Di Gessa Giorgio, Deindl Christian
Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
Department of Social Sciences, TU Dortmund University, Dortmund, Germany.
Eur J Ageing. 2024 Aug 31;21(1):24. doi: 10.1007/s10433-024-00818-w.
Although the long-term consequences of informal care provision have been well investigated, few studies have examined the trajectories of informal care provision among older people and the socioeconomic, demographic, health, and family characteristics associated with them. We use data from four waves of the English Longitudinal Study of Ageing, with 6561 respondents followed for 6 years (2012/3-2018/9). We used group-based trajectory modelling to group people's provision of care over time into a finite number of distinct trajectories of caregiving. Using multinomial logistic regressions, we then investigated the characteristics associated with these trajectories. Four distinct trajectories of caregiving were identified: "stable intensive", "increasing intensive", "decreasing", and "stable no care". Results suggest that although there are socioeconomic, demographic, and health differences across the trajectories of caregiving (with younger women in good health and poorer socioeconomic status more likely to care intensively throughout), family characteristics are their main drivers. Respondents who live alone, with no children, and no parents alive are more likely to never provide care, whereas those with older parents and who live with adults in poor health are more likely to provide stable intensive care. Also, changes in family characteristics (e.g. death of parents, widowhood, or deterioration of the partner's health) are associated with trajectories representing increases or decreases in caregiving over time. Overall, trajectories of informal caregiving undertaken by older people are varied and these patterns are mostly associated with both the availability and health of family members, suggesting that need factors represent the most immediate reason for caregiving commitments.
尽管对非正式护理提供的长期后果已进行了充分研究,但很少有研究考察老年人非正式护理提供的轨迹以及与之相关的社会经济、人口、健康和家庭特征。我们使用了来自英国老龄化纵向研究四轮的数据,对6561名受访者进行了6年(2012/3 - 2018/9)的跟踪调查。我们使用基于群体的轨迹模型将人们随时间的护理提供情况分组为有限数量的不同护理轨迹。然后,我们使用多项逻辑回归来研究与这些轨迹相关的特征。确定了四种不同的护理轨迹:“稳定高强度”、“强度增加”、“减少”和“稳定无护理”。结果表明,尽管在护理轨迹方面存在社会经济、人口和健康差异(健康状况良好且社会经济地位较低的年轻女性更有可能始终提供高强度护理),但家庭特征是主要驱动因素。独居、没有子女且没有在世父母的受访者更有可能从不提供护理,而有年迈父母且与健康状况不佳的成年人同住的受访者更有可能提供稳定的高强度护理。此外,家庭特征的变化(例如父母去世、丧偶或伴侣健康状况恶化)与随着时间推移护理增加或减少的轨迹相关。总体而言,老年人进行的非正式护理轨迹各不相同,这些模式大多与家庭成员的可获得性和健康状况有关,这表明需求因素是护理承诺的最直接原因。