对生活质量的二元影响:一项横断面研究。

The dyadic effects of family resilience and social support on quality of life among older adults with chronic illness and their primary caregivers in multigenerational families in China: A cross-sectional study.

作者信息

Lin Dan, Liang Dong, Huang Minqing, Xu Xinxin, Bai Yamei, Meng Dijuan

机构信息

Nursing College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu province, 210023, China.

The School of Public Health, Fujian Medical University, Fuzhou, Fujian province, 350122, China.

出版信息

Heliyon. 2024 Feb 29;10(5):e27351. doi: 10.1016/j.heliyon.2024.e27351. eCollection 2024 Mar 15.

Abstract

Older adults with chronic illness, as well as their primary caregivers in multigenerational families, may experience a complex interplay of factors that affect their quality of life (QOL). However, this interplay is not yet well-characterized for Chinese multigenerational families in particular. In this study, we analyzed how family resilience and social support affect the QOL of both older adults and caregivers in multigenerational Chinese families specifically. We enrolled 258 pairs of older adults with chronic illness and their primary caregivers in a multicenter cross-sectional study conducted in southern China in December 2021. Using the Actor-Partner Interdependence Model (APIM), we then examined the correlation between family resilience, social support, and QOL in dyadic analysis and found that QOL, family resilience, and social support for primary caregivers were better than those of older adults with chronic illness ( = 3.66-16.3, <0.01). These factors were found to be positively correlated ( = 0.22-0.60, <0.05), except for the family resilience of primary caregivers and the QOL of older adults with chronic illness ( = -0.14,  = 0.04). Additionally, actor effect results showed that when a dyadic member has high family resilience and objective social support, they tend to have a better QOL ( = 0.5-1.48 < 0.01). However, partner effect results showed that when the primary caregiver has high family resilience, this is associated with a worse QOL for the older adult ( = -1.06,  < 0.01). Furthermore, we found that objective social support of dyads does not significantly influence their partner's QOL ( = 0.88/0.31, >0.05) for any pair. This suggests that medical staff should pay attention to the impact of family resilience on the QOL of older adult and caregiver dyads and explore health management plans that focus on binary coping in multigenerational families.

摘要

患有慢性疾病的老年人以及多代同堂家庭中的主要照料者,可能会经历影响其生活质量(QOL)的多种因素的复杂相互作用。然而,这种相互作用在中国多代同堂家庭中,尤其是尚未得到充分的描述。在本研究中,我们专门分析了家庭复原力和社会支持如何影响中国多代同堂家庭中老年人和照料者的生活质量。我们在2021年12月于中国南方进行的一项多中心横断面研究中,招募了258对患有慢性疾病的老年人及其主要照料者。然后,我们使用行为者-伴侣相互依赖模型(APIM),在二元分析中研究了家庭复原力、社会支持和生活质量之间的相关性,发现主要照料者的生活质量、家庭复原力和社会支持优于患有慢性疾病的老年人(F = 3.66 - 16.3,P < 0.01)。除了主要照料者的家庭复原力与患有慢性疾病的老年人的生活质量之间的相关性(r = -0.14,P = 0.04)外,这些因素被发现呈正相关(r = 0.22 - 0.60,P < 0.05)。此外,行为者效应结果表明,当二元成员具有较高的家庭复原力和客观社会支持时,他们往往具有更好的生活质量(β = 0.5 - 1.48,P < 0.01)。然而,伴侣效应结果表明,当主要照料者具有较高的家庭复原力时,这与老年人较差的生活质量相关(β = -1.06,P < 0.01)。此外,我们发现二元组的客观社会支持对其伴侣的生活质量没有显著影响(β = 0.88/0.31,P > 0.05)。这表明医务人员应关注家庭复原力对老年-照料者二元组生活质量的影响,并探索侧重于多代同堂家庭二元应对的健康管理计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d95d/10923707/d17738998163/gr1.jpg

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